Sunday, October 31, 2010

Seattle Office Opening Nov 1st

Dr Michael Rosenfield joined us in Richmond earlier this month to complete his clinical training and is now ready to open our newest clinic serving the Pacific Northwest, including Portland, Seattle, Vancover and Anchorage.

Patients wishing to see Dr Rosenfield in Seattle should contact Jennifer at 1-877-77-DETOX (33869) or e-mail

Saturday, October 30, 2010

Blame the dog

Anyone with a current DEA license to prescribe has heard the stories from patients: my prescription for percocet blew out of the car window…my oxycontin tablets accidentally fell into the toilet….i was house-sitting and my fentanyl patches disappeared….the dog ate my vicodin.


Funny how dogs just hate blood pressure medication but have a real penchant for opiates.


So, it was kind of a relief when one of my delightful patients who is getting himself off suboxone through our Accelerated Opiate Detox program showed up yesterday and told me his dog ate his blood pressure cuff.


This, I can handle. No 12 step program for that pooch.


Joan R. Shepherd, NP

Wednesday, October 27, 2010

AA celebrates its 75th Anniversary

It was pretty big party down in San Antonio, Texas this past July. Over 50,000 people came from all over the world to celebrate, participate, and share their recovery. There were Key note speakers and lots of recovering alcoholics sharing their experience strength and hope. AA has a convention every 5 years.


It is times like this we can reflect on how much this organization has contributed to our world and helped change so many lives. AA has helped many people stop their own personal suffering and helped them start to contribute back to society and lead productive and happy lives. It has helped many of their wives, and children get their loved ones back.


AA has spawned many other 12 step programs including Narcotics Anonymous, Gamblers Anonymous, Al-anon, and others.


AA was also instrumental in helping us understand this disease of addiction and instrumental in even accepting it as a disease. From the early days in 1935, AA taught that Alcoholism is a physical disease. I think that this helped the medical profession to accept this and then continue ongoing research into the disease. These days, of course we have much more understanding of how the brain works and it is easy to understand and accept alcoholism as a disease. But in the early days it took a few drunks to sober up and realize they weren’t crazy. Once they saw that they weren’t crazy and that pretty much anyone could get sober it became a lot more clear that this really is a disease. An early AA saying went like this - “We aren’t bad people trying to get good, we are sick people trying to get well”.


After 75 years I am glad the medical profession has caught up.


Dr Peter Coleman

Sunday, October 24, 2010

“Addicts/alcoholics often compulsively pursue happiness no matter how bad it makes them feel”

Addicts/alcoholics are famous for doing self-destructive things over and over again. A DUI. Jail time for a barroom brawl. A lost job. A divorce. You get the picture. Their continual, insane behavior leads to horrible results. The unfortunate part is that the addict/alcoholic is just trying to be “happy”. Everyone deserves to be happy, right? Not exactly.

Life is not fair. I know, shocker, right?!? Part of the problem of the scourge of addiction is the reality of dealing with bad or negative feelings. Addicts/alcoholics are known for their desire to always feel good, or happy, or content. When life intervenes to prevent such feelings, they usually go bonkers trying to find a way to remove the bad feelings and find better, happier ones through their addictive substance/activity. The turnaround begins when they realize if they compulsively pursue recovery, happiness will show up but not necessarily in the form they expect. While external events are often uncontrollable, internal reactions are not.

There are a very important group of words that caollectively are referred to as the 9th step promises in the A.A. Big Book. They talk about all the ways in which life will change for the one who is willing to embrace the steps and do the work of recovery. For example, one promise states that, “we will know a new freedom and a new happiness” (p. 83). It continues covering such items as “no regret for the past” (p. 83), the experience of “knowing serenity and peace” (p.84), eradication of, “feelings of uselessness and self-pity”, and a shifting of their outlook on life (p.94). These are hefty promises and might seem too good to be true. But, what if, they’re not? What if, when recovery principles are directly applied, lives change dramatically and cause people’s quality of life to be “rocketed into the fourth dimension of existence of which [they] had not even dreamed” (p. 25)?

