Charlie first came to Coleman Addiction Medicine when he was young. Tall, charming, and with a twinkle in his eye, he owned two big trucks and a snowplow attachment. He was energetic and hardworking, juggling several successful businesses. The city’s large snowfall that winter brought him luck and he made a lot of money very quickly.
How We Met
Charlie never had a formal degree, although he took a couple of classes at a local community college. Sitting still was not his style, and he was a very smart man.
We knew Charlie through his beautiful wife. They had two sons. His business was doing very well. He was always helping people. He had a passion for his life, and much preferred repairing a broken fence or working on an engine with friends to watching Netflix.
Unfortunately, Charlie was addicted to opioids. He began with Oxycontin, which was initially easy to buy at the time. When laws tightened, he looked to heroin and later on to Fentanyl.
It took Charlie several attempts before his recovery truly took hold. Typically, patients who get an Accelerated Outpatient Opioid Detox using the Coleman Method enjoy long-term sobriety following a single treatment. After relapsing following a long period of sobriety, Charlie told me that his financial success was hard for him to cope with.
The Stress of Success
“After the storm, all of our trucks were out there. I made over a million dollars that month. I went into ‘celebrate mode’, and all of a sudden I was using again every day.”
Relapses and detoxes became increasingly harder for Charlie. This is in part because fentanyl is a powerful synthetic similar to morphine but is drastically more potent. It also has to do with the way the brain gets used to the drug. Judith Grisel, the author of Never Enough, describes more about opioid addiction:
One way to understand the dilemma of the opiate user is to recognize that because there are no free lunches, the benefits that drugs confer will have to be paid back. In principle, moments of superb contentment demand an equal and opposite experience of distress; the benefit of euphoria will create a debt of dysphoria, and trying to avoid this unpleasant state by taking more drugs will just increase what you owe. In practice, the depth and extent of the withdrawal period are in direct proportion to the duration and intensity of the drug bathing the brain. Just as the first exposure is “best,” likewise, the first time someone tries to get clean is the easiest, and easier still if the period of using was of short duration….medicating it will not only put off the misery but strengthen it for next time.”
The Path to Recovery Becomes Harder
Charlie was on naltrexone three times over the years. His best experience was when he stayed on long-acting naltrexone. In the beginning, he was using our implants that block for eight weeks. When that wasn’t enough, he came monthly for two years to receive a branded injection called Vivitrol.
The Effects of the Pandemic
Recently, the CDC released some troubling statistics: Overdose deaths in the U.S. rose in 2020 to an estimated 93,331. Of those, 69,710 involved opioids.
We knew alcohol consumption increased dramatically throughout the pandemic, and now our concern about opioid use is also confirmed. Covid not only devastated the world by causing illness and death, but the casualties of isolation, job loss, extreme stress, homeschooling, fear, and anxiety took their toll on those struggling as well.
Although Coleman Addiction Medicine has stayed open throughout the pandemic, many of the recommended programs we guide our patients to were either temporarily closed or were doing remote programming. This format was extremely helpful for some patients, but not for others. This is another reason why utilizing long-acting naltrexone therapy is a great option.
Finding Relief With Naltrexone
The tricky part for someone who is using heroin, kratom, fentanyl, or other narcotic pain medications (Oxycontin, Roxicet, Dilaudid, Tramadol, Vicodin, Percocet, etc.) and wishes to switch to naltrexone is that–unless the opioids are completely out of one’s body–the addition of naltrexone can put someone into precipitated withdrawal.
The Naltrexone implant is a pure opiate/opioid blocker and does not create physical dependence or tolerance. It blocks opioids from occupying these receptors. Treatment that lasts for approximately two months will both physically block the drug and rid the body of physical cravings.
What Will Withdrawal Feel Like?
Symptoms Of Opioid Withdrawal
From Judith Grisel, Never Enough
- Panting and yawning
- Irritability and dysphoria
- Restlessness and insomnia
- Fearfulness and hostility
- Increased blood pressure
- Pupil Dilation
- Increased core temperature
- Tearing and runny nose
- Chilliness and goosebumps
We work with our patients and their support people to slowly and carefully, replace opioids with naltrexone. This is what Coleman Addiction Medicine has specialized in for over twenty-five years. At the end of a detox, the opioids are gone and the receptors are now loaded with naltrexone. Our program provides three implants over six months to give protection from using opioids. And while this is an effective block, I cannot over-emphasize the importance of pairing this treatment with counseling from an expert who understands the unique challenges people with a dependence on opioids face. Our expert services at the Coleman Addiction Medicine guide patients to find the right fit for their unique situation.
Charlie chose not to do the counseling piece, and I am still reeling from the call I received late l from his wife. She thanked us in a quiet, faltering voice, for all we had done for her husband over the years and the added years of quality time they’d gotten to have together. Sadly, Charlie was found dead in the driver’s seat of his truck with a needle in his arm.
No one can guarantee that a loved one won’t fatally relapse. What we can do is offer compassionate treatment and an opportunity to stop using opioids and rebuild the pieces of their life destroyed by addiction. Please call our caring folks at 888-705-9615 and we can give you details about how we can help you.
Joan Shepherd, FNP, Coleman Addiction Medicine