Substance Abuse Treatment

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Patients with Substance Use and Alcohol Use Disorders often have other diagnoses that contributed to the use(s). We assess patients for dual diagnoses and treat those simultaneously. ,

All detoxification, withdrawal, counseling and treatments may be done in the comfort and privacy of the client's home. 

Treatment modalities: After an evaluation that may include physical exam,

laboratory work, diagnostic radiology in addition to mental and neurological

exams, patients are treated for any nutritional/hormonal deficiencies/imbalances

with dietary modifications or hormone therapy; IM injections/IV infusions that

promote brain health - such as NAD, which is the mediator of brain functions – are

given; undergo extensive Self-Awareness Therapy via intense Self-Immersion

counseling and individualized experiential treatment that varies from exposure

therapy, retreats, to journeys; and creating new neural networks is achieved

through therapy such as Ketamine or TMS. Extensive research has demonstrated

that both Ketamine and TMS promote neural repair and induce neuroplasticity.

Complementary therapies like acupuncture or meditation are also proven methods

that may be elected. Group therapy is available as well for support.

Traditionally, pharmacotherapeutics have been recommended along with therapy,

but every person is unique and a new course of treatment is developed for each,

like excursions to Mexico, Costa Rica. If medication is prescribed, the person’s

physical health, genetics, stressors, other diagnoses, and neurochemical

imbalances are analyzed to select the best one.

The day before starting Suboxone or Naltrexone, we recommend detoxifying or

balancing electrolytes/vitamins/minerals with infusion(s). The high dose vitamins and

antioxidants help in minimizing withdrawal symptoms and make the transition easier. 

For short acting opioids like oxycontin, hydrocodone, morphine and heroin, you will

need to abstain from using for 12-24 hours. For longer acting opioids like fentanyl and

methadone, you will need to abstain from using for 48 hours.

Day 1 (Induction):

It is important when starting Naltrexone or Suboxone that opioids and alcohol be

minimized in your system to prevent inducing withdrawal symptoms. For short-acting

opioids like oxycontin, hydrocodone, morphine and heroin, you will need to abstain

from using for 12-24 hours. For longer acting opioids like fentanyl and methadone, you

will need to abstain from using for 48 hours. You will feel like you are in early withdrawal

at this appointment but this is important to prevent worse withdrawal symptoms. We

also ask that you have someone provide transportation for you to this appointment as

you will likely not feel well enough to drive. You will be provided Naltrexone/Suboxone.

You will take one strip and wait 30 minutes as we monitor you for withdrawal symptoms.

If you are still feeling withdraw symptoms at this time, we will give you the second strip.

Once you are feeling better you will be provided with one weeks’ worth of

Suboxone/Naltrexone. This appointment is usually 60 minutes in length.

Day 2-7 (Stabilization)

After your fist week of Suboxone/Naltrexone you will return to clinic for a 30-minute re-

evaluation. The goal of stabilization is to optimize your Suboxone/Naltrexone to a dose

where you no longer have cravings and experience few, if any, side effects. Once the

optimal dose is obtained, you will be provided a two-week prescription.

Beyond First Week (Maintenance) 

You will need to return to clinic every two weeks. The maintenance treatment with

Suboxone can be indefinite, helping to prevent future relapses. Depression, insomnia

and anxiety are often present in patients and Ketamine infusions can help with the

symptoms of depression without adding more medications to your regimen. Ketamine

also helps with withdrawal, cravings and healing the brain. Medical Cannabis may be an

option.

Although over 100 different types of neurotransmitters have been identified, a

few of the major ones in the brain include:

• Serotonin – neurotransmitter regulating many functions including mood, sleep, and appetite, lower levels of serotonin lead to depression, anxiety and sleep disorders. Many medications for depression and anxiety prevent serotonin reuptake, leaving more in synapses to elevate mood.
• Glutamate – the main excitatory neurotransmitter, problems with its production or utilization leads to disorders such as depression, schizophrenia, autism, obsessive compulsive and substance use disorders and the repeated mental illnesses and substance use can lead to neural damage; also, excess levels of it can lead to neurotoxicity, such as the aftermath of hypoxia, stroke, and neurodegenerative diseases.
• Dopamine – the neuromodulator that controls cognitive functions in the prefrontal cortex, dopamin exerts three major roles in cognition: (i) gating sensory input, (ii) maintaining and  manipulating working memory contents, and (iii) relaying motor commands. Dopamine also regulates emotion and thoughts, with its deficiency playing a significant role in conditions such as attention deficit hyperactivity disorder (ADHD) and schizophrenia.