We know that this is the case. Time and time again the steps have proven as a solution to a brand new life. There is person after person after person who can testify to how life has changed for them since they embraced the steps, stopped living for themselves, and focused on helping others and living a spiritual life. Only then, did true happiness finally arrive. And it was (is) a happiness of the heart not of external circumstances. It was (is) a happiness just to be alive. To smell the fresh air. To eat blueberry pancakes. To feel the warmth of a hug from a friend or loved one. To see the colors of the leaves change at the beginning of the fall season. And, it was (is) the realization that happiness, while elusive externally, can always be chosen internally.

As you go through the course of your day, think about what would truly make you happy. Is it realistic? Is it obtainable? Would it really satisfy? Maybe so, maybe not. More importantly, can you choose happiness through the gifts of the steps and sobriety no matter what happens externally to you and your life? Think about how ineffective, temporary and damaging attempting to fix your emotions with drugs and alcohol really is. Resolve, just for today, to let go of the drive for happiness and let it come to you. Otherwise…you could look like this guy!

Chris Newcomb - Aftercare Coordinator

Saturday, October 23, 2010

The Coleman Institute Opens its 7th Location in Seattle, WA

The Coleman Institute Opens its 7th Location in Seattle, WA

Richmond-based accelerated detox center now offers addiction in the Pacific Northwest.

Richmond, VA – The Coleman Institute, nationally acclaimed for its Accelerated Detox Technique and Naltrexone implant therapy for addiction treatment, announced today that it will open its seventh US location in Seattle, Washington. The new location, led by Dr. Michael Rosenfield of Emerald City Medical Arts, will bring Dr. Peter Coleman’s premier detox and addiction treatment resources to the Pacific Northwest, including the state of Washington and the greater metropolitan areas of Anchorage, Alaska and Vancouver, British Columbia, Canada. These particular areas have long been affected by controlled substance, alcohol and illicit drug abuse.

“We’re all very excited about Dr. Rosenfield incorporating The Coleman Institute’s services at the Seattle office,” said Dr. Peter Coleman, National Medical Director and founder of The Coleman Institute. “The demand for detox and addiction treatment in the Pacific Northwest is so high that many of our patients were travelling to our San Francisco office in search of a clean, sober and better life. The commute to Seattle from areas like Anchorage, Vancouver and even throughout the state of Washington will be much easier and cost-effective for our patients.”

Despite efforts to revitalize Vancouver, the city holds one of North America’s highest drug addiction rates; in particular, its “Downtown Eastside” area, a 12-block residential zone, hosts nearly 40% of the metropolitan area’s 12,000 intravenous drug users. Alaska maintains the highest per capita alcohol consumption rate in the nation, and its prevalence of alcohol dependence and abuse is twice the national average at 14%. The state of Washington also struggles with alcohol, heroin, cocaine and methamphetamine abuse. Emerald City Medical Arts, which will offer The Coleman Institute’s detox procedures, is located in the heart of Seattle, a central point for all of the major urban areas in the Pacific Northwest.

“Dr. Coleman and I both see the need for change in this area of the country and North America,” added Dr. Rosenfield. “Emerald City Medical Arts already provides Suboxone detox, so integrating The Coleman Institute’s other detox procedures will be integral to providing Seattle residents with the addiction treatment they need.”

Based in Richmond, Virginia, The Coleman Institute adds the Seattle, Washington office as the seventh in its list of national locations: two in California (Los Angeles and San Francisco), and one in Illinois, Indiana, Virginia and West Virginia. Emerald City Medical Arts is located at 16 Roy Street (Seattle, WA 98109) and will begin offering The Coleman Institute’s services on November 1, 2010.

