Tag Archives: Opiate Detox West Palm

MAT MEdication Assisted Therapy opiate detox west palm

Medication Assisted Treatment MAT; A New Breed of Drug Addict

Medication Assisted Treatment Disease Models, and Addiction Treatment for Opiates

Medication assisted treatment MAT in West Palm Beach, FL needs to be addressed. At Whole Health outpatient addiction treatment clinic in West Palm Beach, FL., we see 100’s of patients suffering from drug and alcohol addiction. Many do not have a clear understanding on MAT due to bad information on social media. We see many social media posts giving incorrect information, mainly based on personal experience. MAT must be properly diagnosed by a qualified addiction physician.

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.

Too Many Deaths from Opiate Epidemic

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.

addiction treatment Fort Lauderdale, West Palm Beach, and Miami Florida

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.” At Whole Health outpatient addiction treatment clinic, 70% or greater of our patients 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.

Addiction is a brain disease opiate addiction treatment west palm

There are two prevailing “thought models” which attempt to explain the pathophysiology behind addiction.

Moral Model of 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.

Disease Model of Addiction

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”. And as 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”.

Medication Assisted Treatment MAT Supported

Furthermore, President Obama’s 2017 fiscal year budget includes $1.1 billion 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.

Medication Assisted Treatment (MAT) Education Needed

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.

Whole Health Primary Care Physician Delray Beach FL

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 as a whole, 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 assisted treatment MAT, as it applies to the chronic disease of addiction? As an addiction medicine Doctor, I feel that it is imperative to at least consider utilizing any and all available tools at our disposal, and this includes MAT (Medication-Assisted Treatment.)

Medication Assisted Treatment MAT opiate detox west palm

Having said that, medication assisted treatment MAT should also not be used in a cookie-cutter fashion, and is not appropriate in all forms for all patients. The specifics regarding MAT 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, MAT 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. The 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.

Abstinence, or Die (What’s Really Happening in the Recovery Community)

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?

harm reduction opiate addiction treatment west palm Medication Assisted Treatment MAT

In the course of treating no other disease would that be the sentiment. The logical answer is harm reduction. If a portion of our patients are utilizing some form of medication assisted treatment MAT, 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.

Medication Assisted Treatment MAT Saves Lives

In summary, we have an absolute epidemic of opioid/heroin abuse in this country of a never-before-seen magnitude, and our current 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.

one more time could be your last Medication assisted treatment MAT saves lives

One More Time, Could Be Your Last.

The 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 are 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 carfentanil, a relapse is not necessarily an invitation to “try again,” but is a game of Russian roulette often ending in death.

Harm Reduction – Medication Assisted Treatment MAT

In my time treating 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’s time that we as a recovery community stop preaching and demanding that our idea of “abstinence” in the course of addiction treatment is the ONLY acceptable goal. We must embrace harm reduction.

not one more suboxone treatment west palm one more time could be your last Medication assisted treatment MAT saves lives

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.

For more information on Medication Assisted Treatment MAT, or outpatient addiction treatment options in West Palm Beach, Fort Lauderdale, and Miami please visit our website HERE or call 855.365.1626 (majority of medical insurance plans and Medicare, excluding HMOs. Flexible financial arrangements are available to patients unable to afford their entire deductible or who are without insurance and are paying cash.)

More Addiction and Behavioral Health Treatment Options


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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“.

MAT Part 2 opiate detox west palm

MAT Part 2: Addiction Antagonist Therapy

MAT part 2 Medication Assisted Treatment a continuation of our last opiate addiction treatment article from Whole Health in West Palm Beach, FL., explained the definition and use of MAT or Medication Assisted Treatment, in addressing patients struggling with particular substance use disorders.

MAT Part 2 opiate detox west palm

The first article examined the use of opiate agonist MAT therapy (i.e. buprenorphine products/”Suboxone” and methadone),) while this installment will examine the utility of opiate antagonist MAT therapy. The principle disorder to be focused upon, primarily because of its ubiquitous nature and the fact that we are predicted to experience greater than 50000 fatalities this year (MORE THAN AUTO ACCIDENT DEATHS,) is opiate use disorder.

What is Medication Assisted Treatment MAT Part 2

First, a very brief and simplistic review of neurobiology as it pertains to addiction. Opiate addiction is all about the reinforcing experience the patient’s behavior has upon the brain’s dopamine levels (the “feel good” neurotransmitter.)

