Monday, December 28, 2009

Mike's Story

I asked one of our patients to describe the journey that brought him to The Coleman Institute for an Accelerated Opiate Detox. This is what he wrote for me:

“After sustaining injuries during college football I was introduced to opiate painkillers. During my senior year of college I progressed to using Oxycontin without doctor’s prescribing them to me. After graduating and having free time on my hands my tolerance began to climb out of control. After getting married, I moved 600 miles away from home where I didn’t know anyone in an attempt to stop using. I didn’t use for about a year, but only because I didn’t know anyone to get it from. I slowly learned the difference between choosing to quit and being unable to use.

My wife was homesick and wanted to move back home and thought I was better but subconsciously I knew I was going to start using again, even feeling excited about it. I told myself everything would be ok and under control. I got high the day I moved back home.
I worked long hours fueled by being high all the time and built a successful business from the ground up. The business that I worked so hard to build ended up causing my addiction to grow even faster. I had complete flexibility with my schedule and I used the funds to buy large quantities of Oxycontin. At the worst point I was spending $10,000 a month on drugs while at home my wife struggled to pay the bills.

I had to beg investors for more money to make ends meet at my business. It all came to a head when my wife started catching me using at home and at my office. I knew I had to make the choice to get better or I would lose my wife and son, who is due in April.

After a brief unsuccessful stint with Suboxone therapy my counselor recommended The Coleman Institute. I had nothing else to lose so….why not. Today is Tuesday November 10th and here I lay, right before having my naltrexone pellet implant with high hopes for the future thanks to Joan Shepherd and Dr. Coleman. I can honestly say the first couple days of detox were not that bad, although today has challenged me. I’m ready to wake up tomorrow and start a new life.”

Thursday, December 24, 2009

Holiday Detox

To choose nursing or medicine as a profession usually means sometime in one’s career one will be covering weekends and holidays. So when my children were young, I had to take my turns doing shifts on Thanksgiving and Christmas for many years.

As much as I loved being home during a holiday, from the beginning I was always grateful to be the one ‘wearing the uniform’ rather than being the patient when I did have to work. Being in the position to help someone who has to be stuck in a hospital over the holidays was actually pretty gratifying.

We have patients at The Coleman Institute who are going through Accelerated Opiate Detoxes now, over this Christmas holiday. Clearly they would rather be elsewhere, not having this illness of addiction take over their holiday time. For these people, coming in over the holiday is the only way they can make it work into their schedules. For them, it’s become a life or death situation. They know they are losing their dreams, their families, their professions—their very lives--as long as they continue to use.

And once again, it is with lots of compassion Dr. Coleman, the staff at TCI, and I see these patients over the holidays. We already have patients booked over the NEw Year, so even while we won’t be seeing family practice patients, we will be working with patients going through a detox. If you need some help—we know the problems don’t stop during the holidays. We can be here for you.

Joan Shepherd

Sunday, December 20, 2009

Preliminary results for implants

We have been studying some new Naltrexone Implants for the last couple of months. These are 1.4 gram implants that seem to last at least 2 months. As such, they may be a considerable improvement over the old 6 – 8 week implants.

We have been drawing blood levels on our patients when they come back in 8 weeks for their next implant. So far all the patients have had very good blood levels, indicating that the implants reliably last 8 weeks. It looks like they may even last over 12 weeks in many patients. This would be fantastic. It is so much easier for patients to come back every 3 months – only 4 implants to get a whole year of coverage. We will continue to study these implants and we may even be able to work with the pharmacy to make them last even longer.

Dr Coleman

Thursday, December 17, 2009

Hard work does pay off

I have been just spent the last couple of months in intensive study for my Family Practice Board Exams. I was kind of dreading this because frankly I knew it would be a lot of hard work. And it was.

