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Dr. Kloda's Addiction Medicine Category Articles

Naltrexone for Alcohol Addiction

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

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My Experience with Prescribing Naltrexone for Opioid Dependence

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

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Second Day of Suboxone Induction

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

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First Day of Suboxone Induction – Part II

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.

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First Day of Suboxone Induction – Part I

Suboxone Induction Induction is the process where the patient is induced, or started, on Suboxone. Patients must stop using short acting opiates and opioids (e.g. oxycodone and Heroin) for 24 hours before induction. If a patient is using a long acting opioid such as Oxycontin, he or she must stop using it for 48 hours before induction. Patients need to be somewhere between mild to moderate withdrawal before starting Suboxone.

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Initial Evaluation for Suboxone Maintenance

Suboxone maintenance therapy is where a daily dose of medication is given in order to stabilize and treat opiate and opioid addictions (e.g. oxycodone, Oxycontin, or Heroin). Induction is the process of starting the medication. Different physicians do their inductions in different ways. Here, I will discuss the way that I do inductions in my medical practice. The first day is an initial evaluation to determine: 1. If the patient

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Part III – Hallucinogen Persisting Perception Disorder (HPPD)

Medication treatment for HPPD includes serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft. In addition to treating the anxiety disorder, SSRIs treat HPPD in another way. Hallucinogens such as LSD (“acid”) and psilocybin (“mushrooms”) exert their effect at one subtype of the serotonin receptor. When a patient takes an SSRI, their number of serotonin receptors decreases. With less serotonin receptors around, HPPD symptoms are reduced. Long-acting benzodiazepines (“benzos”) such

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Part II – Hallucinogen Persisting Perception Disorder (HPPD)

HPPD can be thought of as an anxiety disorder due to an acquired synesthesia. Synesthesia is defined as a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces the visualization of a color. HPPD can also be thought of as a form of Post-Traumatic Stress Disorder (PTSD) in response to a bad hallucinogenic “trip”. Cognitive behavioral therapy (CBT) for

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Part 1 – Hallucinogen Persisting Perception Disorder (HPPD)

Hallucinogen persisting perception disorder, or HPPD, is a disorder characterized by the continual presence of sensory disturbances, usually visual, that are reminiscent of those generated by the ingestion of hallucinogens such as LSD. HPPD is different from “acid flashbacks” in that they are relatively permanent from day to day, while flashbacks are transient. The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) lists the following criteria for the diagnosis of

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Medications for Alcohol Addiction

This is Dr. Stuart Kloda. I am an addiction medicine physician in New York City, and I have a solo private office located at Columbus Circle. Today, I am going to be talking about medications that are used in the treatment of alcohol dependence. One of the receptors that alcohol stimulate is the mu opioid receptor. This is the receptor that narcotic pain medications such as Percocet and Oxycontin also

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