Wednesday, April 22, 2009

Naltrexone Implants

Several months ago a husband and wife traveled eight hours to Richmond from West Virginia so Richard, the husband, could get a naltrexone implant.

Richard’s wife, Margaret is a smart, no nonsense emergency room nurse, and Richard is a big strapping guy who works as a night shift supervisor in the coal mines. His job is fraught with potential for injury at every turn. They both work hard and they both bring home a healthy paycheck.
When I first met them, Margaret was still in shock and despair after learning that her husband had a severe drug addiction problem to Oxycontin. Being an ER nurse, she had plenty of experience working with drug seeking patients. I can’t even remember now how she learned that Richard was taking 4-5 Oxycontin 80s most days, but it just about killed her.

Through tears she told me she couldn’t believe it was happening to her family. They have 2 daughters who adore their father. Richard was strong, hardworking, and honest, she’d thought. She was humiliated to think that she had missed all the clues that now seemed so obvious to her…She knew he had been prescribed narcotic pain medicines years earlier when a beam hit the back of his neck, but she thought he only now used them occasionally. For months now he had been coming home after work and never interacting with her or the girls, but it was easy to attribute to the hard work he did all night. And somehow, there was never money in the bank at the end of the month, despite the sizeable salaries and overtime both of them made…Margaret chose not to look too hard at this, always making excuses for their being overdrawn frequently. A little extra overtime more than made up for the deficits.

They heard about a guy who also worked in the mines and had come to The Coleman Institute for a naltrexone implant . He never had to go on methadone or suboxone and he was staying away from opiates. It was convincing enough for Margaret to start doing some on-line research. Not only that, she was pretty clear with Richard: unless he stopped using, she and the kids were leaving.
He received an implant and was told to return to the office in 8 weeks for the next one.
Earlier this week, they returned for Richard’s 2nd implant. When you see someone for the 2nd time after 8 weeks, it’s hard to remember their exact story. But I did remember Margaret’s eyes-they are huge and green and heavy lidded with thick eyelashes—and had been full of tears at our first meeting.

One of the questions on our Repeat Implant Form asks if there are any changes in relationships since the last visit. Now her eyes were beaming. She said for the first time in at least 2 years, there is extra money in their bank account. She told me last week they reserved and paid in full for a beach house for their summer vacation.
Richard said his friends are still skeptical. They can’t believe that some kind of little pellet under the skin can have this kind of effect, blocking cravings in someone who’s been using oxycontin for years

I guess when you’re Richard’s size, you don’t have to prove anything. He just smiled while Margaret made a list of beach items they were going to pick up at Target while they were in the city.

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