If you are considering changing your relationship with opioids, explore 5 things that may stop you from detoxing off opioids and what you could do about it to get your life back.
Accelerated Opiate Detox
We help people with Substance Use Disorder (SUD) get off opioids using an Accelerated Opioid Detox process. Dr. Coleman created this process more than 25 years ago, and it continues to evolve. As a proven outpatient procedure with a 98% completion rate, patients living near one of our offices can spend most of their detox in their own homes.
I still don’t know of any program that uses micro-doses of naltrexone over several days to successfully allow people to transition to a long-acting form of naltrexone. Some people consider this technique a form of “rapid detox,” but—significantly—we do this without anesthesia.
More like this: How Long Does Naltrexone Last & How Can It Aid in My Recovery?
Medication-Assisted Treatments (MATs)
The Medication-Assisted Treatments (MATs) for SUD include buprenorphine, methadone, and naltrexone.
The first 2 medications are long-acting opioids which:
- Occupy the opioid receptor
- Keep a person from experiencing withdrawal from whatever short-acting opioid a physical dependence has developed.
If a person stops these medications abruptly, the patient will experience similar withdrawal to stopping their pain medication or another opioid. For example, if the drug is lost, stolen, or otherwise unavailable.
More like this: Medication-Assisted Treatment (MAT): Higher Success for Recovery
Naltrexone and MAT
Naltrexone, the third evidence-based form of MAT, acts as a ‘blocker,’ occupying space on the opioid receptor without causing physical dependence. It eliminates physical cravings, but there is no withdrawal when naltrexone is stopped.
More like this: Naltrexone: Medication-Assisted Treatment For Opioid Use Disorder
The Coleman Method
The Coleman Method for outpatient withdrawal management slowly ‘bumps’ the existing opioids off the receptors, replacing them with naltrexone, and accompanying this process with a time-tested combination of comfort medications.
Most patients come to the Coleman Institute for help getting off pain medications such as oxycodone, hydrocodone, tramadol, morphine, methadone, buprenorphine, etc. Other patients use street opioids such as heroin and fentanyl or over-the-counter substances like poppy-seed tea or kratom.
Fentanyl Laced Pills
A vast majority of patients who have been purchasing pills, rather than getting prescriptions from their medical providers, believe them to contain oxycodone or hydrocodone. Still, almost invariably, these are pressed pills and include large amounts, if not all, fentanyl.
Recently, a patient swore he purchased his pills from someone who got prescribed pain medication from their doctor. He was astonished to learn there was no trace of oxycodone at all in the pills.
This prompted me to call a toxicologist at a urine drug testing lab to see how accurate these tests were. The toxicologist told me that the expertise of the drug dealers making and selling pressed pills on the streets is now too good. That often, pharmacists cannot tell the difference simply by studying the medication visually.
Similarly, many patients purchasing anxiety medication on the street rather than having it prescribed by their medical providers are shocked to learn that opioid compounds were found in their urine drug screens (UDS). These medications include alprazolam (Xanax®), diazepam (Valium®), or lorazepam (Ativan®).
I have even heard people taking what they believed to be an innocent “headache tablet” discover that it was tainted with fentanyl. And fentanyl is often in cocaine, too.
This is such an unbelievably dangerous situation!
More like this: That Street Pill Might Be Fentanyl and One Pill Can Kill
Detoxing off Opioids: 5 Things That Could Stop You
What prevents someone from seeking help to stop using opioids? These are the five main reasons I have seen working for many years as a medical professional at the Coleman Institute.
1. Price of an Opioid Detox Cost vs. Using Opioids
Detox can be expensive, especially if a person has no insurance. However, some insurers, including Blue Cross Blue Shield, provide in-network coverage for our outpatient detoxes using The Coleman Method.
Our prices depend on the substance someone is using and the duration of the detox. These detoxes can be between 3 to 10 days. However, if cost is a top consideration, it may be helpful to look at the long-term cost of staying on opioids.
According to information from StreetRx, these are the prices people are currently paying for opioids bought off the street:
- The street price of fentanyl tablets is approximately $1.95 per milligram.
- The average street price of methadone is roughly $1.00 per milligram.
- The average street price of oxycodone is approximately $1.40 per milligram.
- The average street price of Percocet® is roughly $1.75 per milligram.
- The average street price of Vicodin is approximately $1.45 per milligram.
- If you have prescription benefits, this is less important.
