The NESPTM
Approach for Narcotic Detoxification
Prescription narcotic dependence, abuse and
addiction has risen more than 335% over the last decade. In addition, other
drugs such as muscle relaxants, sleeping pills, and antidepressants
(“collateral drug abuse”) that are often prescribed to aide the effects of
narcotics, has also risen at an alarming rate.
Many people who know they have a problem don’t
get help because of embarrassment, fear of losing their jobs or they simply
don’t know where they can get help. The Drug Abuse Treatment Act of 2000
(DATA 2000) was passed by Congress in 2000. This opened the door for
physicians to treat narcotic abuse in the office setting which had been
previously outlawed since 1914. In 2002 the drug Suboxone™ was approved by
the FDA for this purpose. The NESP™ approach to narcotic
detoxification program which utilizes Suboxone™ and other modalities
developed by Gregory A. Smith, M.D., QME, was started in 2005.
This revolutionary program is usually
outpatient and can detoxify a patient in as little as 3 hours. Many patients
can return to work the same day they undergo the program. Detoxification is
only the first step. An aggressive approach to treating the addiction and/or
chronic pain after detoxification is achieved using blood-type diets, class
IV laser, cranioelectrical stimulation (CES) and psychiatric/psychological
support. This part of the program is unique and is the key to permanent
success.
Patients come in for an initial consult with
the physician. During this visit the program is explained in detail and the
patient is given instructions and take home information on the program. The
patient then returns on the appointment date for detoxification. Blood and
urine are obtained and medication is given for detoxification. The
medication is sublingual (under the tongue). Patient’s can expect to remain
in the office for 1-3 hours. A follow up visit is then done 24 hours later.
Additional follow up visits occur every week for a total of 5 weeks. Some
patients will require a maintenance program after the initial 5-week
program.
This program is powerful, fast, and effective.
Finally, confidentially is of utmost importance and only the patient and
members of the staff will know the nature of the patient’s visit. Other
patients will be in the office for various other acute and chronic pain
problems, therefore your privacy is guaranteed.
Find out now if you have a
problem with narcotics.
I'm ready to
make an appointment.
Understanding Opioid
Dependence
Opioid
dependence is a disease in which there are biological or physical,
psychological, and social changes. Some of the physical changes include the
need for increasing amounts of opioid to produce the same effect, symptoms
of withdrawal, feelings of craving, and changes in sleep patterns.
Psychological components of opioid dependence include a reliance on
narcotics (opioids) such as Vicodin or OxyContin to help you cope with
everyday problems or inability to feel good or celebrate without using
narcotics. The social components of opioid dependence include less frequent
contact with important people in your life, and an inability to participate
in important events due to drug use. In extreme cases, there may even be
criminal and legal implications
The
hallmarks of opioid dependence are the continued use of drugs despite their
negative affect, the need for increasing amounts of opioids to have the same
effect and the development of withdrawal symptoms upon cessation.
There are
a variety of factors than can contribute to the continued use of opioids.
Among these are the use of heroin to escape from or cope with problems, the
need to use increasing amounts of heroin to achieve the same effect, and the
need for a “high.”
Treatment
Treatment
for opioid dependence is best considered a long-term process. Recovery from
opioid dependence is not an easy or painless process, as it involves changes
in drug use and lifestyle, such as adopting new coping skills. Recovery can
involve hard work, commitment, discipline, and a willingness to examine the
effects of opioid dependence on your life. At first, it isn’t unusual to
feel impatient, angry, or frustrated.
The
changes you need to make will depend on how opioid dependence has
specifically affected your life. The following are some of the common areas
of change to think about when developing your specific recovery plan:
-
Physical – good nutrition, exercise, sleep and relaxation.
-
Emotional – learning to cope with feelings, problems, stresses and
negative thinking without relying on opioids.
-
Social – developing relationships with sober people, learning to resist
pressures from others to use or misuse substances, and developing
healthy social and leisure interests to occupy your time and give you a
sense of satisfaction and pleasure.
-
Family – examining the impact opioid dependence has had on your family,
encouraging them to get involved in your treatment, mending
relationships with family members, and working hard to have mutually
satisfying relationships with family members.
-
Spiritual – learning to listen to your inner voice for support and
strength, and using that voice to guide you in developing a renewed
sense of purpose and meaning.
During
the treatment process, SUBOXONE/SUBUTEX will help you avoid many or all of
the physical symptoms of opioid withdrawal. These typically include craving,
restlessness, poor sleep, irritability, yawning, muscle cramps, runny nose,
tearing, goose-flesh, nausea, vomiting and diarrhea. Your doctor may
prescribe other medications for you as necessary to help relieve these
symptoms.
You
should be careful not to respond to these withdrawal symptoms by losing
patience with the treatment process and thinking that the symptoms can only
be corrected by using drugs. To help you deal with the symptoms of
withdrawal, you should try to set small goals and work towards them.
Frequently
Asked Questions
What is Suboxone/Subutex?
