What is rapid opiate detox? Does it really work, and can it be safe? We review best practices in rapid opiate detox with members of The Waismann Method® Medical Group and invite your questions about rapid detox from opiates at the end.
Opiate receptor antagonists during detox: safe or not?
Today, we talk with some of the most experienced and successful practitioners of rapid opiate detox, The Waismann Method® Medical Group. The Waismann Method® employs the latest forms of Rapid Opiate Detoxification, a process described by doctors over 40 years ago as accelerated opiate detoxification. In the mid 1970’s, the use of opiate receptor antagonists was first used (Blackley 1975, Resnick 1977) to cleanse opiate receptors in the central nervous system, thus reducing the length of opiate withdrawal syndrome from days to hours. This is achieved using a combination of opiate antagonists while patients are sedated.
But still, we want to investigate the practice of rapid opiate detox. Is it safe? Does it really work? We invite your additional questions about rapid opiate detox at the end.
ADDICTION BLOG: I’ll just start with our biggest question: Does rapid opiate detox work? Does the procedure make withdrawal from opiates quicker and less painful? Does it eliminate cravings?
THE WAISMANN METHOD: Absolutely. Rapid opiate detox is a process that uses opioid antagonists and sedatives to induce and speed withdrawal. The length of time required for opiates to come off of the receptors naturally, from say methadone or hydrocodone, could be anywhere from a few days to a few weeks. We achieve very similar results using our process where patients stay with us for a few days and are sedated while detoxing, which usually takes less than a couple of hours.
Regarding eliminating cravings, it’s very important to be able to differentiate between physiological and emotional cravings. In rapid detox, the antagonist medication blocks the receptors which believe they are full. Thus, eliminating the physical cravings, or what some patients describe as the feeling that they are coming out of their skin. This is a tremendous step toward real recovery. With that said, there is an emotional component, where many patients might be self-medicating in order to mask physical or emotional pain. For those patients, proper assessment and post care with the appropriate professional is extremely helpful in minimizing pain and cravings.
ADDICTION BLOG: Does rapid opiate detox eliminate cravings for opiates over the long-term? If not, what’s the best way that former opiate addicts can deal with cravings?
THE WAISMANN METHOD: Over time, opiates change the brain and adversely affect the brain’s production of the neurotransmitters dopamine and noradrenaline. This leads to opiate dependence, tolerance, addiction and cravings. Rapid opiate detox reverses the physical dependence on opiates and the short-term physical cravings associated with withdrawal. Longer-term opiate cravings are caused by the brain’s memory of the good feelings associated with drug use or the circumstances and environment in which they occurred.
Post-detox, it’s recommended that patients take naltrexone for up to nine month to treat the long-term cravings. Naltrexone blocks the opiate receptors and prevents cravings while the brain centers and neurotransmitters normalize. Because cravings are blocked, the risk of relapse decreases. Patients can then pursue treatment to identify and correct the underlying psychological and social issues which led to the opiate abuse.
ADDICTION BLOG: We’ve read a National Institute of Drug Abuse review of a clinical study claiming that “anesthesia-assisted detox; a costly and risky approach; offers no advantage over other methods” of opiate detox. Do you think that this assessment is fair? What other clinical studies exist that argue for rapid opiate detox?
THE WAISMANN METHOD: In the Unites States, there are many procedures that fall under the catch-all terms “ultra-rapid” and “rapid opiate detox”. As a result, it is difficult to conduct a study that measures the safety and efficacy of rapid detox. The NIDA review is no exception. The ultra-rapid detox technique referenced by the study used a technique which was developed over 20 years ago involving a 4 to 6 hour procedure performed under general anesthesia and using oral Naltrexone.
The Waismann Method® of rapid detox has significantly evolved over the past 16 years. The current procedure utilizes moderate IV sedation rather than general anesthesia and is usually performed in under an hour. These changes significantly reduce the risks and discomfort associated with the procedure described in the NIDA study. In addition, not all patients are candidates for rapid opiate detox due to underlying medical or psychological issues. Modifications to the traditional Waismann Method® of Rapid Opiate detoxification are available for patients who are not a candidate for rapid detoxification utilizing IV sedation. The Waismann Method® is not a one size fits all treatment. It is customized for each patient based on their specific medical and emotional needs.
ADDICTION BLOG: The dangers and risks of rapid opiate detox are real and can include serious injury, dehydration, pulmonary/cardiac events and even death. What are the indicators that a rapid opiate detox practitioner is not safe?
THE WAISMANN METHOD: Rapid opiate detox is safe and effective when performed in the proper in-patient facility by appropriate medical professionals and when allowing for an appropriate number of days as an inpatient for pre and post detox based on each patient’s medical history. This is a medical procedure that requires appropriate pre-assessment, preparation and monitoring for several days in order to be safe. The process is rapid, effective and can be comfortable. However, it’s not a miracle, and organs and chemical balances must adjust to the new detoxified state. This takes a few days and varies based on each individual. Each case should be evaluated and treated individually to apply responsible medicine.
A few things that we believe are a must:
- The Waismann Method® is performed in a JCHAO accredited full-service hospital.
- Patients are monitored by licensed medical professionals around the clock.
- Patients undergoing rapid detox with sedation are monitored in the ICU overnight and remain at least overnight in the hospital post rapid detoxification.