For more information regarding this partnership between Dr. Michael Rosenfield and The Coleman Institute, please contact Mike Stevens at 877.77.DETOX (877.773.3869) or visit

About The Coleman Institute

Since 1998, The Coleman Institute has helped hundreds of patients detoxify and recover from the effects of heroin use and other narcotics such as Methadone, Oxycontin, Percocet, and Vicodin. The Coleman Institute’s Accelerated Detoxification Technique combined with Naltrexone therapy makes it unique among addiction treatment methods and leads it to achieve higher success rates than other addiction treatment centers. The Coleman Institute is based in Richmond, Virginia with six other locations in Barboursville, West Virginia, Chicago, Illinois, Jeffersonville, Indiana, Los Angeles and San Francisco, California, and Seattle, Washington.

Thursday, October 21, 2010


Step 10: “Continued to take personal inventory and when we were wrong promptly admitted it”

Mistakes…they happen. The reasons why they happen…that’s a whole different story! Bad mood? Not thinking? Accident? Indigestion? There are many reasons why one has to make apologies in life. If I had $5 for the number of lame reasons I have heard people use as to why they resorted back to alcohol/drug use…I would have a LOT of $5 bills. Regardless of the reason(s), it is nice when someone acknowledges a real or perceived wrong that they have perpetrated on us. And, believe it or not, it is nice when we acknowledge that we have been wrong in our speech and/or actions.

Step 10 is just the vehicle for such a situation. It’s been said that Steps 4-9 are the personal changes steps. If that is the case, which we think it is, than Steps 10-12 are the daily maintenance steps that keep that initial change alive, well, and growing. Why would the creators of the 12 Steps include one about admitting wrongs once you have already done so in Steps 4, 5, and 9? Because those were admissions of past guilt, NOT present guilt. Step 10 is about admitting wrongs as soon as they happen or as soon as possible when they happen.

Part of recovery is personal accountability. If we are not accountable for our words and actions then we pave the way for sailing aboard the “Good Ship Selfish”. This type of “lifestyle vessel” always leaves casualties in its wake, including ourselves. Therefore, we have to keep our personal behavioral books up-to-date, so to speak. The reality is that we are going to hurt people and we will make mistakes. Many of us struggled with the elusive “perfection” standard and ruthlessly held ourselves and others to the same standard. Perhaps when they failed us, we got revenge. This very act of revenge comes from resentment which is an addict’s worst nightmare. It leads to relapse and it’s wrong. The Big Book puts it this way, “Continue to watch for selfishness, dishonesty, resentment, and fear. When they crop up, we ask God to remove them at once (p. 84).”

Step 10 is a lifelong process. We will make new mistakes, that is inevitable. However, we can create new beginnings with a sincere apology and a renewed effort not to repeat the same offense again.

Chris Newcomb - Aftercare Coordinator

New Naltrexone Implant study

I don’t get the opportunity to do a lot of medical research, so I was delighted when Wedgewood Pharmacy asked me to coordinate a study on their new Naltrexone Implants. We had looked at the new implants and they looked beautiful. They were the same diameter as the old ones which meant they would be just as easy to insert, but they were more tightly compressed. The tighter compression meant that they could contain more Naltrexone – in this case 40% more Naltrexone. They were designed to last longer but no one knew if they did last longer and if so, how much longer.


I am delighted to say that we have just finished the study and we can now report that the implants do last considerably longer than Wedgewood’s previous implants….


Oral Naltrexone has been approved in the US since 1984, but its usefulness has been very compromised by poor compliance –patients just don’t take their medicine even though they have all of the right intentions. Sustained-release forms of Naltrexone such as implants or other depot formulations have been developed in an attempt to improve adherence. Wedgewood pharmacy were the first to start making Naltrexone implants back around 1998, and they have been compounding top quality products since then. In 2004, a group of researchers in Sweden studied Wedgewood’s implants and reported their results in a medical journal. Their study showed that the 1 gram implant delivered good blood levels for a median time of 55 days but with a range of 30 to 80 days.


