I am going to change the details for my patient’s confidentiality, but the basic story is spot on.

Alana, a beautiful 23-year-old woman who lives far away from Richmond, VA, convinced her mother to bring her to the Coleman Institute for Addiction Medicine to help her stop using opioids.

Since childhood, Alana has suffered from chronic headaches. She has been treated by neurologists using all the known and even some experimental medications and procedures. To abbreviate her story, she was put on opioids for several years, and then was switched to tramadol in an effort to get her off Dilaudid® (hydromorphone) and oxycodone.

Then, of course, she became physically dependent on tramadol.

She was put on buprenorphine to get her off the tramadol.

Her headaches were long gone, but she was now physically dependent on the long-acting partial agonist, Suboxone® (buprenorphine/naloxone).

In the midst of the headaches and the pain medication, Alana gave birth to a gorgeous baby girl, Estella.

Last week Alana, Alana’s mother, Reysa, 2-year-old Estella, and Estella’s baby doll came to Richmond so Alana could detox off the buprenorphine. She had found us online and called that day.


Traveling alone is one thing, but traveling with a child and all her gear to an unknown city is another whole adventure. Car seat, stroller, pull-ups, clothing, coloring books, and crayons were all packed and flown across the country with the family.

Alana was full of hope. Alana’s mother was full of skepticism.

How could her daughter really get off her pain medication in several days—in an out-patient setting, no less—when experts in her hometown had struggled for months at a time to wean her off her pain medication?

But Alana was persistent and ultimately, persuasive.

Airplanes, rental cars, hotels were booked.

Alana is fluent in English, and Estella is getting there. English is a second language for Reysa, so understanding some of the nuances of how the Coleman Method works was a little difficult to communicate, although Alana did her best as our staff explained it to her.

I could see the concern in Reysa’s face: not only had they spent a lot of time and money to get here, but the very worst thing would be to see her daughter, so full of hope, be disappointed.

I tell patients sometimes that I wish I could hang their picture on the wall as "Patient of the Week," but of course, we are all about confidentiality. However, in another world, Alana’s picture would have been front and center. Her detox went as beautifully as we have come to expect over the more than twenty years the Coleman Institute has become the expert in rapid opioid detox using naltrexone therapy.

The three generations of women were so lovely to work with. Each day as they came for their visit (her detox was five days), Reysa looked a little less concerned. They even had a chance to take Estella (and her doll) to our local petting zoo for an afternoon.

At the conclusion of her detox and the placing of the naltrexone implant, in broken but heartfelt English, Reysa hugged me tightly. “I thought it too good for true,” she said.

I nodded but didn’t speak because I had a big lump in my throat. Estella broke the silence by demanding a diaper change for her baby, and the ladies gathered their gear and headed back home.

Oxycodone, hydromorphone, oxymorphone, the hydrocodone gang, fentanyl, buprenorphine products, tramadol, methadone, kratom, and heroin…Our accelerated outpatient detox safely and comfortably gets people off opioids whether they have been on them for months or years.

I totally appreciate your skepticism and welcome the opportunity to answer any questions you might have if you or a loved one needs some help to get off opioids. Please call us at your earliest convenience.

Joan R. Shepherd, FNP