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
Part 1 – Hallucinogen Persisting Perception Disorder (HPPD)
Hallucinogen persisting perception disorder, or HPPD, is a disorder characterized by the continual presence of sensory disturbances, usually visual, that are reminiscent of those generated by the ingestion of hallucinogens such as LSD. HPPD is different from “acid flashbacks” in that they are relatively permanent from day to day, while flashbacks are transient. The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) lists the following criteria for the diagnosis of
Self-Injurious Behavior
Is There a Connection Between Self-Harm and Addiction? Self Injurious Behavior (SIJ) is defined as the intentional, direct injuring of body tissue, most often done without suicidal intentions. Cutting is a common form of SIJ. SIJ is common in patients with borderline personality disorder (which I will discuss in another post). Borderline personality disorder has a high incidence of concurrent substance abuse. The following video provides an excellent description and
Medications for Alcohol Addiction
This is Dr. Stuart Kloda. I am an addiction medicine physician in New York City, and I have a solo private office located at Columbus Circle. Today, I am going to be talking about medications that are used in the treatment of alcohol dependence. One of the receptors that alcohol stimulate is the mu opioid receptor. This is the receptor that narcotic pain medications such as Percocet and Oxycontin also
Topamax for Alcohol Dependence
There are a lot of medications that are used in addiction and psychiatric treatment that are used as “off-label”. Drug companies test new medications for safety and FDA approval. The medications are tested for specific illnesses in order to demonstrate safety and efficacy. It would be impossible to test new medications for all illnesses. That is why, when a medication is used for an illness not tested by the drug
Naltrexone for Alcohol Dependence
Alcohol exerts its pleasurable effects by stimulating a few different receptors in the brain. One receptor that alcohol stimulates is the mu-opioid receptor. This is the same receptor that pain medications such as Percocet stimulate. Stimulation of the mu-opioid receptor causes the release of dopamine in the brain. Dopamine promotes feelings of reward, pleasure, and euphoria. Naltrexone is a mu-opioid receptor antagonist. This means that it blocks the effects of
Baclofen for Alcohol Dependence
One of the receptors that alcohol stimulates is the GABA-A receptor. GABA-A receptor stimulation results in relaxation and relief of anxiety. Some people drink, in part, to calm symptoms of anxiety. In this type of patient, when the alcohol is taken away, the original anxiety becomes symptomatic, along with new alcohol withdrawal anxiety. So now the patient has to deal with two types of anxiety, and frequently with a dysphoric