All Board Certified Family Practice physicians have to re-certify every 9 years. Of course this is a good idea – who wants to see a physician who has not kept up with the practice of medicine. It sure didn’t seem like 9 years since I last recertified. During that time quite a lot has changed. New drugs have been invented and come into practice. Some old ways of doing things have been determined to actually be harmful. In many situations research has determined the optimal ways to treat diseases that we used to treat in a less scientific manner. Brushing up on my family practice was especially important to me because I have been specializing in Substance Abuse more and more, so it was important for me to do some extra study.

So I was not looking forward to all the reading and extra study that I was going to have to do. But I have to say that embarking on the study program, and completing it was a great experience for me. I read a lot. I went to a very intensive conference in St Louis. I took a lot of practice tests. I made notes. I tested myself over and over. I really put a lot into it. And the benefits I got out of it have been awesome. I got to re-learn a lot of stuff that I had not thought about since medical school – there are a lot of very rare diseases that they want you to know about even though you will never see one in your lifetime. I got to remember just how much I love learning. I got to remember just how much I love studying medicine. I have always been so fascinated with how our bodies work - how absolutely marvelous they are. And studying diseases has always been fascinating. Little TB germs that get into our lungs and sit there for years until our immune system slows down and they come back to get us. Funguses that love to live between our toes. Autoimmune disease where our own antibodies start to destroy our thyroid gland. And sometimes our arteries get clogged up because we eat the wrong things and don’t exercise. I also got to remember just how much I love being able to practice medicine. It also felt good to realize that my brain is still quite good at understanding things and remembering things.

As I thought about my recovery, and what this study program experience has taught me, I realized that more and more I think the purpose of our lives is to learn and to love. We have all been given a marvelous mind and keeping it inquisitive and active is a real treasure. Loving ourselves, our neighbors and our communities is the second part of what we should be doing. In many ways studying and relearning medicine was an act of love - for myself, and for my patients.

So even though it was a lot of work, I sure did get a lot out of it. As my dear old mum used to say, “Peter, you get out of life what you put into it” I think she was right.


Peter C.

Expect the Unexpected

Life sure does throw us curveballs, doesn’t it? The unexpected gift from a friend. The kind word from the checkout clerk. The last minute touchdown by your favorite team. That song on the radio you haven’t heard in years that bring tears to your eyes. Your child crawling into your lap and snuggling up against your side for a long winters nap. All great things to celebrate. These types of curveballs are like wiffle balls…lightweight, easy to hit right out of the park.

Other times, though, life throws us bowling balls that crack our bat and break our wrists…the unexpected auto accident, that health crisis you didn’t expect, a death in the family, a storm that damages your house, that relapse you promised yourself and others would never happen again. These bowling balls often blow away our conception of a calm, peaceful world where all is right and good and true. We don’t expect it and often we don’t accept it.

It’s early December as I write this column. There is a palpable sense of expectation in the air. The seasonal lights are littering the landscape reminding me that this is a special time of year. Radio stations are playing Christmas music over and over and over again…and over again some more! Children are about to pass out with anticipation of what they will get on the big day in about two weeks from the bearded one from the north.

As I think back over 2009, it’s been a good year here at the Coleman Institute. We have been privileged to assist so many addicts struggling to reclaim their lives from the ravages of opiate, alcohol, and benzodiazepine dependence. We’ve walked with our patients as they experienced great victories and even bitter defeat. We’ve celebrated with support people once the light bulb goes on and the addict starts doing all the right things.

Furthermore, in the midst of the struggle, we have come to expect the unexpected. We’ve come to see that the human spirit is tough to crush. We’ve understood the power of compassion and affirmation to a hurting addict with nowhere to turn. We’ve felt frustration and grief over an addict who went back “out there” one more time and never returned. Conversely, we’ve become aware of the joy of success when a patient chooses to live sober one 24 hours at a time. And we’ve learned the power of hope when an addict breathes a sigh of relief and realizes that TCI is there home away for home for the few days they spend with us.

