Tag Archives: Opiate Addiction Treatment West Palm

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Disease Models of Opiate Addiction

Addiction treatment Centers West Palm Beach are doing as much as they can in treating drug and alcohol addiction. They are face with difficult barriers from the insurance companies shortening the length of time payable for addiction treatment.

Addiction Treatment Centers West Palm Beach Fighting the Heroin Epidemic

As most of us are aware, the opioid and heroin problem in our country is at epidemic proportions, and I would go so far as to state unequivocally that we are dealing with a magnitude and severity of a situation in addiction medicine that is unprecedented in nature.  Suddenly, relapse isn’t an “oops let me try again”, it is DEATH.

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A recent CNN article detailed some alarming statistics:  “heroin-related deaths increased 439% from 1999 to 2014. As of 2014, heroin-related deaths had more than tripled in five years and quintupled in 10 years.  In 2014, opioids were involved in 28,647 deaths — 61% of all US drug overdose deaths — and 10,574 were related to heroin, in particular. Data from 2014 reflects “two distinct but interrelated trends,” the CDC notes, a long-term increase in overdose deaths due to prescription opioids and a surge in illicit opioid overdose deaths, mostly related to heroin.”

In my personal addiction treatment medicine practice, I would estimate that approximately 70% or greater of my addiction treatment patients in the West Palm Beach, Florida area are addicted to heroin.  Very clearly, the near-universal mechanism by which we as a country have dealt with substance use disorders to date, namely traditional 12 step rehab, is inadequate in this new and exploding population of opiate use disorder patients.

Two Addiction Treatment Thought Models Adopted by Addiction Treatment Centers West Palm Beach

There are two prevailing “thought models” which attempt to explain the pathophysiology behind addiction.  The first is termed “the moral model”, which asserts that addiction is entirely a choice and secondary to an individual’s moral decision-making (or lack thereof).  This model presupposes that, if not for one’s dysfunctional values and choices, he or she would not have an addiction problem.  The second model is known as the “disease model”, which categorizes addiction as a chronic disease.  ASAM (the American Society of Addiction Medicine) defines addiction as ”a primary, chronic disease of brain reward, motivation, memory and related circuitry”.

us-sergeon-general-Vivek-H-Murthy-pleading-for-medication-assisted-treatment-by-addiction-treatment-centers-west-palm-beach-floridaAs part of a recent landmark statement, the US Surgeon General, Vivek Murthy, distinctly stated that addiction is “a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes, and cancer.”  Furthermore, President Obama’s 2017 fiscal year budget includes $920 million to support cooperative agreements with States to expand access to medication-assisted treatment for opioid use disorders.  All of this did not happen on a whim- these statements and decisions are directly based on clinical evidence that including MAT in the treatment of the chronic disease of addiction increases the likelihood of abstinence from the illicit substance and decreases the probability of overdose and death.

Adopting Medication Assisted Treatment to Save Lives

Accepting addiction as a chronic disease mandates that we, as addiction professionals, view and treat it in the same multi-disciplinary manner in which we treat other chronic diseases. Namely a COMBINATION of medical interventions and behavioral adjustments and modifications.  In other words, we as physicians don’t look at an obese diabetic patient and simply say “lose a hundred pounds and your diabetes will go away” and omit insulin therapy.  Nor do we look at a smoker with emphysema and simply say “stop smoking and you will breathe better” and omit inhalers that improve lung function.  Are the insulin and inhalers, respectively, “crutches” for these patients?

I suppose one could look at it that way, but mainstream medicine, and our society would submit that these medications are imperative to preserve life and improve the quality of one’s life.  So, if the addition of medication is perfectly acceptable, appropriate and the actual standard of care for all these other chronic disease states, why the stigma when discussing medication as it applies to the chronic disease of addiction?   As an addiction medicine physician, I feel that it is imperative to at least consider utilizing all available tools at our disposal, and this includes Medication-Assisted Treatment.

