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 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.
Initial Evaluation for Suboxone Maintenance
Suboxone maintenance therapy is where a daily dose of medication is given in order to stabilize and treat opiate and opioid addictions (e.g. oxycodone, Oxycontin, or Heroin). Induction is the process of starting the medication. Different physicians do their inductions in different ways. Here, I will discuss the way that I do inductions in my medical practice. The first day is an initial evaluation to determine: 1. If the patient
Oxycodone and OxyContin Addiction
Oxycodone is the opioid, or narcotic, that is in pain medications such as Percocet and Oxycontin. Sometimes people who have never been addicted to a drug will say, “Percocet just makes me fall asleep, I don’t understand how anyone could get addicted to that?” The answer is that some people have an “opiate brain.” I treat working professionals and small business owners in my medical practice. They have high pressure
Part III – Hallucinogen Persisting Perception Disorder (HPPD)
Medication treatment for HPPD includes serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft. In addition to treating the anxiety disorder, SSRIs treat HPPD in another way. Hallucinogens such as LSD (“acid”) and psilocybin (“mushrooms”) exert their effect at one subtype of the serotonin receptor. When a patient takes an SSRI, their number of serotonin receptors decreases. With less serotonin receptors around, HPPD symptoms are reduced. Long-acting benzodiazepines (“benzos”) such
Part II – Hallucinogen Persisting Perception Disorder (HPPD)
HPPD can be thought of as an anxiety disorder due to an acquired synesthesia. Synesthesia is defined as a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces the visualization of a color. HPPD can also be thought of as a form of Post-Traumatic Stress Disorder (PTSD) in response to a bad hallucinogenic “trip”. Cognitive behavioral therapy (CBT) for