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Medications for Addiction

Integrated Addiction Medicine & Addiction Psychotherapy
A Confidential & Discreet One-on-one Practice

by   |   July 31, 2012
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ID-100188428ADDICTION PSYCHOPHARMACOLOGY (MEDICATIONS)

Dr. Kloda is highly experienced in using various medications that are usually taken on a daily basis to help maintain abstinence. He will see you in consultation to discuss medications for addiction that might be helpful to you. Dr. Kloda uses medications as a part of medication assisted treatment (MAT).

The definition of “recovery” is when a person changes a dysfunctional life, that is a result of drug and alcohol use, to a life that is functional and healthy. This occurs with either medication alone, or with medication plus addiction psychotherapy. There are now a number of different medications that can be used as a part of medication assisted recovery.

BENZODIAZEPINE ADDICTION

Benzodiazepines (“benzos”) are the class of medications that includes Xanax, Klonopin, Valium, and Ativan. These medications are usually prescribed to treat anxiety. The patients that I see in my medical practice have become physically dependent on these medications from legitimate prescriptions that were being taken as directed. Unfortunately, tolerance withdrawal can develop. Previously effective doses of their medication become ineffective, with withdrawal symptoms either on or in between doses.  Detoxification from benzodiazepines can absolutely be the most difficult detox for patients to accomplish. The anxiety and withdrawal symptoms that develop can protracted and severe. I follow the Ashton Method (www.benzo.org.uk/manual/) for benzo detoxification. In addition, I prescribe medications to not only treat the primary anxiety disorder, but to treat the withdrawal symptoms as well. Antidepressants such as Prozac and Cymbalta are used for the treatment of anxiety disorders. Remeron is antidepressant that works particularly well in treating insomnia, primary anxiety disorders, and benzodiazepine withdrawal symptoms. Some of the medications that I use for treating withdrawal symptoms include Neurontin and Topamax for sleep and anxiety, beta blockers for physical symptoms such as palpitations, and Atarax, an antihistamine, for insomnia and anxiety.

SUBOXONE FOR OPIATE AND OPIOID ADDICTIONS 

For opioid (oxycodone, Oxycontin, Percocet) and opiate (Heroin, Morphine) addictions, Suboxone can be a life saving medication. Treatment with Suboxone is known as Opioid Agonist Therapy (OAT). It is an opioid that is taken as a daily dose in place of the opioid or opiate being abused. Suboxone is also used for outpatient detoxification, or medically supervised withdrawal, to wean patients off from opioids and opiates. Suboxone can be thought of as a much safer and more convenient alternative to methadone. It can be prescribed in a doctor’s office, and filled at a pharmacy just like any other prescription. Due to its unique properties, Suboxone has all of the positive psychological effects of opioids, and none of the negative psychological effects.

ALCOHOL ADDICTION

GABA DRUGS

Stimulation of the GABA-A receptor by alcohol is responsible for alcohol’s anti-anxiety and calming effect. This is the same receptor that is stimulated by sedatives such as Valium and Xanax. In fact, alcohol can be thought of as liquid valium, and Valium can be thought of as freeze dried alcohol. In treating alcoholism, there is a large group of highly functioning professionals, business owners, and working people, who have very stressful jobs, with long hours, who do not drink during the day. Instead, they start drinking immediately after work. Their drinking is heavily driven for the relief of anxiety, tension, and to decompress from the stressors of the day. In treating other alcoholics, there are many with anxiety disorders who use alcohol as their medication to deal with their crippling symptoms. Two medications that I prescribe which work on the GABA system are baclofen (most effective in my experience) and Neurontin (second most effective in my experience). Both medications basically work by treating anxiety. They also provide after work relief of  tension and stress that alcohol would usually provide. These effects are accomplished minus the intoxicating effects of alcohol.