Since then, Wedgewood pharmacy have compounded a 1.4 gram implant that is more tightly compressed and is designed to provide longer lasting therapeutic blood levels of Naltrexone. Our current study was designed to obtain blood levels on patients who received this 1.4 gram implant to determine if it does deliver effective blood levels over a longer duration.


We identified six patients, who had come to us in order to get a Naltrexone implant to help treat their substance abuse problem. They each agreed to participate in a study of Naltrexone drug levels. The patients had blood drawn 24 hours after the implant was put in. They got another blood level after one month and then every 2 weeks until the implant was gone.


The results we obtained were very impressive. All of the patients had therapeutic Naltrexone levels at the end of 6 weeks and 50% of the patients had therapeutic levels at the end of 14 weeks. This is considerably better than the previous implants. It means patients don’t have to come back as often to get their next implant and most of them still have good levels for three months.


We have begun to use these implants in our regular practice and we continue to be very happy with the results. This month we are also meeting with the pharmacists at Wedgewood to see if we can make the implants even better.


Dr Peter Coleman

Ask the Dr!

Dr Coleman will be hosting two free conference calls each month for patients, family, healthcare professionals or any other interested people. These will be open forums to ask questions and discuss issues related to addiction.


In November these forums will be offered on the following days and times:

1. Wed Nov 10th -- 5:30 - 6:30pm (EST)
2. Wed Nov 17th -- 10:00 - 11:00am (EST)


To access the forum call 1-605-475-6333 and enter the code 189583. You can access the call 5 minutes before the scheduled start time.

Webinar Series

The fifth and final in our series of Webinars, titled “New treatments for Benzodiazepine Dependence and Cocaine Addiction” is being offered to all Substance Abuse and Medical Professionals on the following dates and times:

1. Nov 3rd -- 5:30 - 6:
00pm (EST)
2. Nov 11th -- 7:30 - 8:00am (EST)

The Webinar will be presented by Dr Peter Coleman, board certified in Addiction Medicine and practicing Addiction Medicine & Substance Abuse Treatment for 20 years.

Space is limited so please register early by e-mailing with your preferred date(s).

Monday, October 18, 2010

Free range chicken eggs - Whatever!

I’m a volunteer with the VCU-Medical College Speakers Bureau and next week I am looking forward to speaking to a group of people who are gathering together for a family reunion. About 100 members of the clan from all over the country will catch up, hang out, check each other out to see who’s looking good and who’s getting fat or bald. The cool thing is that the person designated to coordinate the reunion has decided to carve out time for a workshop on healthy life style and nutrition. She says her family really needs it.

The gist of my talk will be to distinguish between Primary and Secondary Foods. Secondary foods are what we put into our mouths. Primary foods are everything else: our physical activity, our relationships, our finances, our spiritual life, our creativity, home environment etc….In essence, if a person is bored to tears with his day job, is in a less than healthy relationship, living beyond his financial means, or using addictive substances to relieve stress…it doesn’t really matter if he’s eating the highest quality organic free-range-forage-fed chicken eggs.

The work we do at The Coleman Institute, helping people stop using opiates, benzos and alcohol is a great example of people addressing some Primary Food issues. Our Aftercare Coordinator/Coach, Chris Newcomb helps to steer our clients into treatment programs that allow them to start taking baby steps toward a life of fulfillment, i.e. dealing with Primary Food issues.

Call if you have any questions about our Accelerated Opiate Detox and naltrexone treatment; we love what we do and we’re good at it.

Joan R. Shepherd, NP

Friday, October 15, 2010

A Priceless Investment

I rarely field the questions about cost when people inquire about an Accelerated Opiate or Benzo Detox from The Coleman Institute. Our excellent Intake Coordinator, Jennifer Pius advises people about payment options.


I can, however, speak to people about the value of our product, and what a person might expect to get from his or her investment with us.