- Patients should be admitted at least one day prior to anesthesia detoxification for proper pre-medication and evaluation in order to have a smooth process. How patients react to medications as well as the type and amount of medication needed will need to be assessed by a proper evaluation and knowledge of the patient by our physicians. Allowing at least a day prior to the procedure and having a private room allows us to evaluate and treat patients individually.
- Inpatient post care for a few days in order to professionally help patients through the stabilizing period.
Most rapid detox patients have pre-existing underlying medical conditions. This, in part,is due to the toll that opiates take on a patient’s health such as disrupting chemical balances and organ functions. Additionally, opiates are a numbing device which masks symptoms of underlying medical issues. Because detox procedures are performed in a full-service hospital, underlying medical issues can be monitored by specialists. This setting allows for the administration of intravenous fluids and medication, laboratory studies and co-management of pre-existing medical conditions by specialists including internists, cardiologists, pulmonologists and endocrinologists. Thus, we establish safety and success without delays or transfers to other facilities.
Another factor that sets the Waismann Method® Group apart is that we detox one patient at a time while other facilities treat multiple patients side-by-side in the same room to reduced costs. Our physician’s focus is not divided among multiple patients. Detoxification is a critical time when signs of complications could be missed if physicians attend to multiple patients.
ADDICTION BLOG: What kinds of advantages do you feel rapid opiate detox offers?
THE WAISMANN METHOD: We believe it is a tremendous advantage to opiate dependent patients who can achieve full detoxification while reducing the discomfort associated with more prolonged methods. It causes patients to look for treatment instead of allowing the addiction to progress due to fear of withdrawal, fear of judgment or inability to leave family and work for long periods. Regardless of what after care or recovery treatment a patient chooses, they must be physically detoxed first. This option is safe, humane and dignified.
ADDICTION BLOG: What kinds of advantages do you feel that The Waismann Method® of rapid opiate detox offers?
THE WAISMANN METHOD: The Waismann Method® Medical Group has a comprehensive start-to-finish process that combines state of the art medical and a post-care recovery facility with various approaches based on each patient’s needs. We don’t rush patients through in order to discharge them, and we don’t have a preset protocol for detoxification or a pre-set time period for care. Our post-care process ensures a safe transition with the appropriate professional care.
ADDICTION BLOG: Is it possible that The Waismann Method® becomes a future standard for national rapid opiate detox in the U.S.?
THE WAISMANN METHOD: We hope to at least establish a protocol for safety standards for rapid opiate detox. The word “rapid” cannot supersede the importance of responsible medicine. There are a number of approaches for opiate detoxification that could and should be used when rapid detox is not appropriate due to medical, emotional or financial reasons. Rapid Opiate Detox should be performed where pre-assessment, facilities, professionals, time and proper post care is available.
ADDICTION BLOG: Priced from $17,800 to $22,800, can the cost of rapid opiate detox (Waismann Method®) be lowered? If so, how?
THE WAISMANN METHOD: These costs include 5 to 10 days of 24/7 professional inpatient care. This includes all medical care at the hospital, a stay in a private room, specialists, examinations and detoxification. It also includes an exclusive post care retreat which provides services to regulate physiological and chemical functions as well as expert monitoring to prevent complications and relapse. This is compared to other programs that charge $7,000 to $10,000 for just one day of inpatient medical care (sometimes only a few hours) and then patients are sent to hotel rooms. The Waismann Method® Treatment delivers unparalleled cared and it costs a lot less based on the quality and length of services patients received.
ADDICTION BLOG: What are some practical suggestions for after care or self-care during opiate detox? What can people do in the 7-10 days after coming off opiates to really take care of themselves, focusing on total wellness?
THE WAISMANN METHOD: Assessment is so crucial for long-term sobriety. Patients use opiates for a variety of reasons including chronic pain, anxiety, misdiagnosed depression, OCD, trauma and much more. Opiate dependence is usually a consequence of an untreated or improperly treated condition. Once the opiates are removed, the patient and their medical and mental health professionals can assess the best plan for the underlying condition. There is no single answer and there is no single plan for detoxification and after care. We work with human beings who present a variety of considerations. These must be individually addressed to build the best treatment plan possible.
ADDICTION BLOG: Finally, in terms of safety, who should NOT consider rapid opiate detox?
THE WAISMANN METHOD: Patients with severe psychiatric disorders requiring a dual diagnosis facility and patients who are not a candidate for elective surgery due to health reasons are usually not candidates for rapid detox. That’s why pre-assessment in a full-service facility is critical so that specialists can consult and provide other detoxification options if needed. This is what we call “responsible medicine”.
ADDICTION BLOG: Would you like to add anything about rapid opiate detox or The Waismann Method®?
THE WAISMANN METHOD: What we do is not a secret protocol or a specific process that is applied to all patients. What we have created is a team of medical professionals and addiction professionals headed by Dr. Michael H. Lowenstein and Clare Waismann combining the most advanced protocols and facilities to provide the most responsible, dignified and effective opiate treatment around.
We believe in respect, compassion and responsibility for the well-being of the individuals seeking our help. We have one exclusive Southern California location that treats patients from all over the world due to our reputation and comprehensive care. By treating the whole individual instead of just the symptoms, we give most patients the opportunity to achieve continued long-lasting success.