The active ingredient in both medications is Buprenorphine. Buprenorphine is
a partial agonist narcotic. Medications such as OxyContin, Vicodin,
Norco, and Dilaudid are full agonist narcotics. You can think of a
full agonist (i.e. Vicodin) as a key and the narcotic receptor in the
nervous system as a lock. The key (full agonist) fits the lock perfectly and
opens it unlocking a door that allows a rush of neurotransmitters into the
cells that are responsible for pain relief but other substances enter that
are associated with the development of addiction. Suboxone/Subutex also is a
key (partial agonist) that fits the lock and opens the door but the door
only opens partially allowing enough of the neurotransmitters in for
pain relief and to suppress drug cravings, but the door does not open wide
enough to let some of the other substances in that are associated with
addiction. Finally, there are antagonists (dummy key) that fits the lock
(receptor) but does not open the door; it just sits on the receptors
preventing them from being activated. These drugs (i.e. Naloxone) can cause
immediate withdrawal.
What is crainioelectrostimulation (CES) and
why do I need to use it during the program?
CES is stimulation of the brain with micro currents in a way that helps
patients not crave narcotics. In addition, CES has been shown to be
effective in reducing pain in chronic pain syndromes of various types and
also treats depression and insomnia. You are loaned a unit during the 6 week
program that you can purchase at the end of the program if you choose to
keep it.
How long does the detoxification process take?
This is very fast. In fact on the treatment day, because you are
in early withdrawal which is an indication that many of your narcotic
receptors are unoccupied, when Suboxone/Subutex is administered your
prescription narcotic is displaced and you are technically “detoxed” at that
point. This however does not necessarily address your pain (although
Suboxone/Subutex often provides great pain relief) or the psychological
aspects of your dependence or addiction to the narcotic.
Why can I not take my narcotic pain
medication the day before the treatment?
This is the most important part of the detoxification process. You must
refrain from taking narcotics for 24 hours prior to treatment to insure that
your narcotic receptors in your nervous system will be available for
Suboxone/Subutex to bind and take effect. Some patients have a lot of
anxiety associated with early withdrawals and cannot handle abstaining from
narcotics for 24 hours. If this is the case for you it is mandatory that you
notify the pain doctor before the treatment day so an alternative plan can
be made for you (staying in the hospital the night before and receiving
anti-anxiety medication, or a small prescription for an anti-anxiety
medication you can take at home the day before your treatment day).
What happens if I take my narcotic
medication the day before the treatment day and come in for detoxification
anyway?
This could potentially have disastrous effects on your body. It is possible
to go into an acute withdrawal syndrome if you are given Suboxone/Subutex in
the face of not abstaining from your narcotic medication. You will be
evaluated (drug screen and clinical evaluation) for evidence that you are
indeed in early narcotic withdrawals, if you are NOT, you will be sent home
and given ONE make up appointment for treatment. If you fail to comply with
the protocol on the next schedule treatment day you will be expelled from
the program and you will forfeit 50% of the cost of your program.
Why do I have to take a drug test each time
I have an appointment?
This is to document that you are being compliant with the program. NOTE:
anyone who tests positive for illegal substances such as cocaine or
marijuana will be immediately expelled from the program and will forfeit a
minimum of 50% and a maximum of 100% of the program fees depending on what
stage of the program they are in.
How long will I be on Suboxone/Subutex?
This is determined on a case-by-case basis. Some patients can be
rapidly tapered off in a matter of days to weeks; others may be on the drug
indefinitely if they need it for pain relief and/or to prevent drug
cravings. Comprehensive Pain Relief Group can employ many modalities for
pain relief ranging from nutritional cleanse programs to minimally invasive
surgery depending on what you need and what you are comfortable doing.
Why do I need to see a nutritionist?
The program is designed to target all aspects of pain and narcotic
dependence or addiction. Nutritional cleanse programs and custom programs to
compensate for nutritional deficiencies are essential to becoming pain free
and overall good health.
Do I need to see a psychologist or
psychiatrist?
All patients will be given the option to see a psychologist or
psychiatrist. In addition, information on Narcotics Anonymous will also be
give to you. There is a difference between physical withdrawal syndrome and
dependence vs. true addiction. Patients with true addiction will be strongly
encouraged to go for counseling with a psychologist or psychiatrist. The
pain doctor will help you determine if this is what you need to do.
What happens at the end of the program if I
still have pain?
You will be maintained on the dose of Suboxone/Subutex that
controls your pain. In addition, recommendations and a long-term treatment
plan will be outlined by the pain doctor. This program may be covered by
insurance or there may be additional cost to the patient. This will be
discussed with the patient before or during the final follow up appointment.
What can I do if I have an emergency after
business hours?
If you are having a true emergency you call 911 or go directly to
the emergency room. If you have an urgent problem you will be provided with
a after hours number to reach someone at CPRG for assistance.
Does my insurance cover the program?
One important thing to consider is if you want to use your insurance in the
first place. Using your insurance will notify them of your treatment for
narcotic dependence or addiction and this is something that for privacy
purposes, you may not desire. Paying for the program out of pocket
completely eliminates this problem. Many insurance companies may cover many
or even all the costs of the program. We can provide to you itemized
invoices for you to submit to your insurance for reimbursement.
Are there any side effects to Suboxone/Subutex?
The most common side effects are headache, nausea and pain but
these can be minimized by insuring that you are in early withdrawal prior to
treatment.
I'm ready to
make an appointment.
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Comprehensive Pain Relief Group
700 N. Pacific Coast Hwy. Suite
203
Redondo Beach, CA 90277
Phone 310.798.3334
1-877-PAINMD1 (714-6631)
info@painreliefgroup.com
Copyright © 2006, Comprehensive
Pain Relief Group
All Rights Reserved.
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