Opiate detox West Palm dopamine

All addictions, whether they be substance-based, or behaviorally oriented (such as gambling and sex addiction) are rooted in the basic fact that these activities cause a surge of dopamine in a specific part of the brain known as the nucleus accumbens. This dopamine surge is perceived as the “high.” This feeling is obviously pleasurable, and the patient wants to repeat and repeat the addictive activity, as the dopamine release becomes a positively reinforcing result of the behavior.

Opioids and Medication Assisted Treatment (MAT)

In the case of opioids, when these drugs attach to the brain’s “mu” receptors, the result is a huge surge of dopamine, which floods the nucleus accumbens, resulting in an intense and euphoric “high.” The patient uses again and again to keep experiencing that dopamine high, and if they stop using they get extremely ill with withdrawal symptoms.

Therefore, the actual use of the drug is reinforcing, while cessation of use causes them to feel horrible (i.e. Not using is NEGATIVELY reinforcing.) This “double whammy” almost guarantees that an opioid addict will continue to use and/or chronically relapse (if you recall from the first article, the “success rate” of stand-alone abstinence-based treatment such as various psychotherapy, 12 steps, etc. is only around 10% at best.)

MU Receptors Oral Naltrexone, Vivitrol and Naltrexone Implants

It is at the brain’s mu receptor sites where antagonist MAT therapies exert their effect.  Antagonist MAT therapies include oral naltrexone, intramuscular Vivitrol, and the off-label use of naltrexone implants that typically provide up to three months of medication with each implant. All of these formulations function in the same fashion- they bind to the brain’s mu receptors very strongly (much stronger than opioids,) preventing any opioids from reaching the patient’s brain and causing that euphoric dopamine surge.

Whole Health stops addiction with opiate detox west palm beach

In other words, with antagonists at work the patient will not derive any high from opioids should he or she decide to use them.  Therefore, this breaks the cycle of positive reinforcement and helps patients with opioid cravings because they know if they use they will simply not derive the expected and desired feeling. The various formulations primarily differ amongst one another in how compliant the patient is likely to be on the given therapy.

naltrexone implants opiate detox west palm Whole Health

Generally, the injection, or implant are much more efficacious than the daily oral naltrexone, because the patient can forget or “forget” to take the daily naltrexone, but the injection or implant is in their body for one or three months, respectively.  Incidentally, MAT antagonist therapy (MAT Part 2) helps immensely with alcohol cravings, and there is emerging evidence that they may be useful for other addictions as well, but that is another topic entirely. However, to stay focused on opioids, I think you can see how incredibly useful antagonist MAT can be in extinguishing the Pavlovian behavior of opiate addicts, and really assist them in putting together solid, long-lasting sober time, and often permanent sobriety!

Abstinence for up to Two Weeks (Understanding the Use of Suboxone)

What is the catch? The primary and most frequent and frustrating problem in initiating antagonist therapy is that, depending on what type of opioid the patient was using, we need anywhere between one and two weeks of total avoidance of ALL opioid and opioid-related products. This includes buprenorphine products (i.e. Suboxone) and methadone.  Therefore, for instance, we can’t take a heroin addict, stabilize him or her on Suboxone, and then transfer immediately to naltrexone/Vivitrol/naltrexone implant.

Similarly, we can’t take a patient right out of detox (opioids are actually used to detox opioid addicts) and transfer them to antagonist therapy.  The reason is that, as stated, the antagonist has a much stronger affinity for the brains mu receptors.  If there are any opioids occupying those receptors at the time that antagonists are introduced, they will “kick off” the opioids and result in severe withdrawal for the patient.

Reasons Why Many Do Not Get Antagonist Therapy (Naltrexone and Vivitrol)

So, the primary issue becomes how do we get the patient to be abstinent for the requisite one to two weeks so that we can utilize this effective antagonist therapy? Unfortunately, many addicts are unwilling or unable to be totally devoid of any and all opioids (including Suboxone or methadone) for more than a couple of days before feeling so horrible that they go right back to using. This is, indeed, the eternal challenge of initiating antagonist MAT therapy, and probably the most frequent reason why it is not implemented in more recovering addicts.

It's time for opiate detox Whole Health Delray Beach, FL

There are other reasons as well- not the least of which is a patient who refuses antagonist therapy because they are scared they won’t be able to get high (they are not “ready” to live a sober life.) Other potential downsides to antagonist MAT is that they can cause nausea, occasionally worsen, or cause depression, and can cause liver inflammation (many of our patients have alcoholic, or viral hepatitis, so this is a particularly relevant concern.) Of course all of these potential side-effects are closely monitored and actually different forms of antagonist therapy tend to have more or less of these side-effects, but they are concerns nonetheless.

