In my opinion, the addiction to opiates and opioids, when used intravenously, is an addiction that is different than when they are taken orally or inhaled nasally. Patients have described to me the entire process of injecting opiates as being sexual in nature. The whole procedure for preparing the drug is equivalent to sexual foreplay. Dissolving the pill or liquid in water, heating it up, preparing the syringe, “tying up”
Remeron is an antidepressant that is used in the treatment of anxiety and depressive disorders. It works by increasing the amount of the neurotransmitters serotonin and norepinephrine in the brain. Remeron also has antihistaminic properties (similar to Benadryl), which helps with anxiety and insomnia. The two main side effects that limit the use of Remeron are sedation and weight gain. I do not prescribe it to people that are of
This is Dr. Stuart Kloda, and I am an addiction medicine physician in New York City. I have a solo private practice located at Columbia Circle, and I treat all drug and alcohol addictions. Personal and professional relationships are some of the first things to be affected by addiction. Suboxone is a medication that I prescribe to treat addiction to narcotic painkillers such as oxycodone, Oxycontin, Percocet, Vicodin, and Lortab.
Having been in private practice now for two years, I have started to notice certain trends in patients’ responses to treatment. One thing that has really made an impression on me are the positive psychiatric effects that Suboxone has in some patients. I tend to notice this in a subcategory of patients that have histories of depressive and anxiety disorders that are independent of their drug use. This subcategory of
Some of the patients that I discussed in my previous blog post discussing Suboxone outpatient detox eventually want to taper off of Suboxone (buprenorphine/naloxone). These patients had started using oxycodone or Oxycontin, and basically did not realize what they were getting themselves into until it was too late. I feel that it is reasonable to eventually taper off if the patient is having their first experience with opioid addiction, is
Suboxone outpatient detox treatment is used for dependence on opioids and opiates. When I start a patient on Suboxone (buprenorphine/naloxone), I always recommend that he or she stay on the medication at full dose for at least two months. These two months allow the patient to develop a new lifestyle and routine off of opiates and opioids of abuse. It allows time for personal and business relationships to improve. After
Naltrexone is a medication that comes in the form of a tablet that is taken daily, or as an injection that is given monthly (Vivitrol). Naltrexone works by blocking the mu-opioid, or narcotic pain killer receptor. Alcohol exerts it’s pleasurable effects by stimulating a few different receptors. Surprisingly, one of the receptors that alcohol stimulates is the mu-opioid receptor. In stimulating this receptor, a surge of the neurotransmitter dopamine is
Back to blogging after a long period of absence. I might continue with AA at a later date, but am going to switch to different topics for right now….. Naltrexone is a medication that comes in the form of a tablet that is taken daily, or as an injection (Vivitrol) that lasts for four weeks. Naltrexone is used for the treatment of opioid and alcohol dependencies. It acts as a
On the second day of Suboxone induction, the patient comes to my office feeling well and out of opioid withdrawal. I then have the pharmacy deliver the dose of Suboxone that he or she finished at the day before. I typically see patients again in one week. After that it can be every two weeks or every month. It is unusual for me to need to see patients weekly, as
On the day of Suboxone induction, I make sure that patients are in opiate withdrawal. This is accomplished by patient history and physical exam. I then order the Suboxone film from the pharmacy. The film form of Suboxone is similar to a Listerine breath strip, except it is absorbed only if you put it under your tongue. I am fortunate to have a privately owned pharmacy that I work with.