Do This One Thing to Stay Off Opioids Forever

Courage. Energetic determination. Stamina. All of these things contribute to our individual willpower. Willpower is the key to changing behavior. It is a critical element in working hard to achieve something. If you need willpower to accomplish something, then you are attempting a task that you feel some level of conflict about doing. Part of you knows you need or should do something, but another part of you feels resistance to doing it.

Willpower is a driving force for many patients who seek treatment at Coleman Addiction Medicine

This week, I put a 3rd naltrexone implant in my patient, Slim (not his real name). Slim sought detox treatment for his substance abuse of fentanyl-laced heroin. He spent six of his 37 years behind bars for crimes directly related to his addiction. He never wants to be inside a jail again.

Changing Your Environment for Your Health

In his earlier attempts to self-detox from opioids he tried to remain loyal to his old friends who were actively using. These were friends he spent his childhood with, many of whom are relatives. With extraordinary willpower, he was able to stick to his decision not to use when he was with them. But when stress was high, deprivation was overwhelming, and willpower waned, he relapsed.

During his last stint in prison, he worked in earnest on his sobriety. He went to every meeting that was offered and took advantage of one-on-one time with sober leaders. He made it a point to hang out with clean inmates as much as possible. He read recovery books; Even given the constraints of being in prison, he found ways to change his environment. He said that as soon as he started keeping the commitment to himself, he was rarely bothered by other prisoners to buy drugs.

He says eventually, “It was kind of like I was wearing a new set of glasses, and the only things I could see were things associated with being clean. Like everything else was filtered out. My brain felt peaceful. It was weird—but wonderful.”

The Naltrexone Implant and Post-Treatment Promises

Slim learned that changing who he spends time with, whether in or out of prison, is the most important element for his sobriety. He made commitments and promises to himself such as meeting up with the people who brought sobriety meetings to the prison (once he was released) and not contacting old friends that might still be using. 

He agreed to come every two months to get a naltrexone implant.

Naltrexone is an opioid blocker that does not cause physical dependence, unlike some other medication-assisted treatments, such as buprenorphine or methadone. The implant is roughly about the size of a vitamin pill and goes under the skin in the abdominal area. It lasts about two months, sharply reducing physical cravings.

The implant can be used for individuals who are not only stopping drugs like heroin, but also for pain medications such as fentanyl, Percocet®, Vicodin®, Oxycontin®, and other variations of oxycodone and hydrocodone. (It is also extremely effective for blocking alcohol cravings). Using naltrexone therapy has been the focus of treatment at Coleman Addiction Medicine for over 20 years.

Willpower for Detox and Recovery 

Slim knows that, in addition to his Accelerated Opioid Detox, the secret to his success in detoxing off fentanyl-laced heroin this time is that he changed his environment. He created a space to support his vision of the man he wants to be, the man he is, and the man he is becoming.

He remains highly motivated, and it is paying off for him in all areas of his life.

  • He was recently promoted at his job. 
  • His children love that their dad is hanging out with them, attending their sports events, and helping them with homework. 
  • His fiancé—pregnant with their first child together—has a new level of trust for this man she loves. 

But perhaps the most touching testimony this 6’2, 220-pound man gives is when he talks about his mother and the pride and gratitude she feels, having her son back. Slim talked about this as I placed his implant, and there wasn’t a dry eye in the room, including Slim’s. (No worries, I could still see what I was doing :).)

Benjamin Hardy, author of Willpower Doesn’t Work, says, “If you remain in an environment conflicting with your personal rules, you have only two choices: Conform to a bad environment or battle it through willpower. Both of these are very poor options and ultimately lead to the same place.” 

Slim chose the latter. His willpower prevailed. 

I hope you will allow us to be a part of creating the best possible environment for you or your loved one. A life of recovery is waiting for you.

Joan R. Shepherd, FNP

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