In part 4 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 3? You can catch up on patient selection for The Coleman Method 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.
Essential Differences Between Suboxone and Naltrexone Therapy for People Addicted to Opioids
Dr. Peter Coleman
So people have to know that. So we are recommending everybody stay on naltrexone MAT for at least a year. Some people aren't ready for that level of commitment to their recovery. They don't want to stop that much. They just don't want the craziness of the heroin.
They're better off, but they don't want to stop completely. They want to keep the options open to still do a little cocaine on the weekends or do some ecstasy here and there or still smoke pot or still drink on the weekends and stuff.
Those aren't excellent candidates for naltrexone MAT.
They're better for Suboxone because if they mess up, or when they mess up, and a lot of people even plan it, they're not going to die of an overdose. They're going to be able to get back on the Suboxone.
You see patients that I'm treating with Suboxone. They'll take the Suboxone, and then they'll use heroin on the weekends. Then, they'll stop for a day or two, so they can still get high again.
More like this: Important Differences Between Suboxone and Naltrexone Therapy for People Addicted to Opioids
Dr. Banimahd
Sure.
Dr. Peter Coleman
Those aren't good candidates for naltrexone. So, they're better off staying on this Suboxone until they grow up a little bit and realize what they want out of life. They want to be happy. They want to be stable. They want to have people who love them, and they want to feel good about themselves. Suboxone can help people grow like that if they stay with it. And then they're good candidates to switch to naltrexone.
So that's a big part of our business now is getting people along their recovery journey; they've maybe used methadone for a few years or Suboxone for a while, and now they're ready to give it all up and just be on naltrexone. So that's kind of where I see it.
More like this: Switching from Suboxone® to Naltrexone
Patient Success Story - Getting off Methadone
Dr. Banimahd
I try to follow your patients, the ones that I did a procedure on, as much as I can. And some of the most beautiful success stories I've had is guys being on years of methadone, and you should see the text I get that one of them, his father had me call in and leave a message on his birthday.
More like this: Overcoming the Fear of Stopping Methadone
Dr. Peter Coleman
Right. Right.
Dr. Banimahd
And the surprise was calling him in, but I've had three of your clients that have been long-term methadone users.
Dr. Peter Coleman
Has now switched to naltrexone.
Dr. Banimahd
And one of them we're going on over a year. Another one we're on four to five months. Another one we're in seven, eight months. They're doing wonderfully.
Dr. Peter Coleman
Yeah. It's very gratifying. Those are good candidates. They have stability on methadone, and now they don't need it. What we do with our accelerated detoxes, we can get the methadone out in eight days instead of having to wean down over 18 months, which is what usually happens. And frankly, most people fail. They try weaning down, and then it's just too painful. So they go back up, and yeah.Using Suboxone
Dr. Banimahd
Because it's such a topic of controversy in North America, at least you are not against Suboxone or that kind of medication?
More like this: A Monthly Suboxone Injection?
Dr. Peter Coleman
Not at all. No, I think it's all about patient selection.
Dr. Banimahd
Exactly.
UNDERSTANDING ACCELERATED OPIOID DETOX
Meeting Patients Where They Are At
Dr. Peter Coleman
You need to meet the patient where they're at. No different than any other medical disease we treat. If you've got a person with diabetes, you've got to figure this a person who's good for insulin. Some people only need diet and exercise, and that's all they need. So you've got to tailor. Same with cancer treatment. Or any treatment.
More like this: Restoring Hope: The Gift of Detox
Dr. Banimahd
Good.
Dr. Peter Coleman
Yeah.
Dr. Banimahd
I agree 100%, and you mentioned something I often say, "meet the patient where they're at."
And for me, that's an expression of harm reduction. As you said, you meet them where they're at, the guy that's using.
I, myself, don't turn, and a lot of practices in town, if you test, I don't use the word dirty, I use positive for urine, if you test positive for urine, you're fired from the practice.
Dr. Peter Coleman
Right.
Dr. Banimahd
I do not do that.
Dr. Peter Coleman
Sure.
Dr. Banimahd
It's just now you have to see me every week. And I like that. I noticed you said, “meet the patient where they're at."
Dr. Peter Coleman
Yeah.
Conclusion
Stay tuned for Part 5 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 1-3 and 5-6 below:
