Suboxone outpatient detox treatment is used for dependence on opioids and opiates. When I start a patient on Suboxone (buprenorphine/naloxone), I always recommend that he or she stay on the medication at full dose for at least two months. These two months allow the patient to develop a new lifestyle and routine off of opiates and opioids of abuse. It allows time for personal and business relationships to improve. After
Naltrexone for Alcohol Addiction
Naltrexone is a medication that comes in the form of a tablet that is taken daily, or as an injection that is given monthly (Vivitrol). Naltrexone works by blocking the mu-opioid, or narcotic pain killer receptor. Alcohol exerts it’s pleasurable effects by stimulating a few different receptors. Surprisingly, one of the receptors that alcohol stimulates is the mu-opioid receptor. In stimulating this receptor, a surge of the neurotransmitter dopamine is
My Experience with Prescribing Naltrexone for Opioid Dependence
Back to blogging after a long period of absence. I might continue with AA at a later date, but am going to switch to different topics for right now….. Naltrexone is a medication that comes in the form of a tablet that is taken daily, or as an injection (Vivitrol) that lasts for four weeks. Naltrexone is used for the treatment of opioid and alcohol dependencies. It acts as a
Alcoholics Anonymous – Part IV
What happens at an Alcoholics Anonymous meeting after the introductions? Next, the group is usually opened to general discussion. Many groups do not have speakers for every meeting, so the whole meeting is general discussion. Usually there will a topic such as “surrender”, “acceptance”, “cravings”. There is usually a leader of the group who will call on people to speak who raise their hands. Group members will also “share” in
Alcoholics Anonymous – Part III
A typical AA meeting lasts sixty to ninety minutes. People come in, maybe get a cup of coffee, and sit down. Meetings often start with a prayer, commonly the Serenity Prayer (http://en.wikipedia.org/wiki/Serenity_Prayer). Frequently readings from the Big Book are next, usually that part of Chapter five titled “How It Works” (http://www.step12.com/aa-how-it-works.html). Sometimes, the 12 traditions, which I will talk about later, are read. Often, there will be a “go-around” where
Alcoholics Anonymous – Part II
As can be seen, the 12 steps talk quite a bit about “God” or a “Higher Power.” This is a real turn-off to many people, especially for many alcoholics who feel that God or organized religion has always been against them. This is even recognized in the Big Book (the textbook of AA) in a chapter titled, “We Agnostics.” However, everybody gets to bring their own individual belief about a
Alcoholics Anonymous – Part I
Alcoholics Anonymous (“AA”), is one type of recovery treatment. There are other types of recovery treatments that are effective as well. For the next few blog posts, I will discuss Alcoholics Anonymous. AA is based on the following 12 steps: 1. We admitted we were powerless over alcohol—that our lives had become unmanageable. 2. Came to believe that a Power greater than ourselves could restore us to sanity. 3. Made
Second Day of Suboxone Induction
On the second day of Suboxone induction, the patient comes to my office feeling well and out of opioid withdrawal. I then have the pharmacy deliver the dose of Suboxone that he or she finished at the day before. I typically see patients again in one week. After that it can be every two weeks or every month. It is unusual for me to need to see patients weekly, as
First Day of Suboxone Induction – Part II
On the day of Suboxone induction, I make sure that patients are in opiate withdrawal. This is accomplished by patient history and physical exam. I then order the Suboxone film from the pharmacy. The film form of Suboxone is similar to a Listerine breath strip, except it is absorbed only if you put it under your tongue. I am fortunate to have a privately owned pharmacy that I work with.
First Day of Suboxone Induction – Part I
Suboxone Induction Induction is the process where the patient is induced, or started, on Suboxone. Patients must stop using short acting opiates and opioids (e.g. oxycodone and Heroin) for 24 hours before induction. If a patient is using a long acting opioid such as Oxycontin, he or she must stop using it for 48 hours before induction. Patients need to be somewhere between mild to moderate withdrawal before starting Suboxone.