This is Dr. Stuart Kloda, and I am an Addiction Medicine physician in NYC. I have a solo private practice located at Columbus Circle. Today I am going to talk about the outpatient detoxification from narcotic painkillers such as oxycodone, Percocet, Vicodin, and Lortab, as well as outpatient detoxification from opiates such as Heroin and Morphine. Drug and alcohol detoxification is medically supervised withdrawal. In medically supervised withdrawal, a long acting form of a medication that is in the same class as the drug being abused is given until withdrawal symptoms are alleviated. The medication is then given in doses that are gradually tapered down. This allows for a more comfortable detox. Suboxone is an excellent medication for the outpatient detoxification from narcotic painkillers such as oxycodone and Percocet. It is considered to be very safe, with a low risk of overdose. Suboxone is also unique in that in order to start the medication, the patient has to be somewhere between early to moderate withdrawal. If the medication is started too early, it will cause precipitated withdrawal, which is more severe than regular withdrawal. I use a number of medications to make patients more comfortable overnight before they start Suboxone the next day. Clonidine is an old blood pressure medication that treats symptoms such as sweats, chills, and shakes. I also use the class of medications called benzodiazepines, such as Klonopin, Valium, and Ativan. These alleviate anxiety and insomnia, which are usually a big part of the withdrawal syndrome. Hyoscyamine is also a great medication prescription medication for abdominal cramping and diarrhea. Phenergan is another medication that tends to work very well for nausea and vomiting.
Suboxone (buprenorphine / naloxone) is a medication approved for the office based treatment of opiate (e.g. Heroin) and opioid (e.g. oxycodone, Percocet, Vicodin, Lortab) addictions. Suboxone can be thought of as a much safer, more convenient, and discreet alternative to methadone maintenance. Patients receive a prescription which can be filled at any pharmacy just like other types of medications. In Suboxone (buprenorphine / naloxone) maintenance, the medication is taken at home as a daily dose in place of the opiate or opioid being abused. A stable dose is maintained, in contrast to the cycle of tolerance with escalating doses for the same effect, withdrawal symptoms in between doses, and drug seeking behavior for the opiate or opioid being abused.
If you have ever wondered, “Is there a drug to help with Oxycontin addiction?”, or “Where can I find Suboxone information?”, Dr. Kloda is able to help you obtain the information that you need. Dr. Kloda is a Suboxone doctor taking patients who will prescribe Suboxone for you under medical supervision. If you are already on Suboxone (buprenorphine / naloxone) maintenance, Dr. Kloda can continue your treatment. Kindly note that in order to do so, he will require consent to speak with your previous prescribing physicians.
On the other hand, some patients choose to not go on Suboxone maintenance. Their goal is to do a medical detox off of Oxycontin or heroin and remain opioid or opiate free. A number of physicians believe that this second option is not advisable. They believe that all patients should go on Suboxone maintenance for an extended period of time. However, Dr. Kloda does not agree that all patients require extended periods of maintenance. Instead, he chooses to customize the treatment plan to each individual patient.
It is important to note that Suboxone (buprenorphine / naloxone) blocks the effect of most, but not all, opiates and opioids. In the event that you need to schedule an elective surgery or dental procedure, it is important to have a knowledgeable Suboxone prescribing physician to coordinate pain control with your surgeon or dentist.
Call Dr. Kloda for a free phone consultations at (646) 713-6578.