Benzodiazepines such as Xanax are GABA-A agonists. This means that they stimulate the GABA-A receptor. Stimulation of the GABA-A receptor results in relief of anxiety. With external stimulation of this receptor, by taking Xanax, there is a resultant increase in glutamate. Glutamate can be thought of as an excitatory neurotransmitter. When the relaxing properties of GABA-A are taken away, meaning as the Klonopin or Valium decreases in dose as the
Outpatient Medical Detox Part I: Xanax – Klonopin – Valium – Ativan
Xanax, Klonopin, Valium, and Ativan belong to the class of medications known as benzodiazepines or “benzos”. They are frequently prescribed for anxiety. I will discuss Xanax here as it is the most addictive because of it’s short half-life. The effect of the drug wears off quickly. As a result, patients start taking it more frequently. With more frequent administration, tolerance (need more of the drug to have the same effect)
Stuart Kloda, MD on Suboxone Outpatient Detox for Opiates and Opioids
This is Dr. Stuart Kloda. I am an addiction medicine physician in New York City, and I have a solo private practice located at Columbus Circle. Today I’m going to talk about the outpatient detoxification from opiates such as heroin, and opioids such as Oxycontin, oxycodone, Percocet, Vicodin and Lortab. Drug and alcohol detoxification is medically supervised withdrawal. A medication that is the same or similar to the drug being
Stuart Kloda, MD – Addiction Medicine and Suboxone Doctor in New York City
Hello, my name is Dr. Stuart Kloda, and I opened a unique solo private practice specializing in Addiction Medicine in New York City. I completed a two-year fellowship in Addiction Medicine at the Addiction Institute of New York at St. Lukes & Roosevelt hospitals. I am board certified by the American Board of Addiction Medicine. I offer discreet and confidential one-on-one treatment in a beautiful office at Columbus Circle.
How Long Should Patients Stay on Suboxone Maintenance for Opiate Addiction?
The answer to this question will depend on which physician you ask. The “party line” is to tell patients to stay on Suboxone maintenance from six months to two years. However, my approach is to always tailor the answer to the individual patient. The studies show that opiate addiction has a high rate of relapse. However, this statement does not take patient individuality into account. There are different biologic, psychiatric,
Opioid Agonist Therapy
My opinion is that the ultimate is to be able to stay abstinent without any medication. However, this is not always possible. In general, by the time patients come to see me, they have been unable to maintain any consistent sobriety, if any, on their own. Fortunately, there are now more medications than ever to help patients stay abstinent. Patients who abuse opioids eventually develop tolerance (need more of the
Inpatient Opioid Detoxification – Part II
Some patients elect to do what is called a “non-opioid” detoxification. This can be accomplished as an outpatient as well as via inpatient opioid detoxification. Just like it sounds, with this type of treatment, opioids are not used to taper the patient off of their opioid of abuse. Instead, the patient stops “cold turkey”, and the withdrawal symptoms are managed with symptomatic medications (as discussed in the “Outpatient Opioid Detoxification”
Inpatient Opioid Detoxification – Part I
Blogging on hurricane day in New York City. There are actually three different ways to taper off of opioids: 1. Suboxone taper (discussed in the previous blog) 2. Methadone taper 3. Non-opioid detoxification Most people know methadone as the medication that is given at a clinic as a daily dose for opioid dependence. However, it is also used for inpatient opioid detoxification. It is illegal to use methadone for outpatient
Outpatient Opioid Detoxification
In drug and alcohol detoxification, a medication is given that is the same or similar to the drug being abused. The initial dose is tapered up until withdrawal symptoms are alleviated. The medication is then given in tapering doses down over a specified period of time. Suboxone is a unique opioid that is used for outpatient detoxification. Suboxone only partially stimulates the opioid receptor – i.e. it is a “partial
Opioid Withdrawal
Opioids are the category of drugs that include Heroin, Percocet, Oxycontin, Vicodin, Lortab, Tylenol with Codeine, and Ultram. Technically speaking, Ultram is not an opioid. The pharmaceutical companies developed and marketed Ultram as a non-narcotic alternative to the other drugs mentioned. However, it does act at the opioid mu receptor. I see patients that abuse Ultram and become addicted to it. Symptoms and signs of opioid withdrawal, ranging from mild