I started working as a Nurse Practitioner in the field of addiction 13 years ago. At the beginning, our patients generally sought help getting off of prescription pain medications, heroin, or methadone.
The Accelerated Methadone Detox program using the Coleman Method has remained relatively unchanged throughout this period. It is an 8-day outpatient process. Because of methadone’s long half-life, it takes a bit longer to “nudge” the methadone off the brain’s receptors using micro-doses of naltrexone than it does with shorter-acting opioids like oxycodone. Suboxone® or other buprenorphine products usually require a similar timeframe to methadone.
What Is the Timeline for a Fentanyl Detox?
Our outpatient detoxification process usually takes 3-4 days for a person using up to about 200mg daily of short-acting pain medicines like hydrocodone or oxycodone. We extend the detox for patients on higher doses or with certain co-occurring medical conditions.
The same had been true for heroin for a long time. Many patients started using heroin when their physicians stopped prescribing them opioids or their tolerance to the prescribed medicine had increased so much that they craved stronger drugs. Heroin was simple to buy and fairly inexpensive, especially when compared to buying pills on the street. We used to offer 3-day detox for people who wanted to get off heroin, and for most of our patients, this time frame was perfectly appropriate using our proven protocols.
The Heroin Impact on Fentanyl Detox
However, the situation began evolving a few years ago. Articles began popping up in newspapers about multiple people overdosing at the same place and time. People would come to us to detox off of heroin, but they would have uncomfortable reactions to the micro-dose naltrexone that helps speed up the healing and withdrawal processes. The detoxes became more challenging. We didn’t have a test for fentanyl at that time, but that’s exactly what was going on: fentanyl was getting cut into heroin at an accelerating rate, and our patients were suffering.
Fentanyl is a powerful synthetic opioid analgesic that is 50-100 times more potent than morphine. First used in the 1960s as an intravenous anesthetic, it is legally sold in the US as a Schedule II prescription drug and is used to manage severe pain. It is also prescribed to people with chronic pain who are physically tolerant to other opioids.
Customized Regimen For Suspected Fentanyl Addiction
Although we did not see many patients back in 2011 who were getting fentanyl mixed into their drugs, the DEA reports that is when the deaths from fatal overdoses started increasing. According to the Centers for Disease Control and Prevention, fentanyl analogs were involved in around 2,600 drug overdose deaths in 2011 and 2012. By 2018, 31,335 deaths were attributed to synthetic opioid overdoses and illegally produced fentanyl! This is completely consistent with what we observed at Dr. Coleman’s medical practice.
We adjusted our protocols to take into account the growing presence of fentanyl in street drugs. Every patient with suspected fentanyl addiction receives a tailored regimen with multiple comfort medicines and a slightly longer time period to complete the detox. This keeps our patients safe and as comfortable as possible.
If you or a loved one in the greater New York City area would like to learn more about detoxing off of fentanyl or another opioid at Coleman Addiction Medicine, please give us a call at 877-773-3869 or schedule a callback. We also have unique and proven protocols for helping patients detox from alcohol.