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Community Medical Services

 

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OUTPATIENT DETOXIFICATION

Opiate Detoxification: The First step in Treatment

As the title suggests, Opiate Detoxification is not a treatment but rather a first step in dealing with the acute withdrawal associated with Opiate Dependence.

Opiate withdrawal lasts five to seven days with the third day being the worst. Opiate withdrawal Symptoms include runny eyes, stomach cramps, nausea, vomiting, diarrhea, goose flesh and general agitation as well as sleep disturbance and drug craving. Essentially, it feels like the flu on steroids. We use a slow methadone or Suboxone taper, usually lasting 10-21 days, to deal with these symptoms. What “gets” people in terms of relapse is not the acute withdrawal but rather the craving which we understand, based on brain scan technology, happens in the same part of the brain as hunger and thirst. When you are hungry you eat, when you are thirsty you drink water, and when you crave drugs you use drugs.

If after detoxification there is not a second step such as individual counseling, outside group counseling such as AA,NA, CA and a program that can help with the triggers to use, relapse is imminent. This is a chronic relapsing disease. Thinking that after detox opiate dependence will always simply go away is misguided at best. Often opiate dependence requires long term treatment with either Methadone of Suboxone.

We encourage detoxification if our patients so desire, but we will also be there to help if detoxification is not enough.

SUBOXONE TREATMENT

Community Medical Services is able to provide Suboxone, Generic Suboxone, and Buprenorphine, to our patients based on our Physicians’ assessment of your needs. These programs can be effective for individuals who are physically dependent on opiates such as Oxycontin, Percocet, Demorol, Codeine, and Morphine.

Save Costs on Generic Suboxone:

By providing Suboxone in its newly-released generic form, our patients often pay much less than they would if they were to go to a pharmacy where prices are typically marked up by high percentages. At Community Medical Services, you will receive expertise care from our licensed doctors, counselors, and nurses who are available to you throughout the program. We will help you to reduce drug cravings which will allow you to return to a normal life within days.

Your comprehensive treatment will take place in a doctor’s office setting where you will receive outpatient drug rehabilitation treatment.

CMS prescribes Suboxone for patients that fit the criteria. Your therapy with Suboxone will be a step by step program separated by four phases.

  • Induction
  • Stabilization
  • Maintenance
  • Medical withdrawal

Opioid dependence is a long-term medical condition, which means that some patients may require treatment for extended periods of time to prevent relapse and to stay on track with their recovery. While this can seem overwhelming, we can help keep you motivated, encouraged and excited about getting your life back.

METHADONE TREATMENT

The power of opioid dependency is hard to understand for those who have not experienced it firsthand.  Most people who become addicted to opioids (either heroin or prescription pain medications) follow a downward spiral that commonly ends in imprisonment or death.  Many patients may have been through detox and treatment programs but end up returning to drug use in spite of their best efforts.

Methadone is not a cure for opioid dependency, but it dramatically decreases cravings and withdrawal symptoms, and allows motivated patients to stay away from illicit street drugs for long periods of time.  Methadone does not make people “high” – it simply makes them feel normal and able to function again.  Methadone is always combined with counseling to help people rebuild their lives that have been ravaged by their addiction.

Many people question why it makes sense to “give drugs to drug addicts.”  Years of experience and research have shown, however, that this is by far the most effective approach.  Methadone treatment was developed almost 50 years ago and is considered the standard of care for opioid dependency.  All methadone clinics are strictly regulated by the Federal Government and follow procedures that have been worked out over the years and found to be the most effective.

It would of course be better for patients to simply “stop using drugs” and live lives free of all drugs or medications.  Unfortunately, once a person has developed a dependence on opioids, this approach may no longer be possible and will only lead to repeated treatment episodes followed by relapses.  This does not mean that opioid addicts are “weak” or have no “will power” – it simply testifies to how serious opioid dependency is and how hard it is to treat.  If you have a family member or friend who is addicted to opioids, the best thing you can do for that person is to urge them to enroll in a treatment program where they can get both medication and counseling services and to stick with the program long term.  Telling patients they need to “get off methadone” will likely only lead to them continuing on their downward course.

Patients who are successful in the program may be candidates for tapering off of their methadone dose and eventual discontinuation; although there are others who may need to stay on methadone treatment for life.  Decisions about dosing and tapering need to be individualized and are always made in conjunction with the patient, their families and their support group.  Patients should have a stable home and personal life before tapering and it is recommended that patients taper slowly, usually over many months, in order to avoid withdrawal symptoms and relapsing back to illicit drug use.

At Community Medical Services, we offer treatment with medications such as methadone and buprenorphine combined with counseling in a compassionate and caring environment.  All of our staff are trained and experienced in dealing with substance use dependency and their associated problems – medical, psychological, personal, and spiritual.  We are licensed by the federal government under the Substance Abuse and Mental Health Services Administration (SAMHSA) and accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF).  If you have questions, we invite you to call us for a confidential discussion with one of our staff members.
Call us today to speak with a qualified treatment specialist and to make an appointment.

VIVITROL/NALTREXONE TREATMENT

Vivitrol is a prescription injectable used to treat both alcohol and opioid use disorder. It is useful to both prevent relapse after a successful detox from other opioids and can be used as an alternate to Suboxone and Methadone.

One of Vivitrol’s key benefits is that it can be used on a monthly basis, making it a convenient option for those struggling to travel to an Opioid Treatment Program on a more regular basis.

Vivitrol is a complete opiate antagonist which has no psychoactive properties other than to bind to an opiate receptor in the brain and block the superimposed opiate.  If a patient uses either heroin or an opiate based pain medication while taking Vivitrol, they will feel no effect from that opiate.

There are several applications for this opiate blocker.

  • An individual may want medication-free treatment. They can be tapered from the opiate they are using and after 10-14 days of opioid abstinence, they may begin the Vivitrol treatment which will cover them for a 30-day period.
  • If a patient has been stable for several months or years on Suboxone or methadone and are seeking to detox, they can be tapered from these medications and after 14 days, may switch to Vivitrol and again have a degree of protection from opiate relapse.
  • Another potential application is to provide a safety net for patients recovering from alcohol treatment as Vivitrol will partially block the affects of alcohol if a recovering individual uses, thus preventing a more dangerous relapse.

Differences between Naloxone, Naltrexone and Vivitrol:

Naloxone (Narcan) is a short acting drug which will bring a patient out of an opiate overdose by stripping the opiate from the opiate receptor and is a life saving drug.

Naltrexone, a short acting opiate/alcohol blocking agent has been used for the last 30 years.

Vivitrol is an extended release form of Naltrexone. The extended release properties of Vivitrol helps patient compliance as it does not have to be used every day.

Parenthetically these medications will also blunt the effect of alcohol so they are often used after discharge from a residential treatment program to prevent an alcohol relapse.

Vivitrol Facts:

  • Some agitation and soreness at the site of injection may occur.
  • You may not take Vivitrol if you are pregnant or if you are actively using opiates.
  • You must be 10-14 days opiate free before starting Vivitrol treatment.
  • For more information you may contact any of our listed clinic sites.

Community Medical Services offers a number of different payment options for our patients. We offer both oral Naltrexone and Vivitrol at each of our clinics. Call us today to speak with a qualified treatment specialist and to make an appointment.

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