In part 3 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 2? You can catch up on the opioid crisis in the 90s and how Dr. Peter Coleman created the Coleman Method to combat it 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 MAT” here.
Dr. Banimahd and the Coleman Institute
Dr. Banimahd
I want to note how I came into contact with Dr. Coleman.
Many of you know I operate in Orange County, and I think the treatment industry here could be better. So let's leave it at that. So I have continuously used in my tiny bubble and space, and I don't work with anybody else, whether physicians, treatment facilities, detox programs, etc.
Dr. Coleman didn't reach out to me at first. It was through a business contact or associate. They were reaching out to me, and they're like, "Hey, the Coleman Institute's reaching out to you." And they send me a couple of emails and a letter. And I just kind of threw it away, right?
Dr. Peter Coleman
That was us.
Dr. Banimahd
I was very turned off because I had just left the university, and I was very turned off by what I saw down here.
Then you called, and I was like, "Wow, that's kind of interesting." And you're like, "We're coming out there." So I'm like, "Sure. We can meet."
I was so impressed with your professionalism, knowledge base, and integrity with you. You came out with Gene and Andrew. I was so impressed because I kind of have blinders on to a certain extent for the most part. And we'll get into this with maintenance treatment, being Suboxone, and so forth.
But I was so impressed with you guys, and I'm happy we went forward with this. So that's how our relationship originally began.
Patient Selection for the Coleman Method
Dr. Banimahd
Let's talk about patient selection if we can.
Dr. Peter Coleman
Sure.
Dr. Banimahd
I have my own experience with it. So I have some thoughts on it.
And I've noted that you guys sort of push this as medication-assisted treatment (MAT). I know SAMSHA, the kind of ruling body that is the head honcho on all of these issues, the professional body medication-assisted treatment; they also call naltrexone medication-assisted treatment (MAT).
Tell me your thoughts on that, and can you expand on that for me a little bit?
More like this: Naltrexone: Medication-Assisted Treatment For Opioid Use Disorder
UNDERSTANDING ACCELERATED OPIOID DETOX
Medication-Assisted Treatment (MAT)
Dr. Peter Coleman
Sure. Like I said earlier, almost nobody stays clean and sober. There have been studies going back 40, 50 years, even where you put people on a farm in Tennessee or something.
And soon as they got out, they were back using. You put them in jail for six years, and they're back using as soon as they get out. The addiction is so strong. There was a program that I was working on within the early 90s. And we looked at our alcohol patients, and they had about a 70% success rate doing an IOP, Intensive Outpatient Program.
When we looked at our opioid patients zero, not one person even completed the program, let alone stayed sober. So, that's what you're up against with opioids. There's something about the way they work in the brain, the strength of how good they feel, how long the memories and the cravings and the desire to use just a little bit stays that it's almost impossible for people to resist it without some form of medication-assisted treatment.
Methadone to Treat Opioid Addiction
Dr. Peter Coleman
So that's why methadone came out in the 70s, but people don't really like being on methadone. They prefer not to be. And so, Suboxone wasn't available when I started. So it was methadone or nothing, which didn't work.
So when I heard about these naltrexone implants, medication-assisted treatment, it was like, "That's perfect." It's nonaddictive. There's no withdrawal. You don't have to get off of it. You don't have to go through any withdrawal when you're finished. It completely blocks the cravings.
The only question is how can you give it to somebody, so it lasts long enough that it will do some good? Because we knew that once a day, tablets just didn't work. People didn't take them.
How Does Vivitrol Work?
Dr. Peter Coleman
And I've got some ideas about why that works. It turns out cravings for a drug have a lot to do with its access. So when you put an implant or Vivitrol, which is the other form of naltrexone, long-acting.
Dr. Banimahd
It blocks access.
Dr. Peter Coleman
There's no access to heroin anymore because you can't get high even if you use two or three grams of heroin. And so people know that, and they stop thinking about it. It's like if you're trying to quit smoking and you're on a retreat, and there are no cigarettes anywhere around for a whole week, you stop thinking about cigarettes. As soon as you come back to town, you start thinking, "Should I have one?" Because there's access to it.
When people take the oral tablet, it's just one day, and they know it. And so their brain is already thinking, "I could get high tomorrow. I'm not going to, but I could." And so I've had patients say when they unscrew the cap, it's reminding them that they could get high. That's completely different from a Vivitrol shot where you're done for a month. With an implant for two months, you're done.
They love it. Patients just have no cravings.
The key then is keeping them on it long enough for their brain to go back to normal and for their behaviors to change to learn what real recovery's really about. Because I hate to say, most people want a shortcut. Most people just want the problem to be gone and done with, and it's naive. It's immature and doesn't work that way.
Addiction is a Disease
People have habits. Most people we think have an addiction because of a genetic vulnerability in the brain. And then once they use drugs of some kind or another, it kicks off that disease, and that disease remembers, and it stays there for the rest of your life. So you've got to work at your recovery for the rest of your life. You've got to stay away from vulnerable situations. You've got To not put poisons in your brain that might kick the addiction back in. And people need to learn that that doesn't happen overnight.
You can't remember any new skills. How long did you go to med school? You don't get to be a doctor by just saying, "I want to be a doctor." You have to go to med school and study and learn and change.
Dr. Banimahd
Sure.
Conclusion
Stay tuned for Part 4 of Dr. Banimahd and Dr. Peter Coleman’s interview on the Coleman Institute’s Facebook and Twitter.
Looking for the rest of the webinar series? Check out parts 1-2 and 4-6 below:
