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Addiction Medicine Blog

Dr. Kloda's Addiction Medicine Blog

Stuart Kloda, MD – Xanax Detox – NYC

This is Dr. Stuart Kloda. I’m an addiction medicine physician in New York City. I have a solo private office located at Columbus Circle. Today I’m going to be talking about the outpatient detoxification, or medically supervised withdrawal, from the class of medications known as the benzodiazepines. These are drugs such as Xanax, Klonopin, Valium, and Ativan. They are frequently prescribed for anxiety and for patients with anxiety disorders. Xanax is one of the most addictive of the benzodiazepines. So for the purposes of this video, I’m going to be discussing the outpatient detox from Xanax in patients with anxiety disorders.

The withdrawal symptoms from a drug are the exact opposite of the effect of the drug. So if Xanax is prescribed for a patient with Generalized Anxiety Disorder, and the Xanax is taken away, the anxiety from that disorder is going to come out and rear its ugly head. However, in addition, with the detox, there’s going to be withdrawal symptoms from withdrawal anxiety. There can be withdrawal anxiety, of course, during the detox, however, there can be anxiety immediately after the detox, as well as for a longer period of time afterwards. This being acute, post-acute, and protracted withdrawal. Benzodiazepine detoxification can be extremely difficult for patients because the anxiety level can be so high. So it’s important to have a close therapeutic alliance between the patient and the physician. I accomplish this in my medical practice with weekly office visits, if not more, and by being available on my phone. I am available to my patients seven days a week on my cell phone, within reason of course.

The way to do a benzo detoxification is to take a long acting benzo such as Valium or Klonopin, and substitute it for the short acting benzo Xanax. So a dose of Valium or Klonopin is calculated that is roughly equivalent to the dose of Xanax being abused. The taper is started at that dose, and then the dose is gradually and slowly decreased over a long period of time. It is really important to taper down very slowly, otherwise the taper will be destroyed and the patient will not be able to complete it. Going too quickly will cause way too much anxiety to come out. Now I manage the withdrawal anxiety with a few things. I use a class of medications that work at the same receptor as the benzodiazepines, the GABA-A receptor. However, they don’t have the addictive properties and negative sequelae as using Xanax at high doses. So, as the taper dose decreases, I start adding the medications that I use to balance out the withdrawal anxiety.

I also make sure that the primary anxiety disorder is treated. So for things such as Panic Disorder, Social Anxiety Disorder, and Generalized Anxiety Disorder, the first line agents are the serotonin reuptake inhibitors such as Celexa, Zoloft, and Prozac, as well as the serotonin norepinephrine reuptake inhibitors such as Cymbalta and Effexor.

I have spoken about the psychological anxiety, however, there can also be a somatic anxiety as part of the withdrawal symptoms. The word somatic means body, so some patients will have palpitations, chest tightness, and even a feeling they want to crawl out of their skin. Beta blockers can be very effective for this. Beta blockers are a cardiac medication used to slow the heart rate down and control blood pressure. However, it also calms the nervous system down.

The other thing that I strongly encourage during benzo detox, and during any detoxification, are weekly acupuncture treatments. I have found acupuncture to be extremely effective, and a really great complement to the treatments that I just outlined. In addition, I highly encourage exercise, and I always encourage a lot of gym memberships.

The last thing I’m going to mention is the Ashton Method. The Ashton Method is a method of benzo detoxification from England that essentially is a long slow taper using Valium instead of Klonopin, which is more commonly used in the United States. I have had a number of people contact me and ask me if I use the Ashton Method. The answer is yes, I do use the Ashton Method. However, I’ve also had a number of people contact me and say that it is the only way to do a successful benzo detox. I have to say that for quite a while, I have been doing long slow tapers with Klonopin with a lot of success, in part because of the medications that I use. So while I do use the Ashton Method, I at the same time cannot discount my clinical experience and many happy patients.

If you would like more information, you can call and speak with me directly at (646) 713-6578. Thank you.

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  • He is a man who has a clear understanding of the mentality of this delicate situation. His professionalism and knowledge is unrivaled. He literally has changed my life and turned it around and I am now headed in the direction that I have always should have been headed towards. He is an expert in the field and I basically owe him for giving me my life back. He is extremely respectful and tells it how it is which is what you need with this type of treatment. I can not thank him enough.

    Anthony M

  • I can’t say enough about Dr. Kloda. I have been on Suboxone for a little under two years. I’ve always wanted to taper off, but my previous doctor did not seem interested in doing so. Instead, I think that she was just trying to keep me on it indefinitely so that she could get more office visits. I switched to Dr. Kloda, and the difference has been phenomenal. I have a very demanding and high pressure job. Dr. Kloda has been able to successfully start tapering me off, while allowing me to continue working without feeling sick. He takes his time, listens, is patient, and does not make you feel bad about yourself or judge you. I wish that I would have started Suboxone with him to begin with.

    J Greenspan

  • I feel fortunate that I found Dr. Kloda, and especially right before the holidays. He is the one that was finally able to help me stop drinking. I have been drinking my entire adult life. My drinking was getting more out of control the older that I was getting. Finally, at the age of 53yo, I have stopped drinking. It has now been one year since my last drink. Dr. Kloda prescribed baclofen for me. The baclofen actually takes away my cravings for alcohol. It even makes me feel indifferent to it. I have gone to rehab and detox a couple of times, and nothing has ever worked for any extended period of time. It is amazing that with just one presciption, along with counseling by Dr. Kloda, my life has really turned around.

    I enjoy working with Dr. Kloda. He is not formal or stuffy. I have never felt judged by him, and I think that he genuinely cares about his patients. His approach to addiction treatment is very open minded. I think that he is an unconventional guy, which I believe makes him very good at what he does.

    Mike C

  • Smart, intuitive, and actually cares about you. Highly recommended!

    Joseph B

  • I started seeing Dr. Kloda for alcohol abuse six months ago. I can only say I wish I’d started seeing him sooner. He is extraordinarily thorough in assessing a diagnosis and was able to start me on a course of action that has kept me away from alcohol from the moment I went to his office. And, for me, the process has been surprisingly easy. This will likely not be the same result for everyone, but for those it works for, my goodness, it works well. I have actually not wanted alcohol since I started the treatment.

    I’ve seen comments about cost but I can only ask you to do a cost benefit analysis. The immediate savings I’ve seen from not buying alcohol combined with the longterm savings of reclaiming my health more than make up for the cost of seeing Dr. Kloda. In addition, there are the unseen future costs – court costs, hospital bills, loss of income, etc. – that are too often part of the equation with alcohol addiction. I feel like this was an investment that provide immediate and longterm returns.

    I thank Dr. Kloda every time I see him and I do it publicly here as I am truly thankful for the help he has given me. I have my life back and I owe it to him.

    Paul N, New York NY

  • Dr. Kloda is an experienced and well versed doctor. He is very empathetic with his patients and understands their needs. He has helped me a great deal with a slow Valium taper. He constantly monitors your progress. He is available by phone anytime and a great doctor.

    Chris H, New York NY

  • Dr. Kloda has been treating me with Suboxone for the past six months. My addiction to Percocet was getting worse, and I was becoming scared. I tried 12-step AA and NA meetings, but they were definitely not for me. I was eventually referred to Dr. Kloda by a co-worker, who is also a current patient of his. He came highly recommended, and I have been delighted with my treatment. Most importantly, I have found him to be extremely competent. He is also a nice guy who seems to genuinely care about me. When he says that he is available by phone seven days per week, he really means it! I have zero complaints – praises only!

    M Pryce, New York NY

  • Ok so some of the reviews are still skeptic and yes it is not cheap. But Dr Kloda is helping my wife. Her original dr who put her on the Rx drug did not know how to fix it and another Dr who had years of experience wanted to up her dose and give her more addictive drugs. Then there was the rehab places that wanted to take her out of state without her family. So that wasn’t working for us. We had serious trust issues with every Dr that we talked to.

    With lots of internet research she found Dr Kloda. After a few conversations with him she studied the Ashton method and found she wanted to go down this road.

    We find Dr Kloda to be extremely knowledgable about this method and about the chemical interactions on the various drugs that replaced her addictive drug. She has been doing well with his help and is almost done with the addictive drugs. Each session is an analyst of her well being and if she can reduce that week. Scripts are written and med boxes are filled. Outside of the sessions Dr Kloda is always available by phone for emergencies or if we have questions big or small. Other reviewers stated he only cares about the money and the TV fame. We found Dr Kloda cares a great deal about the person. He totally understands what we both are going through and is always there for my wife and I.

    Jeffrey R, Brooklyn NY

  • As much as I tried to quit cigarette smoking on my own, I had always gone back to it. It’s a horrible habit and I know it has terrible health consequences so I finally decided to get some professional help from someone who knows how to deal with all sorts of addictions from both the medical and psychological standpoint. Dr. Kloda helped me finally kick the cigarette habit; without him, I would have still being smoking myself to death. I really liked the fact that he spends a lot of time with you during his visits; I never felt rushed.

    Helen A, New York NY

  • I do not usually write many online reviews but on occasion I find a retailer or service provider that really is exceptional or is horrible enough that I feel I need to write a review.

    The reason I am writing this particular review is because Dr. Kloda is an exceptional Doctor.

    My background as an addict is extensive , and for these reasons I feel that I have a certain level of authority when if comes to Doctors and recovery. I’ve been in recovery in one form or another on and off for almost 20 years and I have been on Suboxone for about five years, I spent most of this time in recovery directed by two other doctors that prescribe Suboxone.

    Thomas V, Fulton NY

  • I was surprised to see a two star review for Dr. Kloda, so I am writing a five star review in response. Dr. Kloda was recommended to me by another patient of his, and he has been treating me for the past two years. I have found him to be extremely competent, genuinely caring, and available for questions and concerns.

    His office charges are in line with many other physicians in Manhattan, and you definitely get your money’s worth. He does not just write prescriptions. In addition to meds, He talks to you and does addiction counseling, as well as give you general advice and support.

    Joseph B, New York NY

  • As a patient, I can attest to Dr. Kloda’s expertise and practice and excellence. He is a remarkable physician. He is attentive, supportive, and is at the cutting edge of addiction medicine. He is broad minded in his approach and treats each of his patients with understanding and concern. He is extremely thorough and appreciates differences, both physiological and psychological. I found him remarkably intuitive and he means it when he says he is available by phone–and boy sometimes you need that. I found out recently that he is sometimes called on to speak to other doctors and psychiatrists about all kinds of addictive treatments and meds, including benzo’s–which so few doctors know about. I was fortunate to find him. I highly recommend him. And no, I have no affiliation with him or his practice other than as a patient.

    Jon F, Manhattan NY