It doesn’t happen like this all the time. But it did happen yesterday. Room to room, patient to patient, over and over---I heard one success story after another.

Mack, off fentanyl since mid-April. Sleeping well, doing home renovation projects he’d put off for years. He now has the time, the energy and the money to do so.


Setting Recovery Up for Success

Sid, no alcohol since June when he was capsized by Corona—the virus, not the beer. When he had to work from home with the stress of young children and an anxious spouse, vodka really helped…until it really didn’t. He was at the point where vodka and OJ started around 10:00 a.m.—it settled his mild tremors. This habit was easily justified as he saw meme after meme about how others were using booze to cope with Covid.

Jill, experiencing the pain of her dear, deceased husband’s birthday— sober for the first time on this date in six years. She has been off pills—which she thought were oxycodone--but were actually fentanyl—for eight months. She has a small community of sober people who understand why she took extra mind-numbing medication on this date in previous years.

Bart is five months away from his last drink. He is a quiet introvert and told me yesterday he understands now why his wife couldn’t stay in their marriage. When his mind was controlled by the effects of alcohol, he was always playing the victim role. His job, his wife, his parents were always the reasons for his problems in the past. While he admits to still having cravings for alcohol from time to time, it doesn’t take long to reinforce his new, and growing, belief system that his life is so much better without the booze. He regularly attends the 12 Step We Agnostics meetings via Zoom.

Will these people continue to stay sober? People use substances for so many reasons—to deal with emotional or physical pain and suffering or for some, a habit has turned into a physical dependence. Our brains have powerful memories when it comes to the dopamine released by these addictive substances.


What Perfect Storm is Present When a Person Relapses?

Down the hall in another exam room were Keith and his sister. From southern Maryland, Keith had detoxed at the Coleman Institute several years ago. He stayed off opioids for about five and a half years, enjoying the fruits of this decision, rebuilding a life. But although Covid and politics have saturated recent media platforms, the opioid epidemic rages on. In the last several months, Keith has lost five close people because of their addiction to opioids. The most startling thing about this (to me) is that while two overdosed, three of these five committed suicide. The desperation of being unable to stop, the despair of their life trajectories, the complete loss of hope drove these people to take their lives. And in a weak moment, slayed by the grief of these losses, Keith allowed himself to get sucked back into the maelstrom of his addiction.

The farther away the drug, the better the chances of sobriety, but creating diligent practices to optimize success is of paramount importance. Situations that evoke strong emotion, triggering anxiety, fear, or sadness can catapult a sober person back to ground zero. It is incredibly important to understand the brain’s vulnerability when re-exposed to any dopamine stimulating substance.



UNDERSTANDING ACCELERATED OPIOID DETOX



Medical Detox for Substance Use Disorder and Alcohol Use Disorder

The Coleman Institute for Addiction Medicine’s offices in Richmond, Virginia and near Boston, Massachusetts can help you get started in, or return to--a life of recovery. We specialize in safe and efficient outpatient detoxes off opiates/opioids such as heroin, morphine, fentanyl, hydromorphone, oxymorphone, oxycontin, roxicet, hydrocodone, poppy seed tea, kratom, methadone, and more. We also help people who need a medical detox off alcohol and benzodiazepines.

The hallmark of our treatment for over 20 years is to use long acting naltrexone at the completion of the detox. Naltrexone is a pure opioid blocker, so it simply resides on the opioid receptors, preventing other opioids from taking up residence. One of the main reasons people choose naltrexone over buprenorphine products for Opioid Use Disorder is that it does not create physical dependence. Therefore, when a person is ready to stop taking this particular form of Medication-Assisted Treatment, no withdrawal occurs. With our long-acting naltrexone formulations, patients do not need to return to the clinic for daily, weekly, or biweekly urine screens. And let’s face it, during a pandemic, the fewer trips to a medical facility, the better.

Is naltrexone as effective as buprenorphine? According to the National Institute on Drug Abuse, yes:
“A NIDA study showed that once treatment is initiated, a buprenorphine/naloxone combination and an extended release naltrexone formulation are similarly effective in treating opioid use disorder. Because naltrexone requires full detoxification, initiating treatment among active opioid users was more difficult with this medication. However, once detoxification was complete, the naltrexone formulation had a similar effectiveness as the buprenorphine/naloxone combination.”

Source

Long-Acting Naltrexone for Recovery

Part of the uniqueness of the Coleman Method for detoxing is that we are able to successfully detox the vast majority of our patients and transition them onto long-acting naltrexone.

Our patients seeking treatment for Alcohol Use Disorder benefit from naltrexone as well, but differently. In this case, the naltrexone helps to cut down on the impulse to drink, and the pleasure associated with drinking. Although it won’t make a person ill if they drink alcohol while naltrexone is present in their system, they are simply able to release their attachment to drinking more easily.

With enduring attention to their recovery, I know that all the patients I mentioned earlier can continue lives of sobriety. Perhaps the greatest contribution the Coleman Institute for Addiction Medicine can make in people’s lives through our accelerated detox programs is restoring hope.

If you or your loved one wants to learn more about what we do, give us a call at 877-773-3869. In the meantime, stay safe and take care.

Joan R. Shepherd, FNP

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