However, you don’t have to be a math whiz. For example, if someone is buying 100 mg of Percocet® every day, a relatively small dose in the spectrum of what we treat, they are spending about $5,000 a month on their habit.
Included in the price of an Accelerated Opioid Detox offered at the Coleman Institute is 6 months of long-acting naltrexone and case management.
Further, the cost of an outpatient detox program is far less than that of an in-patient program.
More like this: Accelerated Opioid Detox: Explained Using The Coleman Method
2. Opioid Withdrawal Pain
People who have experienced not being able to get their opioids or pain medication and know what withdrawal entails are legitimately terrified to suffer this again. The Coleman Method uses a minimum of 5 comfort medicines to help treat the symptoms of opioid withdrawal.
We would rather ‘over-deliver’ than ‘over-promise.’ I let my patients know that they will experience about 20-22 hours of relative comfort and 2-3 hours of relative discomfort during a typical detox.
Patients invariably tell us this is the ‘easiest detox’ they have ever had. When you call to discuss your particular situation with one of our providers, we are happy to answer any questions about the comfort meds for you.
More like this: How Can I Get Off These Bloody Pain Medications?
UNDERSTANDING ACCELERATED OPIOID DETOX
3. How Long Does It Take To Detox From Opioids?
The usual time frame for an Accelerated Opioid Detox (AOD) is between 3 to 10 days. However, your health history, the substance used, and other medical factors play a role in determining the exact number of days needed for your opioid detox.
How Long Does It Take To Detox From Pain Medication?
Typically, a person who is prescribed and taking 150mg or less of pharmaceutical-grade medications such as Roxicet® or hydrocodone may be able to do a 3-day detox.
More like this: How Can I Get Off These Bloody Pain Medications?
How Long Does It Take To Detox From Fentanyl or Methadone?
A detox that involves fentanyl, or the chance that fentanyl may be present, but you’re not sure, will typically require a minimum of 5 days. A detox off methadone or buprenorphine products is generally scheduled for 8 days.
In most cases, we can help patients get off even very high doses of methadone (200mg+ daily). Unless a person is on an extremely high amount or has other coexisting medical concerns. In that case, we may extend the detox to 10 days.
More like this: Detox With Compassion and Competence: Fentanyl, Heroin, and Methadone
Outpatient Detox Program
Our patients appreciate the format of an outpatient detox program. Rather than being stuck in an impersonal hospital with the possibility of limited access to loved ones, our model allows the patient and their support person to have a relatively brief daily visit to the clinic. After, they can enjoy the comfort of staying home, being in a hotel, or nearby Airbnb for the detox duration.
It is as close as you can get to an “at-home detox” while benefiting from access to the amenities and equipment of a physician’s office during daily outpatient visits.
Although we do not complete detoxes or insert naltrexone implants on the weekends, we see patients 365 days a year, minimizing the time people need to take off from work. In addition, we do our best to schedule patients at their earliest convenience.
More like this: Coleman Method for Outpatient Detox off Opioids and Alcohol
4. Is an Opioid Detox Safe?
Our staff is dedicated to making this experience comfortable for our patients and safe. This is why we insist that a reliable support person accompanies each patient we treat. The comfort medications we use generally cause some sedation, so the support person is responsible for transporting the patient and giving medicines as instructed.
Our outpatient approach eliminates the additional risk of complications from such procedures rather than using general anesthesia as an ultra-rapid detox in a hospital setting.
Additionally, a provider is on-call for patient support 24/7.
More like this: Why We No Longer Perform Anesthesia Detox
5. Fear of Stopping
You have probably heard the sentiment, “the best time to plant a tree was 20 years ago. The next best time is now.”
It takes a giant leap of faith to commit to living a life free of opioids. Our medical and case management staff work as a team to provide you with the resources you will need going forward. Some people will benefit from in-patient treatment after completing a detox; others may find that an intensive outpatient program or one-on-one counseling meets their needs. All our patients will have the opportunity to discuss a treatment plan with their case manager.
More like this: the Coleman Institute Resources
Conclusion
There is probably nothing quite as satisfying for our staff as seeing our patients enjoying the fruits of their drug-free life. If you have other concerns besides those I’ve listed here, we are happy to address them to the best of our ability. Please schedule a callback with one of our Care Advocates below by clicking the button below or call 877-773-3869 to speak with us right away.
Joan R. Shepherd, FNP
