Ramon decided to stop taking methadone during the COVID-19 pandemic. Was it essential or was it elective? Perhaps in Ramon’s case, it was a bit of both.

Going to a methadone clinic was never what he pictured for himself. Ramon’s story includes neck and back surgery, several years of pain medication, a move to a rural community where the nearest pain management doctor was over an hour’s drive, and finally — resignedly — driving 45 minutes a day to the methadone clinic.


A Difficult Medication Regimen

While Ramon, age 56, happily married and a grandfather of 3, got along well with the staff at the clinic, it was difficult for them to personalize his medication regimen. He had a very active job that involved a lot of traveling. This often meant he would leave his home by 4:00 am to be first at the clinic so he could then travel to his working destination. He didn’t want to be in pain or in withdrawal, but he had to be alert enough to drive and function well.


Experimenting with the “just right dose” was challenging. For most of his time at the methadone clinic, Ramon was on 80 mg a day. But at one point, frustrated with being locked into this lifestyle, had weaned himself down as low as 20 mg daily.


A dose that low was not sustainable. He was in a perpetual state of chills, diarrhea, and muscle cramping.


Many of these symptoms are notably due to Post-Acute-Withdrawal Syndrome (PAWS) PAWS as it is referred to, which is the result of a drug withdrawal having a toxic effect on the chemicals in the brain. Those who are in an intoxicated state or in substance withdrawal can experience many adverse effects during this time. These effects can further increase anxiety, psychosis, and depression levels.


It is important for those dealing with PAWS, to have the aid of a medical professional that can oversee the detox process and can help to manage such symptoms. At The Coleman Institute, we recognize that these symptoms can be difficult, uncomfortable, and life-threatening. This is why our team of medical professionals are trained and available 24/7 to support patients, provide treatment plans, and offer guidance even through the most troublesome of times.


Detoxing During Coronavirus


National epidemiological data has shown a direct acceleration during COVID-19 of the number of overdose-related deaths from May 2019 to May 2020. At the very peak of the pandemic, more than 81,000 fatalities occurred from drug overdose-related scenarios. This also being the highest number of fatalities ever recorded in a 12-month period.


Due to the Coronavirus, those who have had substance use disorder have been hit particularly hard. For instance many individuals, lost the feeling of having supportive communities during this time due to feeling of "isolation" and "non interaction". Opioids also spread to be the main substance that drove an increase in overdose fatality, increasing 38.4% from the 12-month period.


For many, the choice of a rapid detox cleanse may seem nonexistent during "non-normal" times but it is even more important to protect your health and well-being during such an outbreak. Detox is essential to many individuals' road to recovery and those suffering from a substance use disorder during the pandemic could see even more adverse effects on health during this time.


When the COVID-19 virus began sweeping across the country, all the clients at the clinic were given take-home doses amounting to a week or several week’s worth. The staff checked in with them regularly by phone and all clients were instructed to be readily available for these calls. Ramon’s frustration peaked when he was expected to come to the clinic for random urine screening.


“I don’t have the kind of life that I can stop everything at any time and drive 45 minutes away at the drop of a hat…and I was terrified to go near that clinic with the hundreds of patients they serve.” Not every client at the methadone clinic was as mindful of social distancing and hygiene as Ramon was.


Having tried to stop methadone himself in the past, Ramon knew he couldn’t do it on his own. His wife searched “Rapid Methadone Detox” online and found the Coleman Institute for Addiction Medicine. Ramon gave us a call.


UNDERSTANDING ACCELERATED OPIOID DETOX


A Personalized Detox Experience . . . Even During COVID-19


While most other detox programs typically offer treatment for patients currently on 30 mg of methadone or less, our outpatient program at the Coleman Institute can detox patients from methadone doses up to 300 mg.

Besides methadone and buprenorphine products, the Coleman Institute specializes — and has for over 25 years — in helping people off the whole spectrum of opioid medications including:


  • Oxycodone and hydrocodone products
  • Hydromorphone and oxymorphone
  • Fentanyl
  • Heroin
  • Kratom

We have even helped detox off poppy seed tea. Detoxes are completed with the use of long-acting Naltrexone, which is a non-addictive opioid blocker that reduces cravings and helps to reduce the risk of relapse.


Ramon had a good detox experience. We kept him comfortable with multiple medications, and by day 8, he was free from methadone. He felt like a man who was released from prison. . . until a few days later when he called the office and told me he had zero energy and he couldn’t sleep.


Both of these conditions, the lack of energy after an opioid detox and insomnia, are extremely common. What makes it more difficult in Ramon’s case include his age, the length of time he had been on opioids (a few years of short acting opioid pain medications before he even started the methadone), and methadone itself, which is more difficult to stop.


Real Tips to Replenish Energy After Detox

While there is no magic pill available to restore energy after an opioid detox, there are several strategies that will help a person through it:


  • Sleep as well as you can. Avoid caffeinated products. Get rid of anything in your bedroom that lights up — even your little green charging light can make the brain think it’s time to wake up. In Ramon’s case, I prescribed some strong (non-addictive) sleeping medication.

  • Indulge in self care. Drink lots of water. Eat well. Get outside and walk — slowly and mindfully — letting yourself be captivated by nature. (I detest sounding like Pollyanna, but being in nature is scientifically proven to make you healthier and happier.)

  • Please journal. Keeping a diary of your daily thoughts, feelings, physical sensations, aspirations, bits of learned wisdom is not only helpful while you are doing it, but will be so powerful to look back on in a few months when you are really back to normal.

  • Consider being part of an on-line recovery community. I am so impressed by the realm of available meetings offered around the world at all times of day or night. AA, NA, SMART Recovery, Refuge Recovery…just to name a few. Even if you aren’t a ‘meeting kind of person’, hearing how others are reaching out for help or to share solutions, can cultivate a mindset of gratitude and hope.

    Is an opioid detox essential or elective? If you’d like to discuss your situation further, please give us a call at: 877-773-3869.


    Joan R. Shepherd, FNP

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