Antagonist Therapy is Not Habit Forming (Naltrexone and Vivitrol)

In summary of our MAT Part 2 education, antagonist MAT can be incredibly helpful in the treatment of opioid use disorder (and other addictions,) assuming the proper timing of treatment initiation, and appropriate patient selection. Antagonists are not narcotics, are not habit-forming, and have no discontinuation syndromes.

1 year of opiate addiction treatment West Palm Beach, FL Whole Health

I typically shoot for a twelve month period of closely monitored treatment in my opioid addiction treatment protocol at Whole Health in West Palm Beach FL. With the continuation of cognitive based therapies such as structured PHP/IOP/OP programs, NA/AA, 12 step work, spiritually based programs, or whatever positive and helpful course of psychotherapy my patient gravitates towards. Success rates (which I define as prolonged abstinence- greater than one year) utilizing this methodology in my practice have been impressive and encouraging.

The real question is how to effectively bridge the gap between opioid use and antagonist MAT so that we don’t lose patients to recidivism secondary to severe discomfort.

Comfort Meds and FDA Unapproved Meds

There are some “comfort meds” we use with variable efficacy, such as clonidine, vistaril, baclofen, trazodone, etc., but these are rarely able to accomplish bridging of that gap.  There are other methods of bridging this gap, including plant-based detox regimens (i.e. Ibogaine) that detox the patient without the use of opiates, which are extraordinarily interesting and deserving of further research, but they are currently not legal for use in the US.  There is also a exciting new non-pharmacologic, “non-substance” device called the Bridge device for opiate detox which when installed on the patient’s ear, can significantly or totally ameliorate withdrawal symptoms, also without the use of opiates.

As usual, insurers presently consider this modality experimental and will not reimburse for its use (though I am optimistic that this will and should change.) If we could just bridge that gap we could really get a lot more patients on effective antagonist therapy, and this is where I truly believe that what the recovery community at large deems “true sobriety” can be much more frequently attained. Until then, I will continue to pray for progress and utilize the appropriate available medications to assist my patients in the avoidance of death, and the realization of the most rewarding and fulfilling lives they can possibly experience.

“We,” collectively in the recovery treatment community, owe it to our patients to place whatever personal biases we may possess aside, and make this our unified and uncompromising goal at all times!

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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“.

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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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“.


Hep C Addiction Treatment West Palm Whole Health Dr Ligotti

Suboxone Clinic Offers Addiction Professionals HEP C & CPR

FREE Hepatitis C and CPR Training for Addiction Professionals

Addiction Treatment

Suboxone Clinic West Palm

You must register at the top right of this page to attend. Registration is limited to the 1st 100 registrants. Please register today.

February 6, 2018
11:30 am – 3:30 pm

Whole Health ( Addiction Treatment West Palm / Opiate Detox West Palm )

402 SE 6th Ave Suite A,  Delray Beach, FL 33483

Sponsored by

Suboxone Clinic West Palm

Outpatient Addiction Treatment

The opioid epidemic is killing more people than car accidents.  Florida Gov. Rick Scott declared the opioid epidemic a public health emergency on May of 2017, and it is still in effect. This is good news for those of us at the front lines. Whole Health, in West Palm Beach, is educating addiction Treatment centers, and sober living facilities on Hep C, and providing information on Hep treatment scholarships (including meds) for their patients.

Addiction Treatment West Palm Educates on Silent Killer

While the official numbers of deaths cannot be compiled quickly enough, the information that is available clearly shows the opioid epidemic is growing extremely fast.  In 2015 heroin, fentanyl, oxycodone, and other opioids were directly responsible for the deaths of 3,896 Floridians, according to the most recent Florida Department of Law Enforcement statistics. Generation Z requires more education on what is fueling the opioid epidemic, diseases that are left untreated, ways of prevention including Medication Assisted Treatment (MAT) to understand the treatment options available.

