Tampa Bay Detox
NALTREXONE THERAPY (Revia)
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.
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.
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.
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.
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.
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
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:
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.
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