Tampa Bay Detox

NALTREXONE THERAPY (Revia)
 

1. What is Naltrexone Therapy and why is it important?
2. What is the Naltrexone implant?
3. Are there any risks and side effects?
4. How long should I be on Naltrexone therapy?
5. What happens after Naltrexone Implantation?
6. What is the risk of overdosing following treatment?
7. Naltrexone Pellet Program

1. What is Naltrexone Therapy and why is it important?

We believe that the ultimate goal of any detoxification program is to have patients on Naltrexone. Naltrexone is a pure narcotic antagonist. That is, it attaches to the endorphin or opiate receptors in the brain and completely blocks them. This means that if someone tries to use any kind of opiate while they are on Naltrexone, they feel no effect because all of the receptors are completely blocked. While Naltrexone is in the body, it is virtually impossible to relapse. Naltrexone has been available as an oral tablet since the late 1970s. However, it only has duration of action of around 24 to 48 hours and in practice, it has been found that most patients either forget or purposefully choose not to take their medicine. Then in a short period of time they go back to using Heroin. Higher success rates have been achieved when patients are forced to take their medicine, either by concerned family members, or by a court system such as probation or parole. For this reason, we strongly recommend the Naltrexone implant. We believe that Naltrexone therapy should be given for 12 months. This gives the patient a chance to have their brain physically recover from the damage from the narcotics. It also gives the patient an excellent chance to begin on the road to recovery.

2. What is the Naltrexone implant?

This is a special formulation of Naltrexone, which is designed to release slowly over a 6-10 week period. It is placed under the patient's skin and so it is effective and does not allow the patient to forget or skip their medicine. We highly recommend it because it is so effective. There are some potential side effects with the Naltrexone Implant including infection, irritation or inflammation and sometimes even some skin breakdown over the implant site. A licensed pharmacist in New Jersey manufactures the implant for us. While the Naltrexone implant has not yet been submitted to the FDA for approval, the medications it contains are fully approved by the FDA.

Are there any risks and side effects?

As with any medical procedure, there are some risks and potential problems. There are some risks associated with the Naltrexone pellet as mentioned above. There is some risk of taking the Naltrexone Therapy before the detoxification is complete. If taken too early, Naltrexone will push people into a complete withdrawal state and if the detoxification is not completely over, then there will be some withdrawal symptoms. If done too early, these can be severe. The timing of the Naltrexone Therapy is discussed in detail with each patient individually. It is to be expected that patients will feel some withdrawal symptoms but our treatment program should minimize these.

How long should I be on Naltrexone therapy?

We believe strongly that patients should be on Naltrexone therapy for at least twelve months. This prevents them from relapsing back to narcotic use and gives the patients a chance to start making changes in their lives and building up a support program. We highly recommend at least two Naltrexone implants and then switching to oral Naltrexone for the balance of 12 months.
 

What happens after Naltrexone Implantation?

We believe strongly that detoxification without appropriate follow-up and treatment is almost always unsuccessful. Our full time counselor meets with all our patients and their families to determine the optimum treatment program following detoxification. We insist that all of our patients be willing to participate in an appropriate treatment program as part of their after- care. This should include 12-step programs and professional therapy. We expect that all patients will identify and begin therapy with an appropriate substance abuse treatment facility in their area as soon as possible following the implantation. They will also need to be involved with a physician who specializes in substance abuse.
 

What is the risk of overdosing following treatment?

Studies show that there have been patients who have died following periods of abstinence from narcotics. This appears to be caused by lack of tolerance following a period of abstinence. Naltrexone is extremely good at making people abstinent but when the Naltrexone wears off, patients have a very low tolerance. It is extremely easy for them to use too much Heroin or other opiates and have an overdose which can be fatal. Patients need to understand this clearly and be extremely careful if they do relapse back to narcotic use. In my experience, the fatal overdoses that we are aware of have usually not happened on the first time of using and so patients need to be very careful for at least the first month. It is also may be possible to overdose if the patients try to override their Naltrexone therapy.
 

Naltrexone Pellet Program

First implant on seventh day clean after a naltrexone tablet and/or a negative naloxone challenge Second pellet before 60 days (no naloxone challenge necessary) Criteria to stop pellet injections:

1. 90 days clean
2. Regular attendance at Twelve Step meetings
3. A sponsor
4. A job or school (basically a life)
5. Trust reestablished in family and friends
6. You trust yourself (you can always go back on a pellet at any time)

Pellet therapy is replaced with oral therapy for a short time. A tablet is carried at all times and taken for urges or any positive thoughts regarding mood-altering substances. If tablets are needed daily or major life situations i.e. weddings or funerals occur pellet therapy is reconsidered.

Meeting attendance continues with office visits periodically and whenever necessary.

Wound Care: Keep your dressing clean and dry for 48 hours. NEVER apply a heating pad to the wound site, since severe burns may occur on the skin. You must leave the bandage on for 24-hours. Do NOT soak in a bath/tub. If you shower, you must cover the wound with plastic to keep dry. After bandage has been removed, you must wash the site gently with warm soap water and pat or air dry. You may apply a small amount of antibacterial ointment (Neosporin) for 2 days. You may take Motrin as directed for any pain associated with the implant.