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The Coleman Institute has developed an advanced out-patient treatment
protocol detoxifying patients from opiate
dependence. The 3-day Accelerated
Detox Technique is most commonly recommended for Heroin and
prescription narcotic users. The 5-day Medically
Supervised Detox program is available for light Heroin users
(less than $50/day habit) and light Oxycontin users (less than
50 mg/day). The 8-day program is offered for Methadone users as
Methadone is more difficult to detox from. Each detox is completed
without the use of risky anesthesia and in the comfortable setting
of our medical offices. Since 2001, when the current protocol
was developed, we have successfully detoxed 99% of our patients
and put them onto the 6-10 week time release Naltrexone
Implant greatly increasing their opportunity for long-term
abstinence. Our doctors are certified by the American Society
of Addiction Medicine and are committed to helping patients and
their families get their lives back. For more details on each
program, choose a program at the top of the page.
Our Detox Programs are designed to remove all of the opiates
that are attached to the patient’s brain receptors in the
most comfortable, safe and speedy process as is possible. When
people come in to detox, they have a certain amount of opiates
that are attached to the receptors in their brain. Any detox procedure
needs to assist the patient in getting rid of all of those drugs
so that the patient and the patient’s brain are completely
drug-free. At that point the detox process is completed. If patients
detoxify on their own without any assistance, the drugs wash out
of their brain in usually around seven to ten days. Given withdrawal
symptoms, this process is extremely painful and most patients
are unable to tolerate it on their own.
If Naltrexone is given at any time, it pushes all of the opiates
off of the receptors and out of the brain in about twenty to sixty
minutes. This process is extremely uncomfortable, but can be successful.
In the past The Coleman Institute has performed around three hundred
of these procedures, in a process called Ultra Rapid Detoxification
(URD). The patient’s experience was so painful that it was
necessary to put them under general anesthesia and then keep them
in the hospital for another twenty-four to forty-eight hours under
extremely heavy medication. The URD was successful, but we’ve
developed an easier and safer process, the Accelerated
Detox Technique.
In Accelerated Detoxification we meet with the patient for a
preoperative assessment and ask that they be in as much withdrawal
as possible, usually around twelve to twenty-four hours. We provide
pain relief medication during this time to ease any withdrawal symptoms. In this
way, by the time we meet with them they’ve already started
the detoxification and their brain is already preparing for a
full detox both physically and psychologically. We then give them
a combination of several medications that help to push out some of the
remaining opiates out of the brain and off of the receptors, similar
to what Naltrexone does. However, it’s also an opiate antagonist,
which means that it also relieves withdrawal symptoms.
On the final day of the detox the patient fasts and takes a large
dose of oral Valium before arriving in the office. The oral Valium
lasts a long time and provides good sedation throughout the whole
detoxification procedure. We usually insert an IV so we can provide
extra sedation throughout the course of the day. We then start
introducing an opiate antagonist, which starts pushing the patient’s
opiates out of the brain. Unlike an URD where this all happens
at once, we gradually introduce these drugs over a six to eight
hour period, which is much easier for the patient to tolerate.
By the end of the day the patient has received full doses of antagonists
and we can insert the Naltrexone implant, knowing that they are
fully detoxified and will not get any extra withdrawal symptoms
once they leave the office.
Phases of Withdrawal
After working with hundreds of patients, it is clear that there
are three fairly distinct phases of withdrawal:
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Acute Withdrawal –
This is the process most people recognize as withdrawal. It
is the most severe and lasts seven to ten days. It is characterized
by extreme agitation, cold chills, nausea and vomiting, diarrhea,
abdominal and muscle pains. It usually peaks around the fourth
day and then starts resolving. In the Accelerated Detoxification
Technique, the acute phase is essentially completed within
the first twenty-four hours.
-
Sub Acute Withdrawal –
This second stage is a withdrawal period that varies enormously
from patient to patient. It lasts anywhere from one to eight
weeks. It is the process of the brain healing and restoring
its normal endorphins and neurochemicals. It is characterized
essentially by fatigue during the day and insomnia at night.
Initially these symptoms can be quite severe so that patients
may not sleep for the first week or two, but gradually they
resolve completely. Additionally there may be some mild agitation
and anxiety as well as depression, mood swings and increased
aches and pains.
-
Post Acute Withdrawal Syndrome
– This third phase of withdrawal can last up
to one or two years. This sounds formidable, but in reality
the symptoms are so mild that they’re extremely tolerable
and during this phase patients feel better than they have
for years so it’s really not a major problem. It is
more of a situation that as patients look back they realize
that by the third month they are a lot calmer, more relaxed,
happier and self assured than they were one month earlier.
At a year they have improved even more. Patients are more
calm and relaxed as things continue to get better and better,
provided they work their program.
Although our Detox Programs help patients through the most difficult
Acute phase of withdrawal, it is essential that patients work
an Aftercare program to remain opiate free. Our counselors are
happy to assist in evaluating and recommending such programs,
please see our Aftercare Program
for more information.
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