Ensuring Addiction Treatment Clients Get the Correct Care

responsible-medical-care-by-addiction-treatment-centers-west-palm-beach-FloridaHaving said that, medication assisted treatment should also not be used in a cookie-cutter fashion and is not appropriate in all forms for all patients.  The specifics regarding medication assisted treatment medications are beyond the scope of this introductory article, but will be detailed in a future editorial.  However, suffice to say that, when used responsibly and appropriately, MEDICATION ASSISTED TREATMENT saves lives.  Our national academy and addiction authority, ASAM, our surgeon general, our Country’s President and addiction medicine physicians in the trenches with these patients concur that that is, indeed, the case. This goes far beyond addiction treatment centers West Palm Beach and is a serious national problem.

The addiction treatment centers West Palm Beach recovery community cannot continue to treat our current climate of heroin addiction in a rigid, dogmatic fashion, or thousands of more deaths will be left in the wake- guaranteed.  I would submit this question to the recovery community as a whole: given the REALITY that abstinence is only attainable by approximately 10% of our patients addicted to heroin, what should our answer be to the other 90%?  Attain the recovery community’s traditional idea of abstinence or go die?  During the treatment, no other disease would that be the sentiment.

harm-reduction-plan-b-for-addiction-treatment-centers-west-palm-beach-florida-fighting-the-heroin-epidemicThe logical answer is harm reduction.  If a portion of our patients are utilizing some form of medication assisted treatment, yet going to work, having meaningful relationships, and living a fulfilling life devoid of crime and an elevated risk of death and communicable disease, what is wrong with that?  If I could actually attach a title to the current arena of mainstream heroin addiction treatment it might be “Abstinence- worth dying for.”  The unyielding ideals in the context of the current patient population are at the very least antiquated and simplistic, and at the very most, downright dangerous.

In summary, we have an absolute epidemic of opioid/heroin abuse in this country of a never-before-seen magnitude, and our current and historic methods of dealing with alcoholism and other addictions are NOT WORKING.  Traditional 12-step, “abstinence-based”, one-size fits all programs are simply NOT acceptable as a uniform approach to this new and evolving segment of addicts, and these patients are DYING IN RECORD NUMBERS.

not one more addiction treatment centers west palm beach must adopt medication assisted treatmentThe primary difference between heroin and alcohol or other drugs of abuse is that with ANY relapse, just ONE use or momentary lapse in judgment, the heroin addict has a significant rate of sudden death.  Perhaps being dogmatic about traditional, Big Book, 12 step programs is more acceptable when the risk of relapse does not include the very high likelihood of immediate death.  But, because of the totally unknown mixture of drugs in each purchased “bag” or “cap”, including the most potent opioids known to man, namely fentanyl and carfentanyl, a relapse is not necessarily an invitation to “try again”, but is a game of Russian roulette often ending in death.

In my time treating addiction patients with substance use disorders I have often heard the statement “the definition of insanity is doing the same thing over and over again and expecting a different result.”  I think the way we are currently treating our heroin-addicted patients accurately, albeit ironically, fits that definition.   It is time that addiction treatment centers West Palm Beach and nationally stop preaching and demanding that our idea of “abstinence” in the course of addiction treatment is the ONLY acceptable goal.

We can continue jumping up and down screaming abstinence-based rhetoric while our patients continue to die, or we can think more pragmatically about the issue and consider the non-judgmental addition and acceptance of appropriate medically-based therapies to the paradigm of addiction treatment.  Our patients’ lives truly depend on our willingness in the recovery community to adapt to this uncharted territory by implementing the same treatment paradigm that we use as a society in any other chronic disease.

