Monday, December 19, 2011

Holiday Detox

It’s not unusual for patients to express how different it feels to be treated at The Coleman Institute.

Yesterday, a gentleman from Maryland who came to The Coleman Institute for a Rapid OpiateDetox remarked about his previous doctor who had treated him for pain, but did not have experience in treating the physical dependence which subsequently developed.

 He knew how to get the patient on pain meds…but didn’t know how to help him get off pain meds. In frustration his doctor cut him off, basically telling him he ‘didn’t need the meds anymore’, and implied it was a character flaw that he was still using them. 

He’d been chastised, lectured to, and judged for his inability to stop. At best, he felt like a second class citizen; on bad days—like a criminal.

 He told me it was a refreshing experience to come to a facility staffed by medical professionals who understood the disease of addiction.

Besides recognizing addiction as the medical condition that it is, another feature that distinguishes us is our commitment to working with our clients’ schedules.

We cared for several patients getting off methadone and other opiates throughout the Thanksgiving holiday, and we will be treating patients through the Christmas and New Year’s holidays as well.

If you or a loved one is ready to commit to starting 2012 drug-free, please give us a call. We’ll have the (virgin) eggnog ready. 

Joan R. Shepherd, NP


Thursday, December 15, 2011

Opiate Recovery (without Naltrexone Implants) is extremely difficult

Since doctors first started treating addiction, it has been clear that long term recovery rates for patients with opiate addiction are very low.  In 1989, I worked in a very good outpatient treatment program here in Richmond Va.  After a few years, we studied our success rates.  Our alcoholic patients did quite well - about 60% were still sober after six months.  But when we looked at our heroin addicts, it was a completely different story - not even one patient who had been hooked on opiates was still off drugs after six months.  Most of the patients didn’t even complete the 8 week program.  They dropped out of treatment because they had relapsed back onto their opiates – (This was before I started using Naltrexone implants).  I realized at that time, that without help, most patients are just not able to overcome the intense cravings to use again.

A recent study from a VA Hospital in Washington State affirmed my experience.  Their study showed terrible success rates, even with very good treatment.  They studied 112 patients who wanted to get clean, and were admitted to a hospital for detox.  22 % didn’t even complete the detoxification process!  What is worse, and very significant, is that after only 3 months there were only 3% who were still free of opiates!

Three percent success rates with regular treatment is awful.  And this was a good program - their detox methods were standard, they offered intensive therapy, either inpatient or outpatient, and they offered other long term support for all their patients.  And, even with all of this, they had only 3% of their patients who were drug free after three months.

There is a lot to learn from this study.  First, the withdrawal symptoms from opiates are so strong that many patients do not complete the acute phase of detox.  Second, most of the patients that do get through the acute detox period suffer from post acute withdrawal symptoms and quickly relapse, within the first three months. When you think about results like this, it is not surprising that many physicians and many treatment facilities give up on having their patients get completely off drugs. Instead, they recommend long-term opiates like Methadone or Suboxone. Fortunately, we have found a better way to help patients stay completely drug free! We use a non-addictive medicine that decreases cravings and helps patients avoid relapse – Naltrexone Implants.

I have to say I am very proud of the programs we have developed here at The Coleman Institute to help patients get through the critical time period of early recovery.  Our Accelerated Detox Program is comfortable for the patient and it has over a 99% success rate at completing the detox.  It is very rare that patients who start our program drop out and do not complete the detoxification.  

At the end of the detoxification process, we insert a small Naltrexone Implant.  It is an easy procedure that usually takes only 5 minutes.  The Naltrexone implants we use provide excellent protection during those first critical months when the brain is crying out so strongly for opiates.  

A number of research studies have shown that patients using Naltrexone Implants achieve a 60% success rate, even after 12 months.  We have similarly good success in our offices. 

It feels good to be providing programs that help patients get completely off drugs and start to reclaim their lives. 

The staff and I The Coleman Institute wish all of you a great Holiday Season and a Happy New Year!!!

 ~ Dr. Peter R. Coleman


“A man dies daily, only to be reborn in the morning, bigger, better and wiser.” – Emmett Fox
We are entering the final stretch of 2011.  The temperatures are dropping.  The turkey has been digested.  Christmas lights are starting to light up the avenues, byways, and highways of our nation.  And yet at this time of year, people tend to be so stressed out.  Whether they are celebrating Christmas, Hanukkah, Kwanzaa, or just being with family and friends, this time of year lends itself to stress, frustration, and sickness more than most of the rest of the year.  Why?  I wish I knew the answer.  

                However, one thing remains constant regardless of what day of the year the current one is, we always restart who we are and where we’re going at the start of each new day.  Psychologists say that one of the best times to figure out what is really important to you is by paying attention to your first thoughts when you wake up in the morning.  It is during the first moments that we wake up that we are most vulnerable.  Think about it:  You’ve been asleep, usually all night, and now you have woken up to a new day.  Your body begins to charge up.  Your mind starts to wander and race about the day ahead.  And you receive what might be termed a ‘daily rebirth’.  That is, seeing that you are 6 feet above ground, you get another chance to go through life.  This is GREAT news!  Unfortunately, most of us never choose to see our lives this way.  Instead, most of us get stuck thinking about bills to paid, deadlines to be met, kids to get to school, significant others to please, and rest and relaxation that seems unattainable.  I think there is a better way to begin our new days ahead.

