Recently substance abuse and its treatment have risen in the consciousness of society. With recent television shows such as A&E’s Intervention, a general acceptance of substance abuse as a medical not moral issue is developing. Couple this with the recent liberal trends in dispensing opiate pain medications and anti-anxiety medications results in a trend of sorts. According to the most recent nationwide survey conducted in the United States by the National Institute of Drug Abuse (NIDA), an estimated 6.3 million persons, or 2.7 percent of the population age 12 and older had used prescription psychotherapeutic medications non-medically in the month prior to being surveyed. This includes 4.7 million using pain relievers, 1.8 million using tranquilizers, 1.2 million using stimulants, and 0.3 million using sedatives. The problem is on the rise. According to this survey carried out in 2003, the increase in rates of addiction to prescription medication is significant when compared to previous survey results.
Substance abuse providers are seeing a new profile of patients; that of apparently normal professionals often successful in all other aspects of their lives. Dr Mark G. Agresti, Vice Chair of the Department of Psychiatry at Columbia Hospital explains that most of today’s addicts are hooked on prescription medication—pain relievers, tranquilizers, stimulants and sedatives—not illegal drugs purchased on a street corner somewhere.
James Bevell, Director of Admissions for Poinciana, at Palm Beach, a facility that treats patients presenting with this profile, explains that these programs are adapted specifically for high functioning, motivated people who need individual attention and guidance. “Patients can free themselves from chemical addictions and continue with their lives”, he says.
Bevell states that ‘Executive Detox’ is an emerging service being provided to this new patient demographic.
“Many people who have been otherwise successful in their lives yet find themselves addicted had found their choices limited and unacceptable when seeking treatment. In years past the only alternatives were psychiatric hospitals or free standing substance abuse hospitals. They used to find themselves thrown into a system which was often overburdened and understaffed. Some found themselves misunderstood, misdiagnosed and mistreated. These patients could not tolerate the treatment and therefore went largely untreated,” he says.
According to Bevell, the concept includes an important component of luxury and confidentiality.
“Even though Poinciana is a hospital-based program, patients are discretely separated from regular hospital patients and other clinical facilities. At this center, they are offered exclusive concierge services for patients and family members. Upon request, they are even provided a private escort to accompany the patient to the facility”, he says.
The creators of the plan promise that this method allows patients, while under the supervision and care of a medical team of experts in addiction, to withdraw in comfort from substance dependency as they continue to work or study. They add that this method is different from other treatment programs because it is individually modified for each patient, taking into consideration not only their medical history, but also their personal issues as well. It is a holistic, bio-psychosocial approach.
“This is not cookie-cutter medicine. It is a program created to suit the needs of the individual—one patient at a time,” Dr. Agresti clarifies.
Dr. David J. Stern, an internist who practices in West Palm Beach, explains the general procedure as follows: “Patient arrives for assessment and medical examination by a Board Certified physician and substance dependency specialist. Then he/she is diagnosed and treated according to his/her specific needs. Patient receives a regimen of safe and effective medications, such as Buprenorphine, that promptly eliminate symptoms of withdrawal, including anxiety, sleeplessness as well as debilitating aches and pains normally associated with detoxification.”
Throughout course of treatment, patient's physical and psychological progress is monitored daily by a team of addiction specialists. Bevell adds, “This safe and carefully controlled program may allow patients to return to their daily schedules within 2 or 3 days, and is a much safer alternative to the Rapid Detox Programs being offered.”
After detox, patient returns home, to work or to his or her studies. Although consideration of further treatment options is recommended, hospitalization or confinement to a rehab facility is not strictly necessary.
According to the initiators of this new curative method, recurrence rates are minimal, and that is important because recurrence is the greatest obstacle detoxification treatments have encountered so far.
The new methodology is even applied, with some variations, for conquering addiction to Methadone, a drug used in treating addictions.
Dr. Agresti explains: “Treatment for Methadone is different than our standard treatment for conventional opiate dependency. Methadone poses additional problems and the course of treatment is longer. But the good news is we can help. Here's how it works. Utilizing a medical protocol called Rapid Receptor TransitionTM (RRT), the doctor will safely and comfortably switch your medications, monitoring your progress daily. After 7 days, when Methadone is out of your system you will be switched over to Buprenorphine. You may return home. Where you can follow up with an outpatient provider who will wean you off the Buprenorphine over the next 4 to 6 weeks. You may go back to work, your studies, or daily chores immediately. You will have energy. You will no longer crave Methadone or opiates.”
