Johnny first came to the Coleman Institute for Addiction Medicine when he was a young man, full of energy, and working hard at building a business. His work boots were a testimony to how he spent his time, and he dearly loved whatever vehicle he drove. Tall, charming, with a twinkle in his eyes, he owned two big trucks and a snowplow attachment, and when his city was covered in snow, he made bank. With the help of his father, he purchased more equipment, hired more guys, and continued to invest in and grow his business.

Johnny never had a formal degree, although he took a couple of classes at a local community college. Sitting still was not his style, but oh was he street smart.

How We Met

We knew Johnny through his courtship with the beautiful woman he fell in love with and married on an island in the Caribbean; it was like a movie set. They had two sons. His business thrived.

He was always doing things to help people. He had the means and the heart, and he much preferred repairing a broken fence or working on an engine with friends to watching Netflix.

Johnny was addicted to opioids. He started with Oxycontin (and other narcotic pain medication) which was very easy to find and buy at one time. As prescribing laws tightened, he turned to heroin, and eventually, street fentanyl; pressed and powder.


The Stress of Success

While many patients who get an Accelerated Outpatient Opioid Detox using the Coleman Method enjoy long-term sobriety following a single treatment, it took Johnny several attempts before his recovery truly took hold. At a return visit after relapsing following a long period of sobriety, Johnny told me that his success was a huge trigger.

“After the snowstorm, every one of our trucks was out there plowing. I made over a million dollars that month. I went into ‘react-and-celebrate-mode’, called an old dealer I knew, and BANG, I was using again every day.”

The Path to Recovery Becomes Harder

Relapses and subsequent detoxes became increasingly difficult for Johnny. This is partly because fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent. It also has to do with the way the brain adapts to the drug. Judith Grisel, the author of Never Enough, describes the plight of the opioid addict:

"One way to understand the dilemma of the opiate user is to recognize that because there are no free lunches, the benefits that drugs confer will have to be paid back. In principle, moments of superb contentment demand an equal and opposite experience of distress; the benefit of euphoria will create a debt of dysphoria, and trying to avoid this unpleasant state by taking more drugs will just increase what you owe. In practice, the depth and extent of the withdrawal period are in direct proportion to the duration and intensity of the drug bathing the brain. Just as the first exposure is “best,” likewise, the first time someone tries to get clean is the easiest, and easier still if the period of using was of short duration….medicating it will not only put off the misery but strengthen it for next time.”

Over the years, Johnny detoxed with us three times. He did well when he stayed on long-acting naltrexone—at first in the form of our naltrexone implants which will confer blockage for about eight weeks, and then he came monthly for over two years to receive a branded naltrexone injection called Vivitrol. Naltrexone rests on the same receptors that opioids use, so it effectively stops physical cravings. This is a huge help for people who are re-imagining, then re-creating a life free from drugs.

The Effects of the Pandemic

Only weeks ago, the CDC released some harrowing statistics: Drug overdose deaths in the United States rose 29.4% in 2020 to an estimated 93,331, including 69,710 involving opioids.

The ‘season’ of Covid not only wreaked havoc directly by causing illness and death, but the casualties of isolation, job loss, extreme stress, homeschooling, fear, and anxiety took their toll as well. We knew alcohol consumption increased dramatically throughout the pandemic, and now our concern about opioid use is also confirmed.

Although the Coleman Institute has stayed open throughout the pandemic, many of the treatment programs we guide our patients to for follow-up care were either temporarily closed or were doing the best they could through remote programming. This format was a godsend for some patients, but for others, just not intense enough to provide the necessary support. Again, this is a strong argument for utilizing long-acting naltrexone therapy.

Finding Relief With Naltrexone

Naltrexone, which is a pure opiate/opioid blocker (or antagonist) and therefore does not create physical dependence or tolerance, resides on the opiate receptors, thus blocking these drugs from occupying these receptors. It is an implant that lasts for approximately two months and will not only physically block the drug but also will eliminate physical cravings. The tricky part for someone who is using heroin, kratom, fentanyl, or other narcotic pain medications (Oxycontin, Roxicet, Dilaudid, Tramadol, Vicodin, Percocet, etc.) and wishes to switch to naltrexone is that--unless the opioids are completely out of one’s body--the addition of naltrexone can put someone into precipitated withdrawal.

What Will Withdrawal Feel Like?

Symptoms Of Opioid Withdrawal

From Judith Grisel, Never Enough

  • Panting and yawning
  • Pain
  • Irritability and dysphoria
  • Restlessness and insomnia
  • Fearfulness and hostility
  • Increased blood pressure
  • Diarrhea
  • Pupil Dialation
  • Increased core temperature
  • Tearing and runny nose
  • Chilliness and goosebumps

This is what the Coleman Institute has specialized in for over twenty-five years. We work with our patients and their support people to slowly and carefully, replace opioids with naltrexone. At the completion of a detox, the opioids have been removed and the receptors are now loaded with naltrexone. Our program provides people with a total of three implants, spanning six months of protection from using opioids. And while this is an effective blockade, I cannot overemphasize the importance of coupling this treatment with counseling and the support of others who understand the unique challenges people with physical dependence on opioids face. Our case management services at the Coleman Institute for Addiction Medicine guide patients to find the right fit for their particular situation.

Compassionate Treatment

Johnny never felt like he needed the counseling piece, and I am still reeling from the call I received late last week from his wife, Gretchen. In a quiet, faltering voice she thanked us for all we had done for her husband over the many years of working together and the added years of quality time they’d had together. Sadly, last month Johnny was found dead in the driver’s seat of his Ford F550 with a needle in his arm.

No one can guarantee that a loved one won’t have a fatal relapse, but I can assure you that this story is the exception. What we can do is offer effective, compassionate treatment and a realistic opportunity for a person ready to stop using opioids and rebuild the pieces of their life destroyed by their addiction. Please call our caring folks at 877-773-3869 and we can give you more details about how we can help you.