Fred came for an implant yesterday. He detoxed off of street fentanyl 10 weeks ago. He was about a week late for his scheduled naltrexone implant and as the time drew closer to his return visit, he was getting antsy.

An argument with his wife, who is rightfully having trouble trusting Fred, caused him to get — in his own words — “a f__k-it attitude”. He found his old contacts easily, bought heroin and crack and, for the first time in weeks, ingested drugs into his body.

Using Naltrexone Therapy To Avoid Relapse

The naltrexone was still blocking his opiate receptors. This was a mixed blessing in Fred’s mind. The whole time he was fighting with his wife, he knew he was setting himself up to use. He said he was actually watching the whole thing play out, as if he were in the theater, stoking the argument so he could blame her for feeling so misunderstood, storming out of the house, calling a guy he only called when he wanted to get high — a guy who agreed with every complaint he made about his wife. Fred said it was like being on a circuit he told himself he couldn’t get out of…even though he knew he could. By then, he didn’t want to.

He was not surprised when he didn’t get high. The long-acting naltrexone implant was still blocking most of his opioid receptors. He could have continued to use and perhaps displace enough naltrexone to get high and possibly overdose, but by then, he was feeling pretty stupid and pretty disgusted with his choice. He went back home.

So when Fred showed up for his implant, his urine was positive for fentanyl, cocaine, and THC.

Because he had only used once and it was obvious the naltrexone was still blocking opioids, we were able to give Fred his second implant without the danger of putting him into precipitated withdrawal.

Reminder: Relapsing Is Not Failing

I was so grateful that Fred came back. Our whole staff enjoyed his sense of humor and swagger during his detox. His wife, Deb, was clearly devoted to this man, even though she rolled her eyes more than once at his jokes. Fred had used heroin for a few years when he was young, then had a clean period of close to eleven years.

Three years ago he was prescribed pain medication for a back injury, and it didn’t take long for him to slide into daily use and buying drugs on the street. He hid it for a while, but when Deb and his daughter became aware and convinced him of their support, he signed on for a detox. (by the way, we were able to get him in three days after he called). Slipping up after the detox and the first implant, it would have been so easy for Fred to get stuck in a shame, fear, and failure story, and be lured by the siren call of the opioids.

Our outpatient opioid detox at the Coleman Institute for Addiction Medicine helps determined people to not only get off street drugs such as heroin, pressed pills, and fentanyl, but also prescription pain pills such as oxycodone, Percocet®, Dilaudid®, Opana®, Ultram®, hydrocodone, and methadone. We know it’s hard. Our outpatient detox program allows our patients to safely, quickly, and pretty comfortably, get off addictive substances and switch to naltrexone.


Reduce Withdrawal Symtoms When Stopping Naltrexone

Unlike methadone or Suboxone®, naltrexone is merely a blocker. Although the other two medications are accepted treatments for Opioid Use Disorder, naltrexone is the only one that will not cause physical dependence. When a person is ready to stop using naltrexone, there is simply no withdrawal.

The Coleman Institute has specialized in the use of long-acting naltrexone treatment for over 20 years. Among the many reasons to use long-acting naltrexone, and even more compelling as the world adjusts itself to life during a pandemic, is the elimination of daily clinic visits for methadone and weekly or bi-weekly clinic visits for buprenorphine products.

Staying Committed to Recovery

Fred got his implant and promised to return in two months. He also decided that he would take advantage of our social worker, Judi’s offer to help him find a therapist to work with. I couldn’t help but think about a blurb I had just read describing Kintsugi, the Japanese art of putting broken pottery pieces back together with gold — built on the idea that in embracing flaws and imperfections, you can create an even stronger, more beautiful piece of art.

In the words of Andrea Montovani...

The kintsugi approach makes the most of what already is, highlights the beauty of what we do have, flaws and all, rather than leaving us eternally grasping for more, different, other, better. In other words, the experiences you have, and the person you already are, suffice. You may occasionally chip and break and need repairs. And that’s fine. But reality is the best and most abundant material on the planet, available to anyone, comes for free, and we can all use what we already have — including our flaws — to be even more beautiful.”

Please schedule a call below if you’d like to learn more about our Accelerated Opioid Detox process.

Joan Shepherd, FNP