Suboxone doctor west palm whole health dr ligotti Hep C Training

Hep C Education for West Palm Addiction Treatment Centers, and Sober Living Facilities

According to the CDC many in the US are affected by Hepatitis C. The numbers are incredibly high for intravenous drug users, and unknown to the general public, baby boomers;

cdc_hepatitis C treatment

Others at risk include anyone that has;

  • shared any equipment to inject drugs (syringes, needles, snorting straws, etc…).
  • Injuries from a needle sticks in a healthcare setting. This is the most common way Hep C is spread.
  • babies born with a mother that has Hep C
  • Sharing needles, syringes, snorting straws, or other equipment to inject drugs
  • Needlestick injuries in health care settings
  • Being born to a mother who has Hepatitis C

Less commonly, a person can also get Hepatitis C virus infection through

  • Tattoos done in an environment that is not sterile
  • Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
  • Having sexual contact with a person infected with the Hepatitis C virus

Unchecked Hep C Putting Addiction Treatment Center Clients at Risk

Treatment centers must check their clients for Hep C, otherwise they are putting their entire population at risk. With 60 out of every 100 intravenous drug users, and 30 out of every 100 baby boomers having Hep C, it is critical that treatment centers test their clients for Hep C. This event is focused on educating treatment centers, and sober livings on how severe the hidden epidemic of the silent killer is, and options available for Hep C treatment.

Suboxone Clinic West Palm Beach, FL Offers Addiction Treatment Professionals HEP C, and CPR Training

In an “Opioid epidemic Prevention Event” sponsored by Whole-Health of Delray Beach that includes Boca Raton Fire Rescue, we wish to present tools to addiction professionals, treatment centers and sober living facility operators to help save lives by providing Hepatitis C, and CPR training (certificate of completion).


Whole-Health of Delray Beach, the premiere leader in addiction medicine, is proud to sponsor this life-saving event.

Addiction Treatment West Palm

Addiction Treatment West Palm

Dr. Ligotti will be providing education on Hep C, and revealing treatment options for treatment center clients that are covered by most insurances, with little to none out of pocket expense. 

You must attend this Event to Get info on Hep C Treatment Scholarships (including Meds). The public is welcome, and addiction professionals are encouraged to get info for their clients. 

Hepatitis C Treatment Scholarships

Suboxone Clinic West Palm Offers Hep C Treatment Scholarships

In addition, Whole Health will be providing 5 complete Hep C treatment scholarships, including free access to medication.  If you are a treatment center, and have a client with Hep C, contact Whole Health at 855-965-1626 to see if they qualify.

cpr training suboxone clinic west palm beach Florida whole health

Charlie Coyle of Palm Beach County Rescue will be providing CPR training with a certificate of completion.

Charlie Coyle is a 15-year paramedic who is an EMS training Captain for Palm Beach County Fire Rescue. He has an associate of science degree in Emergency Medical Services.

The EMS education for Palm Beach County Fire Rescue and other municipalities has been under Charlie’s direction for the past 4 years.

For the past 6 years Charlie has been a co-author of Palm Beach County Fire Rescue’s EMS protocols including dispatch instructions and recently authored the regional wide Palm Beach County EMS protocol book which has now been adopted in Broward County.

Mr. Coyle has had the distinct honor of attending the King County Resuscitation Academy along with the Resuscitation Cadaver lab hosted by Dr. Keith Lurie –a leading cardiac arrest expert. The American Heart Association also uses Charlie to speak, plan and perform Hands-Only CPR training for over 1000 people during the Heart Walk every year in Palm Beach County.

Current certifications and publications:

  • American Heart Association CPR Instructor and provider
  • Advanced Cardiac Life Support Instructor and provider
  • Pediatric Advanced Life Support Instructor and provider
  • Prehospital Trauma Life Support Instructor and provider

Here is a link to a study by Palm Beach Fire Rescue on How Would Use of Flow-Focused Adjuncts, Passive Ventilation and Head-Up CPR Affect All-Rhythm Cardiac Arrest Resuscitation Rates in a Large, Complex EMS System?

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Addiction Treatment West Palm Whole Health Dr Ligotti


Unchecked Addiction Treatment Diseases

Recognizing unchecked addiction treatment diseases must be included in every person’s treatment plan. We see many cases where our clients have been in treatment and did not know they had diseases directly related to their addiction. In a recent instance, Mary, a 23-year-old female with a long-standing history of intravenous drug and alcohol abuse. We found several issues that were left unchecked with this individual.

Individuals Reaction to Unknown Drug Abuse Related Diseases

When we informed her, the first response was, “What does that mean?” Then, “How did this happen?”.  She was just informed that she has hyperthyroidism (an overactive thyroid disease).  Every day here at Whole Health people are diagnosed with conditions they don’t fully understand. We thoroughly check all our patients in recognizing unchecked addiction treatment diseases.

recognizing unchecked addiction treatment diseases dr ligotti

Unchecked Addiction Treatment Diseases

When incorporating integrative medicine with addiction treatment medicine, we can discover many conditions upon physical examination and routine blood work that can exhibit an extensive array of signs and symptoms if left untreated.  We are educating the community in recognizing unchecked addiction treatment diseases.

