Dr. Van Hoozen does subspecialize in the treatment of drug addiction. Medications are now available that will help with the treatment of drug addiction. Along with these prescription medications patients are also strongly encouraged to have a counselor who deals with drug addiction.
Suboxone (Buprenorphine with Naloxone). This is a semi-synthetic opiate with a mixture of agonist and antagonist nuroceptors. Its primary use is to treat heroin and other narcotic addictions and has equal effectiveness as Methadone in the treatment of narcotic addiction but doesn’t require a daily visit to a Methadone clinic for dosage. Patients should be warned that they are recommended not to drink at all or with extreme moderation and should not be taking diazepams. Diazepam’s are anti-anxiety medications such as Xanax (alprazolam) and Ativan (lorazepam and Clorazepam). The basic idea is to provide a narcotic controlled substance with an antagonist Naloxone to avoid respiratory depression that occurs often with street drugs and overuse of prescription drugs. Respiratory depression can lead to the patient’s death. Suboxone allows the patient to function normally in our society and not have to be dependent on illicit drugs.
The way this works is that patients with drug addiction problems will present to our office for an intake visit to make sure they are appropriate for this type of treatment and that they understand all the ramifications thereof. Then they will be set up for an induction appointment. This is when they are asked to come into our office in a state of withdrawal and they are given increasing doses of Suboxone to eventually titer them up to their actual daily dose. Although this will be done on the first and maybe second visit, it sometimes takes upwards of 2-3 months to have it titrated to the patient’s own specifications.
The patient should expect to spend 6 hours of time in our office on the day of the induction appointment. Patient will eventually be sent home and asked to return the next day. Once tittering is completed, usually by the second day, patient will be asked to come in weekly for the first 2 months and then biweekly for the next 2 months. Urine drug screens will be done during each visit during the first 4 months.
Patients will need to be seen monthly after this to get their monthly prescription of Suboxone. Prior to that they will be given daily doses, weekly doses, and then biweekly doses by prescription. Patient is expected to get initial liver enzymes levels and will have to get additional comparison testing throughout their treatment.
Patients should be aware they will be subjected to random pill counts. Patients who have previously seen other doctors outside our area who wish to see a more convenient physician for treatment should make an initial entrance appointment and decisions will be made based on their previous treatment and records to decide at what phase of the post initial treatment program they should be started at.
If you have any questions, please feel free to contact our office. Realize that with Suboxone we are limited to the amount of patients we can take care of on an active basis.
Vivitrol is a medication that is injected monthly to treat both alcoholism and narcotic addiction. This medication is pure opiate antagonist and is supposed to reduce the cravings for narcotics by 75% and the craving for alcohol by 90%.
Patients wishing to use Vivitrol have to be off narcotics for at least 7-10 days and alcohol for at least 24 hours. This is an injection that is given monthly upwards of 6 months to 1 year. After that period if patients want to go off the Injection form of Naloxone they can do so or be transitioned to an oral form at that time. Patients will come in and be expected to give a urine drug screen at that time. Liver enzymes will also be monitored initially as well as during the monthly treatment.
The way this medication works is that it decreases the desire to use narcotics and alcohol but patients should be aware that if they do use narcotics that it blunts the effects of the narcotic dose initially and if the system is overwhelmed (patient takes more narcotics than they usually do) then the patient can go into respiratory distress and it can be fatal. Patients can use other medications that are non-narcotics. Patients will also be asked to carry a bracelet ID to make sure that medical personnel know that they are on this mediation. This doesn’t control desires for other drugs such as benzodiazepams, cocaine, marijuana or amphetamines including meth. It is strictly for opiate and alcohol treatment.