In this season of the unexpected (see Christmas morning and the gifts you didn’t expect to actually get), I invite you to expect the unexpected. Expect to be sober. Expect to be clean. Expect that sobriety is well worth the struggle. Expect the Promises to come true in your life. Expect to be amazed. Expect to be transformed. Expect to receive joy. Expect to receive love and friendship. Expect to experience the unexpected. And remember that to “get clean and stay clean” is the most unexpected gift of them all. Merry Christmas. Happy Holidays. Happy Kwanzaa. Happy Hanukah. Seasons Greetings. Expect the unexpected!

Until next year,

Chris Newcomb - Aftercare Coach / Coordinator

Monday, December 14, 2009

Dumping the Loser

Beth came in with her Mom for a follow up implant. Two months ago she’d gone through an Accelerated Opiate Detox from heroin. Several years earlier her sister had gone through an Utra-Rapid Detox with The Coleman Institute (we are no longer doing those).

Beth is smart and beautiful. She finished high school and was headed for college when heroin got in the way. She’d been extremely involved in her church and left that behind for a while.

Since her detox she’s signed up for school again and has become extremely active in a recovery program for young adults at her church. One pesky little problem she’s having is losing the boyfriend. I couldn’t help but point out to Beth the ‘victim’ language she was using during our visit.

Me: Are you still seeing Evan?
Beth: Yes.
Me: is he still using?
Beth: well, yes….some.
Me: why are you still hanging out with him?
Beth: I feel responsible that he’s on heroin. Before he met me he was just using pills, so I’m trying to help him by taking him to church meetings.
Me: So, he’s using heroin because of you, and you are absolutely positive this is true?
Beth: Well, maybe he’d have tried it with someone else if he hadn’t met me.
Me: You feel like you are responsible to help him, to save him?
Beth: Yes. He makes me feel guilty if I don’t hang out with him and take him to these meetings.
Me: No, you are choosing to feel that way. He can’t make you feel anything.
Beth: I guess so.
Me: how do you feel—in your gut—when you close your eyes and imagine going to his place, seeing him use, taking him to church.
Beth: my stomach goes into knots and my head aches. I feel like I’m shackled.
Me: And take a minute to imagine who you would be if you could let go of the thought that “I am responsible for Evan’s recovery”…
She was quiet for several minutes. When she opened her eyes, they were teary, but she was smiling...
Beth: I’d be free. I’d be hanging out with fun people and laughing a lot. I’d be making plans to go to college.

Clearly, it’s time for Beth to be that person; to believe the truths that set her free, and not the lies that shackle her. We’ll see where Beth is in two months when she returns for her next implant. Hopefully she’ll be examining her beliefs daily and dumping the ones that no longer serve her.

Friday, December 11, 2009

Family Reunion

I know perfectly well that going through a detox isn’t supposed to be fun. But…what the heck? What if it is a little fun?

We just had a group of 9 people take over the detox wing of The Coleman Institute earlier this week. Three of the family members were clients detoxing from heroin or pills; the other 6 were various family support members.

They should have had t-shirts printed up—it was like a raucous family reunion! By night they played cards in the hotel, by day they hung out and had meals together. On the final day of detox, they played guitar with Chris and moved from room to room being incredibly grateful for the opportunity to reclaim their ‘lost’ family members.

Three weeks prior to their arrival, one family had lost a son to a heroin overdose. His parents, step-parents, cousins and remaining brother are committed, together, to recovery and all three signed up for The Freedom Plan, ensuring a year’s worth of naltrexone implants; a year’s worth of peace of mind.

Tuesday, December 8, 2009

Doing the thing we think we can't

“We gain strength, and courage, and confidence by each experience in which we really stop to look fear in the face... we must do that which we think we cannot.”