NALTREXONE AND THE SINCLAIR METHOD

One of the receptors that alcohol stimulates is the mu-opioid receptor. This is the same receptor that is stimulated by narcotic pain medications such as Percocet and Vicodin. Activating this receptor causes a release of dopamine in the brain. Dopamine is a neurotransmitter that is responsible for feelings of pleasure, reward, and euphoria. Naltrexone is a medication that is a mu-opioid receptor antagonist, meaning that it blocks the receptor. If a person drinks while taking this medication, the alcohol will have a much less pleasurable effect. With the Sinclair Method, naltrexone is prescribed in a very specific way. Patients are told to continue drinking as they normally would, but they must take the medication one hour before they start drinking. By taking the medication this way, the intense pleasure associated with drinking is diminished. The main goal with the Sinclair Method is to achieve the process of extinction for cravings for alcohol. With extinction, when a behavior which was pleasurable and positively reinforcing, becomes less pleasurable and less positively reinforcing, the behavior gradually stops occurring. This gradual process eventually leads to less cravings and less desire for alcohol. The goal with the Sinclair Method is to eventually enable people to either stop drinking or to moderate their drinking.

If you would like more information about alcoholism treatment, call me directly for a phone consultation at (646) 713-6578. Thank-you.

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  • He is a man who has a clear understanding of the mentality of this delicate situation. His professionalism and knowledge is unrivaled. He literally has changed my life and turned it around and I am now headed in the direction that I have always should have been headed towards. He is an expert in the field and I basically owe him for giving me my life back. He is extremely respectful and tells it how it is which is what you need with this type of treatment. I can not thank him enough.

    Anthony M

  • I can’t say enough about Dr. Kloda. I have been on Suboxone for a little under two years. I’ve always wanted to taper off, but my previous doctor did not seem interested in doing so. Instead, I think that she was just trying to keep me on it indefinitely so that she could get more office visits. I switched to Dr. Kloda, and the difference has been phenomenal. I have a very demanding and high pressure job. Dr. Kloda has been able to successfully start tapering me off, while allowing me to continue working without feeling sick. He takes his time, listens, is patient, and does not make you feel bad about yourself or judge you. I wish that I would have started Suboxone with him to begin with.

    J Greenspan

  • I feel fortunate that I found Dr. Kloda, and especially right before the holidays. He is the one that was finally able to help me stop drinking. I have been drinking my entire adult life. My drinking was getting more out of control the older that I was getting. Finally, at the age of 53yo, I have stopped drinking. It has now been one year since my last drink. Dr. Kloda prescribed baclofen for me. The baclofen actually takes away my cravings for alcohol. It even makes me feel indifferent to it. I have gone to rehab and detox a couple of times, and nothing has ever worked for any extended period of time. It is amazing that with just one presciption, along with counseling by Dr. Kloda, my life has really turned around.

    I enjoy working with Dr. Kloda. He is not formal or stuffy. I have never felt judged by him, and I think that he genuinely cares about his patients. His approach to addiction treatment is very open minded. I think that he is an unconventional guy, which I believe makes him very good at what he does.

    Mike C

  • Smart, intuitive, and actually cares about you. Highly recommended!

    Joseph B

  • I started seeing Dr. Kloda for alcohol abuse six months ago. I can only say I wish I’d started seeing him sooner. He is extraordinarily thorough in assessing a diagnosis and was able to start me on a course of action that has kept me away from alcohol from the moment I went to his office. And, for me, the process has been surprisingly easy. This will likely not be the same result for everyone, but for those it works for, my goodness, it works well. I have actually not wanted alcohol since I started the treatment.

    I’ve seen comments about cost but I can only ask you to do a cost benefit analysis. The immediate savings I’ve seen from not buying alcohol combined with the longterm savings of reclaiming my health more than make up for the cost of seeing Dr. Kloda. In addition, there are the unseen future costs – court costs, hospital bills, loss of income, etc. – that are too often part of the equation with alcohol addiction. I feel like this was an investment that provide immediate and longterm returns.

    I thank Dr. Kloda every time I see him and I do it publicly here as I am truly thankful for the help he has given me. I have my life back and I owe it to him.

