Some people in the addiction community do not consider a person with opiate or opioid addiction to be in recovery if he or she is on methadone or Suboxone. It is unfortunate that this dogmatic and dated line of thinking is still employed by some who provide addiction treatment. When a patient starts taking methadone or Suboxone, he or she goes from the destructive use of an opioid to a
Treatment of Cocaine and Methamphetamine Addictions
Cocaine and methamphetamine addictions can be extremely difficult to overcome. With these two drugs, there are no highly effective medications to use as a part of medication assisted recovery. The use of these two drugs causes a surge of dopamine in the brain. Dopamine is thought of as being the “reward” and “pleasure” neurotransmitter. The brain’s natural production of dopamine becomes depleted with continued use. The depression and fatigue that
Stuart Kloda, MD – Xanax Detox – NYC
This is Dr. Stuart Kloda. I’m an addiction medicine physician in New York City. I have a solo private office located at Columbus Circle. Today I’m going to be talking about the outpatient detoxification, or medically supervised withdrawal, from the class of medications known as the benzodiazepines. These are drugs such as Xanax, Klonopin, Valium, and Ativan. They are frequently prescribed for anxiety and for patients with anxiety disorders. Xanax
Outpatient Medical Detox Part III: Xanax – Klonopin – Valium – Ativan
Some patients will develop somatic symptoms during their medical detox. These are symptoms such as palpitations, chest tightness, and feeling “that I want to crawl out of my skin”. These symptoms can be treated with a class of medications called beta blockers. Beta blockers are a class of heart medications that slow the heart rate down. They calm the nervous system down as well. I use Betaxolol. It is a
Outpatient Medical Detox Part II: Xanax – Klonopin – Valium – Ativan
Benzodiazepines such as Xanax are GABA-A agonists. This means that they stimulate the GABA-A receptor. Stimulation of the GABA-A receptor results in relief of anxiety. With external stimulation of this receptor, by taking Xanax, there is a resultant increase in glutamate. Glutamate can be thought of as an excitatory neurotransmitter. When the relaxing properties of GABA-A are taken away, meaning as the Klonopin or Valium decreases in dose as the
Outpatient Medical Detox Part I: Xanax – Klonopin – Valium – Ativan
Xanax, Klonopin, Valium, and Ativan belong to the class of medications known as benzodiazepines or “benzos”. They are frequently prescribed for anxiety. I will discuss Xanax here as it is the most addictive because of it’s short half-life. The effect of the drug wears off quickly. As a result, patients start taking it more frequently. With more frequent administration, tolerance (need more of the drug to have the same effect)
Stuart Kloda, MD on Suboxone Outpatient Detox for Opiates and Opioids
This is Dr. Stuart Kloda. I am an addiction medicine physician in New York City, and I have a solo private practice located at Columbus Circle. Today I’m going to talk about the outpatient detoxification from opiates such as heroin, and opioids such as Oxycontin, oxycodone, Percocet, Vicodin and Lortab. Drug and alcohol detoxification is medically supervised withdrawal. A medication that is the same or similar to the drug being
Stuart Kloda, MD – Addiction Medicine and Suboxone Doctor in New York City
Hello, my name is Dr. Stuart Kloda, and I opened a unique solo private practice specializing in Addiction Medicine in New York City. I completed a two-year fellowship in Addiction Medicine at the Addiction Institute of New York at St. Lukes & Roosevelt hospitals. I am board certified by the American Board of Addiction Medicine. I offer discreet and confidential one-on-one treatment in a beautiful office at Columbus Circle.
How Long Should Patients Stay on Suboxone Maintenance for Opiate Addiction?
The answer to this question will depend on which physician you ask. The “party line” is to tell patients to stay on Suboxone maintenance from six months to two years. However, my approach is to always tailor the answer to the individual patient. The studies show that opiate addiction has a high rate of relapse. However, this statement does not take patient individuality into account. There are different biologic, psychiatric,
CBT for Substance Use Disorders – Part III
One of the key components of CBT is the “functional analysis”. In a functional analysis, the following are identified before and after each episode of drug and alcohol use: Triggers Thoughts Feelings Behaviors Positive consequences Negative consequences A functional analysis is done together in sessions, as well as individually by the patient outside of sessions. The idea behind the functional analysis is that if patients understand their behavior, and remember