I was a little concerned when my yoga teacher started our class with this quote by Eleanor Roosevelt. My mind went running: Must be some pretty hard poses she’s got in store for us today…I hope I can balance….my elbow feels a little sore….I’m the oldest one here, I shouldn’t be doing these challenging poses… sure would have been nice to stay in bed on this rainy morning…wonder what I’ll eat when I’m done…and blah blah blah…

The funny thing about looking fear in the face is that often there isn’t much there. I remember once as a kid, I woke up in the middle of the night terrified to see a snake on the floor in my bedroom. I screamed for my father who sleepily came to my door, turned on the light, revealing my socks. My brain had created an entirely different, horrifying scenario.

The whole idea of yoga is joining the body and mind. It comes from a Sanskrit word meaning yoke or union. The type of yoga that I practice most is Vinyasa, so every movement is connected with either an inhalation or an exhalation. The idea is that the postures are more like breathing exercises than gymnastics. The breathing keeps one in the present. There is no space for worrying about the past, nor anticipating the future. Only breath, where you are, at the moment. No place else to be.

The lessons learned ‘on the mat’ at yoga class are intended to be taken ‘off the mat’ every bit as much as the message from the preacher doing Sunday services, or the pearls gleaned from an AA or NA meeting.

Many people who are anticipating an Accelerated Opiate Detox are stuck in the fear of painful experiences from previous attempts to stop. Many are obsessed with what the future will bring.

Creating new pathways for the addictive brain starts with being present and showing up. Breath by breath, fears dissolve and transformation happens. Churchill once said “…I remember the story of the old man who said on his deathbed that he had had a lot of trouble in his life, most of which had never happened.” Call The Coleman Institute if you are ready to do ‘that which you think you can’t’. You can, and we can help.

Saturday, December 5, 2009

Bring your Baby

When I gave birth to my two daughters many years ago, I was in a pretty nice room at a local hospital. Since then birthing suites have evolved into very peaceful, beautiful, homey yet functional settings.

So I just couldn’t seem to help myself from hovering in Suite B at The Coleman Institute earlier this week. A young couple from North Carolina was here with their 3 week old son. Dad is detoxing from opiates. The lighting is soothing, Mom is nestled in a big comfortable reclining chair nursing her baby. Dad is snoozing in bed. It feels as warm and cozy a nest as any respectable birthing room.

A few months ago we had twin 8 month old girls. We borrowed a playpen and everyone took turns holding them so their Mom could focus on being a support person for their Dad, her husband. It worked seamlessly.

Just wanted to mention how accommodating we can be regardless of your circumstances. …and it’s sooooo nice to have a baby or two around.

Tuesday, December 1, 2009

Rebalancing the Brain

When we meet a patient for the first time at TCI for an accelerated opiate detox, our main focus is helping him or her detox from the drug of choice. Because Dr. Coleman has been doing this for many years, most detoxes go smoothly; in fact a patient recently described his experience as “an elegant detox”. It’s true—the techniques and medications have been tweaked and refined over many years, and our patients have a 99% completion rate. We know, however, that this is just the beginning of a new life for our patients.

A person who has been abusing opiates will have a brain very depleted in dopamine, the neurotransmitter that reigns in the pleasure center. Production of dopamine essentially shuts down after prolonged use of opiates. Often patients describe feelings of depression and exhaustion and boredom in the first few weeks after completing a detox.

Studies show that if a person can remain free of opiates, the dopamine in the pleasure center of the brain will return. How quickly the dopamine returns varies from person to person, and this is an area of growing interest to us.

Many treatment centers around the world are responding to patients’ interest in restoring health without depending solely on drugs. Instead they are focusing on an integrative approach that includes using the 12 Step model as well as replenishing the depleted neurotransmitters to rebalance the brain chemistry.

The Coleman Institute has relationships with such addiction treatment centers. All of our patients are assessed to determine aftercare treatment needs, and if this type of treatment following your detox is of interest to you, we can connect you with the appropriate people.

Be on the lookout later this week for a questionnaire to get an idea of how your own dopamine levels are looking. And as always, don’t hesitate to call if you or a loved one needs some help.