    Paul N, New York NY

  • Dr. Kloda is an experienced and well versed doctor. He is very empathetic with his patients and understands their needs. He has helped me a great deal with a slow Valium taper. He constantly monitors your progress. He is available by phone anytime and a great doctor.

    Chris H, New York NY

  • Dr. Kloda has been treating me with Suboxone for the past six months. My addiction to Percocet was getting worse, and I was becoming scared. I tried 12-step AA and NA meetings, but they were definitely not for me. I was eventually referred to Dr. Kloda by a co-worker, who is also a current patient of his. He came highly recommended, and I have been delighted with my treatment. Most importantly, I have found him to be extremely competent. He is also a nice guy who seems to genuinely care about me. When he says that he is available by phone seven days per week, he really means it! I have zero complaints – praises only!

    M Pryce, New York NY

  • Ok so some of the reviews are still skeptic and yes it is not cheap. But Dr Kloda is helping my wife. Her original dr who put her on the Rx drug did not know how to fix it and another Dr who had years of experience wanted to up her dose and give her more addictive drugs. Then there was the rehab places that wanted to take her out of state without her family. So that wasn’t working for us. We had serious trust issues with every Dr that we talked to.

    With lots of internet research she found Dr Kloda. After a few conversations with him she studied the Ashton method and found she wanted to go down this road.

    We find Dr Kloda to be extremely knowledgable about this method and about the chemical interactions on the various drugs that replaced her addictive drug. She has been doing well with his help and is almost done with the addictive drugs. Each session is an analyst of her well being and if she can reduce that week. Scripts are written and med boxes are filled. Outside of the sessions Dr Kloda is always available by phone for emergencies or if we have questions big or small. Other reviewers stated he only cares about the money and the TV fame. We found Dr Kloda cares a great deal about the person. He totally understands what we both are going through and is always there for my wife and I.

    Jeffrey R, Brooklyn NY

  • As much as I tried to quit cigarette smoking on my own, I had always gone back to it. It’s a horrible habit and I know it has terrible health consequences so I finally decided to get some professional help from someone who knows how to deal with all sorts of addictions from both the medical and psychological standpoint. Dr. Kloda helped me finally kick the cigarette habit; without him, I would have still being smoking myself to death. I really liked the fact that he spends a lot of time with you during his visits; I never felt rushed.

    Helen A, New York NY

  • I do not usually write many online reviews but on occasion I find a retailer or service provider that really is exceptional or is horrible enough that I feel I need to write a review.

    The reason I am writing this particular review is because Dr. Kloda is an exceptional Doctor.

    My background as an addict is extensive , and for these reasons I feel that I have a certain level of authority when if comes to Doctors and recovery. I’ve been in recovery in one form or another on and off for almost 20 years and I have been on Suboxone for about five years, I spent most of this time in recovery directed by two other doctors that prescribe Suboxone.

    Thomas V, Fulton NY

  • I was surprised to see a two star review for Dr. Kloda, so I am writing a five star review in response. Dr. Kloda was recommended to me by another patient of his, and he has been treating me for the past two years. I have found him to be extremely competent, genuinely caring, and available for questions and concerns.

    His office charges are in line with many other physicians in Manhattan, and you definitely get your money’s worth. He does not just write prescriptions. In addition to meds, He talks to you and does addiction counseling, as well as give you general advice and support.

    Joseph B, New York NY

  • As a patient, I can attest to Dr. Kloda’s expertise and practice and excellence. He is a remarkable physician. He is attentive, supportive, and is at the cutting edge of addiction medicine. He is broad minded in his approach and treats each of his patients with understanding and concern. He is extremely thorough and appreciates differences, both physiological and psychological. I found him remarkably intuitive and he means it when he says he is available by phone–and boy sometimes you need that. I found out recently that he is sometimes called on to speak to other doctors and psychiatrists about all kinds of addictive treatments and meds, including benzo’s–which so few doctors know about. I was fortunate to find him. I highly recommend him. And no, I have no affiliation with him or his practice other than as a patient.

    Jon F, Manhattan NY