                Mr. Fox rightly asserts that each of us die daily.  Biology proves that fact.  All you have to do is look at our culture’s obsession with youth and beauty (read: cosmetic industry in the U.S. makes over 1 billion dollars annually) in spite of the fact that aging is an unalterable fact of life!  However, what he says after that fact is pretty astounding.  First, his perspective is positive.  He doesn’t say that we wake up smaller, worse, and more stupid although that may happen to a few select individuals (see the Darwin Awards).  His vision is that we awake to a new day bigger than the last because we got through it.  We survived the soaring highs and low lows.  That is something to be happy about it!

                Fox also makes note that we wake up better than we did a day earlier.  Of course, many days we don’t feel that way but it’s true.  If I face the challenges of the day and fail, I am still better for having faced them.  It’s when we run from the challenges of life that we get ‘worse’, so to speak, in our personal growth. 

                Finally, Fox adds that we get wiser with each new day.  Nothing could be more true!  I’ve learned so much throughout my short life.  And the more I learn, the more I grow.  And the more I learn, the more I want to learn.  And, the more I grow, the more I want to grow.  It is addictive, pardon the pun.

                So, as you face the stress of this time of year, I encourage you to take those first few twilight moments as you wake-up and remind yourself of how much bigger, better and wiser you are on this day than you were just 24 hours ago.  Believe it or not, you’ll be surprised at what you find.  Submit yourself to a rebirth each morning.  Embrace the re-calibration of the new day.  Finally, embrace the rebirth of a new calendar year and all that it can bring to you and yours! 

- Chris Newcomb, M. Div. 

Wednesday, December 14, 2011

Special Delivery!!!

I saw a patient in follow-up today who just made me smile.  He came in for his 6th implant today; so although he’s had one relapse on his journey, he’s been clean for most of the year.  And he is one peaceful, happy, and grateful man!

He has a girlfriend who chose to stay with him because he committed to getting and staying clean.  He has proven this to her by coming to The Coleman Institute for regular appointments and going to AA meetings several days a week. His consistent choices are helping him stay clean one day at a time. 

Today, he told me that he and his – now fiancé- planned a pregnancy and she is about 8 weeks pregnant!  They will wrap up a ‘onesie’ (you know, one of those little baby long-john outfits with the built-in feet) and present it to his parents on Christmas Day.  They will be first-time Grandparents…and yes, they will be thrilled!

He told me that the most interesting thing for him since he has become sober is realizing how he used to view the world.  He says he used to blame others for all his problems.  Now, he says he can see how his behavior affected others.  He is starting to give back in little ways, like coaching his niece’s basketball team.  He promised me he’ll bring a picture of the baby’s ultra-sound in two months.  I can’t wait for that chapter!  

- Joan Shepherd, FNP

Thursday, December 8, 2011


A couple of weeks ago, we did an Accelerated Alcohol Detox on a lovely young man who is happily still among the living.  He was involved in a pretty bad motor vehicle accident and ended up in the hospital after blowing a breath alcohol level of 2.8.  Yikes!!!   Amazingly, he didn't get hurt too badly. 

At The Coleman Institute, we steer people into the most appropriate level of aftercare which may also include therapy.  He didn't talk much during the detox because he's a pretty quiet guy.  After he completed his detox, he started going to his I.O.P. (Intensive Out-Patient) classes.  I think the experience was kind of like a drowning, thirsty guy getting water.  He realized for maybe the first time in his life that he was surrounded by people who KNEW him! 

This not in any way discounting his very supportive family.  They talked about feelings and what happens when we don't know how to express them.  They discussed the A.A. 9th step promise: "We are going to know a new freedom and a new happiness."

He said good things were already starting to happen.  He owed over $10,000 for his emergency room visit, and he has no health insurance.  He received a call a couple of hours before his follow up appointment with me from the patient advocate at the hospital: the entire debt has been dissolved!  He is looking for more good things to continue.  I have no doubt they will!

- Joan Shepherd, FNP   

Thursday, December 1, 2011

Affirmations of a Warrior

Chris Newcomb, M.Div.  

I love action movies.  In particular, I like movies with action heroes who are the epitome of muscle bound, gun-toting, tough guys who obliterate the enemy.  Why?  Because every guy wants to be THAT guy!  Whether they admit or not, there is not a guy out there who hasn’t wished, at one time or another that they had the body of Arnold Schwarzenegger, the fighting skills of Chuck Norris, and the suave of George Clooney combined with the black tie good looks of any James Bond actor (or if you’re a child of the 80’s who wanted to be the Ultimate Warrior…see picture above).* 
There’s good news:  even if you are none of the above, you can still be a mental warrior.  Below you will find the 5 mantra’s of Warrior Affirmations for Recovery**.  I challenge you to speak these out loud first thing in the morning and last thing before you go to bed for the next 5 days.  Keep a written record of how you feel each day and if you notice any changes in your thoughts and/or behavior as it pertains to your sobriety.  You never know what you will gain if you do not try!
Warrior Affirmations:

Ø  I am a warrior.  I live in a no excuse world.
Ø  I am a warrior.  I play at 100%.
Ø  I am a warrior.  I do whatever it takes.
Ø  I am a warrior.  I keep my commitments no matter what.
Ø  I am a warrior.  I never give up.

* Ultimate Warrior and Warrior Affirmations are separate, unrelated entities
**Warrior Affirmations are from an anonymous author