For instance, Sam (not his real name) just marked a year of being clean. He came every two months for a naltrexone pellet. What did he get for this investment?


He got his family back.

He got his job back.

He got sleep back.

He got gratitude back.

He got peace of mind back.

He got laughter back.

He got true friends back, and has made some new ones as well.


This list will continue to grow. As our staff gathered around to give him a big farewell, congratulations hug, I couldn’t help but think—like the cheesy credit card commercial—Recovery: It’s Priceless.


Joan Shepherd - FNP

Tuesday, October 12, 2010

Towing and Recovery

Yesterday on my bike a huge flatbed roared past me. Stenciled onto the back of the cab were big red letters: TOWING and RECOVERY.

I thought, now that would be an interesting way to tout our own services at The Coleman Institute…

I looked up a couple definitions of Towing:

“The act of hauling something (as a vehicle) by means of a hitch or rope” and another, “assisting a vessel unable to maneuver by pulling, pushing or towing alongside”.

Either of these makes a nice metaphor.

While most of the clients we work with come of their own free will, there is still a bit of reluctance to leave the familiar-albeit-miserable life of opiate (alcohol or benzo) addiction.

We are delighted to do our part to ‘tow’ you along as you navigate one of the more formidable parts of entering Recovery: Detoxification.

It’s not painless, but there is a sense of release and relief for the person who has reached out for help and put himself in our hands.

Call us if you need a Tow job. We call it our Accelerated Opiate Detox. Recovery is then one step closer.

Joan R. Shepherd, NP

Monday, October 11, 2010

Compassion and Competence

Last week was busy and wonderful at The Coleman Institute.

We helped a married couple with two children detox off a variety of opiates they’d been using for some several years. They’d kept it a secret from their family, but their lives had turned into a series of exhausting, shame-filled activities centered around getting money for drugs, hiding, and trying to hold things together with a very thin thread.

Another great guy came from Oklahoma with his entourage; the whole fam damily was with him! It was so fun to work with him and help him get off the 120mg of methadone he’s been a slave to for seven years. I think all of us here in Richmond would have a warm welcome in Oklahoma, should we head west.

Finally, a woman who’s been on the maximum doses of fentanyl for back pain for many years, sick of her dependence on medications, tired of the side effects, the lack of energy, the minimal pain relief being provided, bravely went through an Accelerated Opiate Detox. I checked in with her a couple days later. She also works in the medical field and said, “I cannot find one bad thing to say about my experience. Every single one of you were so nice and professional. I told my Mom I want to volunteer at The Coleman Institute.” That felt pretty good, because honestly, our staff really does love working in this specialized field. We’ve got the right blend of compassion and competence to get people through a tough process.

Joan R. Shepherd, NP

Saturday, October 2, 2010

Dependence, Tolerance and Addiction

Nursing 2010 recently published an article about managing pain in addicted patients. The author discussed the fact that there are a few buzz words associated with addiction and substance abuse that can be a little confusing.

Dependence is a normal physiologic response to chronic opioid use. If an opioid is abruptly withdrawn from a person on long term opioid therapy, the person will experience a withdrawal syndrome.

Tolerance occurs as the body adapts to chronic opioid use. Because of tolerance the opioid’s effects-both positive and negative-tend to lessen over time. Most adverse reaction such as nausea and sedation diminish, but so does pain relief. The person who’s becoming tolerant to an opioid will report more pain despite receiving the usual drug dosage. Tolerance is also a normal physiologic response and not a sign of addiction.

Addiction is a chronic, neurobiologic disease with physiologic, psychological, genetic, and environmental components. It’s characterized by four C’s:

· Craving for the substance

· Lack of Control over the substance

· Compulsive use

· Continued use despite harm.

At The Coleman Institute we help people get off opiates through our Accelerated Opiate Detox and naltrexone implants. We love what we do and we’re good at it.

Joan R. Shepherd, NP