 

60% Intravenous Opiate Detox Drug Users Hep C

Addiction Treatment and Hepatitis C

60% Intravenous Opiate Detox Drug Users Hep C say, “I think I’ve got Hep. C”. It is an all-too-common phrase I hear in my addiction medicine practice (West Palm Beach, FL).  As a matter of fact, I would estimate our patients (60% Intravenous Opiate Detox Drug Users Hep C) who are intravenous drug users are, in fact, positive for the hepatitis C antibody.  According to NIDA (National Institute on Drug Abuse), 2.7–3.9 million people are living with HCV in the United States and, amazingly, deaths from hepatitis C now EXCEED deaths from the HIV/AIDS virus!

This is increasingly common incidence of this disease and its impacting on my patient population as well as the recovery community. We are educating the entire community by discussing symptoms, transmission, diagnosis, and treatment of the hepatitis C virus.

Understanding Hep C and Opiate Addiction Treatment

Opiate Detox Drug Users Hep C education dr ligotti delray beach

Hepatitis C is a viral liver disease, currently the most common blood borne infection in the United States. It is much more contagious and transmissible than other similar infectious agents.  Hepatitis C infection can be either acute or chronic.  Acute hepatitis C is oftentimes without symptoms and patients progress to chronic infection completely unaware of their exposure to the virus.

Therefore, so many patients are surprised when they test positive.  Less commonly, symptoms of acute infection may include jaundice, abdominal pain, nausea and vomiting, and impressively elevated liver function tests on blood work.  After acute exposure to the hepatitis C virus, approximately 75-85% of patients go on to become chronically infected with the virus, and these are the patients for whom treatment is considered.

Detecting Hep C in Opiate Addiction Treatment

Opiate Detox Drug Users Hep C education dr ligotti opiate detox west palm beach

Hepatitis C is extremely contagious and spreads primarily through blood exposure.  This includes our patients who suffer from the disease of addiction and who share needles, spoons, cotton, water, or any other injection equipment. It also includes, those who share other drug paraphernalia such as snorting straws, with a person who has hepatitis C.  Sexual transmission is also possible, but thought to be unusual.

Opiate Detox Drug Users Hep C

Opiate Detox west palm beach stop Hep C dr ligotti

The importance of diagnosing and treating chronic hepatitis C is to hopefully avoid the two most important risks of the disease; cirrhosis/liver failure, and liver cancer (hepatocellular carcinoma).  The diagnosis of hepatitis C is made from bloodwork performed on a patient.  Screening bloodwork to test for hepatitis C detects the body’s immune system’s response to the virus. It is the hepatitis C antibody that is first detected when somebody “tests positive” for hepatitis C.  The test will confirm the fact that the patient’s body has “seen” the hepatitis C virus at some point in the past. The next step is to perform a hepatitis C viral load and genotype test.

A positive viral load confirms the actual presence of hepatitis C virus in the patient’s blood. This quantifies how much virus is present. While the genotype tells us what type of hepatitis C infection we are dealing with (six main types), and this is important for determining the most effective treatment regimen.  It is important to note that most patients whose immune systems naturally “clear” the acute hepatitis C viral infection on their own (15 and 25% of patients) do so within the first six months of infection.

Therefore, physicians will monitor viral loads at six months following first detection to give patients a chance to clear the infection on their own.  If at six months there is still a positive viral load (active infection), treatment is considered.  Again, approximately 75-85% of people will go on to develop chronic infection and will need to consider treatment.

New Hep C Treatment with 90% Success Rates

To date there are several newer oral medications for Opiate Detox Drug Users Hep C, alone and in combination products. The choice of medication depends in part on the genotype of the hepatitis C infection, but the specific details and exact medications are beyond the scope of this article.

Suffice to say, the general advantages of these drugs when compared to older interferon-based regimens include significantly fewer side effects and cure rates well over 90%- very impressive results!  However, one of the primary barriers to these newer hepatitis C treatment regimens is the exorbitant price tag and the cumbersome task of getting insurance companies to pay for the treatment.

