In part 2 of Dr. Peter Coleman's and Dr. Banimahd's interview, they discuss how you can detox off opioids with naltrexone as medication-assisted treatment (MAT) versus using Suboxone.

Have you missed part 1? You can catch up on a brief history of Dr. Coleman here.

Explore the recap of Dr. Peter Coleman’s YouTube video, “Dr. B interviews Dr. Coleman about the Coleman Method for Opioid Detox and Naltrexone MAThere.

Opioid Crisis

Dr. Peter Coleman

Then came the opioid crisis back in the late '90s. We started seeing many people starting to use heroin coming in from Columbia, which was very potent, and many people died. And when you look at success rates with heroin and other opiates, it's horrible.

Almost everybody relapses unless they use some form of medication-assisted treatment (MAT). Then, you see people go to jail for three months or six months, or six years.

And if they don't get treatment, they're back using again as soon as they get out.

It makes no sense.

And there were a lot of overdoses and death, so it was a significant need. So I thought, "well, what can you do?"

More like this: Medication-Assisted Treatment (MAT): Higher Success for Recovery

Long-Acting Naltrexone

Dr. Peter Coleman

I realized that naltrexone is a drug that's been out since about 1982 as a tablet. But it doesn't work well as a tablet because people take it for one day and get high the next day. So then I heard about this implant. So you could put this naltrexone implant and insert it into the person's subcutaneous (fat tissue).

Dr. Banimahd

This is the early 90s, correct?

Dr. Peter Coleman

98.

Dr. Banimahd

98.

Dr. Peter Coleman

Yeah.

The naltrexone implant would last six to eight weeks.

So as soon as you put it in, people are like, "Wow, my cravings have gone." Because their opiate receptors are blocked by naltrexone, they can't get high even if they try; a lot of them try but can't get high, and they love it because their cravings are gone. They're like, "I got my life back. This is amazing."

More like this: How Long Does Naltrexone Last & How Can It Aid in My Recovery?

Dr. Peter Coleman

So that's what we started doing. So the Coleman Institute has been doing this for 21 years now.

The big challenge is how we get them detoxed. You've got to get people entirely off drugs to detox before you can put them on naltrexone. So, we've developed the Accelerated Opioid Detox that is now being offered in Orange County.

Needing to Find Another Doctor

Dr. Peter Coleman

So we needed to find another doctor, and that's when we came across you.

We interviewed about seven or ten doctors, and you rose to the top as the guy we wanted to work with. And it's been a great relationship ever since, providing the treatment that we've developed out here. So that's kind of what we do.

Using Naltrexone in the 90s

Dr. Banimahd

I feel the same way about you guys. I want to go back to when you first started doing this. So in the late '90s, you're like, "You know what? I can use naltrexone."

Dr. Peter Coleman

Yeah.

Dr. Banimahd

Then you started considering the issue of, "Well, how do I get them to the place where I put this naltrexone implant in?"

Dr. Peter Coleman

Yes.

Dr. Banimahd

And you weren't happy with the fact that they can take the 50-milligram pill every day; I think it's 50 mils, it is 50 milligrams?

Dr. Peter Coleman

Yeah, yeah.

Dr. Banimahd

So you wanted something a little more stable and held them kind of accountable to their choices, at least in the early stages.

What were you doing in the beginning? Were you telling them to, "Hey, stay clean for a few days and come and we'll do an implant?" And did that develop?

Dr. Peter Coleman

Yeah.


UNDERSTANDING ACCELERATED OPIOID DETOX


The Coleman Method

Dr. Banimahd

I'm familiar with your method and know proprietary issues. But, I love it for the right patients that we choose.

I want to think it's me, but I've gotten so good at it. I've had a few methadone guys that they're like, "This, was it? This is a joke." And I'm like, "Well, I'm good at it." And I'm just joking. I'm like, "I might be better at it than everybody out there except Dr. Coleman."

But it's a beautiful way you approach it. But in the beginning, what were you doing? Were you telling people, "Hey, stay clean for a few days and then come back?"

More like this: How Do I Get Off Methadone?

Dr. Peter Coleman

We tried that, and no one could do it. And so, we had to develop a way of getting people off all the opioids. And so the way I look at it is people come in, they've got the drug sitting on their receptor. When they come in to see us, they've reached a pretty high level and got a get to zero before you can put them on naltrexone because, as soon as you put them on naltrexone, they're going to go straight to zero in five minutes. And so, instead of a ten-day withdrawal period, they're going to zero in five minutes. It's traumatic for the body.

The Truth About Anesthesia Detox

Dr. Peter Coleman

So for the first three years, I did the anesthesia detox to hire an anesthesiologist. We'd put them to sleep for four hours.

Dr. Banimahd

Wow.

Dr. Peter Coleman

Yeah. Put a tube down into their stomach, crush up naltrexone, give it to them, and you'd watch their body go through this horrible withdrawal, but they were asleep. So they didn't care. The problem is they woke up, and they still felt terrible. They hadn't recovered. All the drugs were gone off their receptors, they were clean, but their body and brain hadn't healed yet. So it was a horrible next few days where they would be confused and delirious and out of touch with reality and agitated and dangerous, frankly.

More like this: Why We No Longer Perform Anesthesia Detox

Dr. Banimahd

And there are all the dangers associated with going through the anesthesia procedure, whether side effects.

Accelerated Opioid Detox

Dr. Peter Coleman

That's right.

So in 2002, I learned some techniques of how Australian doctors do it. And I combined some things I'd been doing, and we came up with this outpatient procedure, no anesthesia, spread it out over three or four days, but still get almost a 100%.

We still get a 97% success rate.

And like you said, we talked to some insurance executives in Boston last week, and they're going to start covering our program. And I was like, "We've gotten good at it."

So we know exactly how much medicine to give of this kind and this kind to get them to zero. And the patients are usually, like you said, "That's it? I'm done?"

More like this: Accelerated Opioid Detox: Explained Using the Coleman Method

Dr. Banimahd

Yeah.

Dr. Peter Coleman

Yeah. Not for everybody. It's tough for some people. Some people genetically seem to be more set up to have a stricter withdrawal than others.

More like this: 5 Things You Must Know Before Starting Naltrexone Therapy

Dr. Banimahd

Yeah. And we'll get a little more into that in the following article.

Conclusion

Stay tuned for Part 3 of Dr. Banimahd and Dr. Peter Coleman’s interview on the Coleman Institute’s Facebook and Twitter.



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