Such disorders include thyroid dysfunction, vitamin deficiencies, sexually transmitted infections (STIs), anemia, and many more.  The symptoms from these underlying medical issues can, and often do, contribute to our patients relapsing on their drugs of choice as they struggle to feel “normal” in the face of always feeling terrible!

As one specific example of recognizing recognizing unchecked addiction treatment diseases, many studies have shown opiate use can cause changes in thyroid-binding globulin (TBG: a circulating protein produced in the liver).  High TBG levels can cause elevated TSH which is indicative of hypothyroidism (underactive thyroid), liver disease, and can be seen in pregnancy.  On the other hand, low TBG levels can lead to elevated Free T4 and Free T3 which is indicative of hyperthyroidism.

Advantage Dealing with a Specilized Physician

In Mary’s situation, routine labs were checked within 1 month of her last use that showed mildly elevated Free T4 and a low thyroid stimulating hormone (TSH).  At this point we recommend re-checking thyroid function in one month for follow up and re-assess.  Upon doing so, we have found that Mary’s Free T4 continued to be elevated and TSH was low.

An ultrasound of Mary’s thyroid was performed in our office which showed multiple thyroid nodule.  Mary was then sent for a thyroid uptake scan to further clarify her clinical state and to evaluate for the likelihood of thyroid cancer.  Luckily for Mary, her thyroid scan was not concerning.

After thorough evaluation and discussion with Mary, it was discovered that her biological mother also had hyperthyroidism, specifically Graves’ disease, which tends to run in families and is more common in women than men.  Mary had been experiencing symptoms for a while but was never aware that her symptoms could be from something other than withdrawal symptoms. In treating our patients, we are always recognizing unchecked addiction treatment diseases.

Mary realized her recent weight loss, racing heart, palpitations, nervousness, difficulty sleeping, frequent bowel movements, and no period for the past 6 months were all contributing to her new diagnosis of hyperthyroidism.  In retrospect, she realized that she had felt so poorly for so long, and wondered if she started and continued using drugs because she felt so terrible.  Now Mary can be treated appropriately and her symptoms should resolve accordingly, hopefully contributing to her ability to stay clean and sober.

Diet is Often Left Untreated in Addiction Treatment

Also, when people use drugs and/or alcohol, many times they do so in a binge fashion.  It is very common in this time period for a person to eat unhealthily, if they eat at all.  With this poor nutrition comes vitamin deficiencies such as B1 (Thiamine), B12, folic acid, iron and these can lead to anemias (a low amount of red blood cells in the body).

It is also common for an individual to be dehydrated due to lack of fluid intake or while experiencing withdrawal symptoms such as diarrhea, vomiting, sweating.  With this comes electrolyte changes; decreased or increased sodium levels and decreased potassium levels.  Consequently, these electrolyte changes can cause muscle weakness, muscle spasms and cramps, confusion, lethargy, and even seizures.

The aforementioned are just a few examples of how general medical problems intertwine with our patients’ addiction issues.  Make sure your Doctor, or rehab capable of recognizing unchecked addiction treatment diseases. At Whole Health, we focus on “Integrative medicine”, or the combination of physical medical diagnosis and treatment alongside effective psychiatric care.  This combination of body and mind medicine offers our patients, whether living in our community or staying at a local treatment center, a true holistic approach to healing and gives them every chance to succeed!

Dr. Ligotti has completed training sponsored by the American Academy of Addiction Psychiatry in the use of Suboxone for the rapid outpatient treatment of opiate addicted patients. He also has specialized training and DEA authorization as a physician offering office-based opiate detoxification using Suboxone (opiate detox West Palm). Dr. Ligotti is among a very small number of physicians licensed to offer this treatment in a private office-based setting. You may be interested in some of Dr. Ligotti’s other articles on medication assisted Treatment (MAT) like “What Does (MAT) Medication Assisted Therapy Mean for Generation Z?.

Deanna Weilbacher, PA-C

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You may also be interested in some of our other articles on addiction treatment; “What Does (MAT) Medication Assisted Therapy Mean for Generation Z?“, and “Treating Addiction (Pregnant Women“.