Opiate Detox Drug Users Hep C Insurance and Tests

Insurance companies in general require a large battery of tests and information be compiled before they will cover the cost of hepatitis C treatment.  These tests include various blood and urine tests as well as imaging studies and “staging” of the hepatitis C infection (how much damage has been done to the liver).

This staging has traditionally been accomplished by liver biopsy (obviously an invasive and less than desirable procedure).  However, a new technology exists called Fibroscan. We are seeing, insurance companies covering in most cases, all of the costs.

Fibroscan Painless Test Saving Lives from Hep C

New Hep C test drug and alcohol addictin treatment west palm dr Ligotti

Fibroscan is a painless, non-invasive test that simply measures the elasticity of the liver.  This elasticity tells us how much damage has been done to the liver and is sufficient for “staging” the patient’s liver disease.  Fibroscan is an amazing technology that makes invasive biopsy unnecessary in most cases and gives insurers the information they need to pay for these incredible new treatments for hepatitis C!

Helping Opiate Detox Drug Users Hep C

Currently there are very few Fibroscan machines in West Palm Beach area. Many insurers require a Fibroscan diagnostic test to approve treatment coverage. We are seeing insurance companies covering in most cases, all of the costs. The limitation of this test is making it very difficult for our chronic hepatitis C patients in the recovery community to access treatment for their hepatitis C.

Whole-Health is a drug and alcohol addiction treatment practice focused on the comprehensive medical care of our recovery community. Since we have with many patients in the recovery in the West Palm Beach area, it was determined that we really can greatly increase access to hepatitis C treatment.  Therefore, Whole-Health has purchased a Fibroscan machine in our effort to better serve the medical needs of our recovery community.

Opiate Detox West Palm, and Drug and Alcohol Treatment West Palm

Now, instead of inconvenient specialist referrals and dealing with transportation issues, our recovery patients with hepatitis C can be evaluated and treated at our office here in Delray Beach, Fl. We have been providing opiate detox West Palm, and unequalled drug and alcohol addiction treatment West Palm for well over a decade.

We are very proud to add this additional service to our practice. It is just another example of how Whole Health is the premiere leader in comprehensive medical care in the practice of addiction treatment medicine!  We encourage all our at-risk patients to come in to be screened for hepatitis C.

We also hope that patients with known hepatitis C will visit our opiate addiction practice in the West Palm Beach area (855) 965-1626, so we can coordinate testing, assist with insurance requirements, and start these amazing new treatments to help eliminate this virus from our recovery community!

Addiction Treatment Ft Lauderdale Whole Health Facebook Group Addiction and Behavioral Health Options

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Addiction and Behavioral Health Options

This group is designed to provide a resource for addiction and behavioral health professionals and individuals seeking addiction help, and individuals in recovery. In this group, you can network with professional peers and individuals seeking information on treatment from the specialists, strengthen your position in the treatment field and forge valuable new relationships. This is a place to get information on treatment, search for help, network, give and receive referrals from addiction centers, psychiatrists, psychotherapists, occupational health physicians, practitioners, health counselors, psychologists, social workers, nurses, front-line practitioners, and many other sources. Share current information, interact with each other, meet leaders in the field, and be exposed to the latest research and clinical methods and techniques. Group members can post information on treatment, info about their services, share information about addiction, recovery, holistic treatments, mental health, marketing, social media and business strategies. Group members are encouraged to network and refer each other.
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Medicated Assisted Recovery is possible. Come share your experience without stigma or judgement. This meeting is a self-support group and is open to all.

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Medicated Assisted Recovery is possible. Come share your experience without stigma or judgement. This meeting is a self-support group and is open to all.

EVERY Sunday at noon in Santa Ana, CA.

Please SHARE this post, it could bring hope and recovery to those attempting Medicated Assisted Treatment

You may also be interested in some of our other articles on addiction treatment; “Unchecked Addiction Treatment Diseases“, “What Does (MAT) Medication Assisted Therapy Mean for Generation Z?“, and “Narcan Education by Opiate Detox West Palm Doctor“.