Hello. I’ve had a history of using drugs and alcohol and I’ve been clean and sober for almost five months, but I was still experiencing a lot of brain fog and a lot of just not certain with my own thoughts, not being able to trust myself. So I decided to come and see Dr. Starr And to do the NAD+ therapy. And I’ve been doing it for a few days now and each day I’m seeing great progress, feeling a lot of clarity. It was recommended to me by a friend who did it, who experienced great results. And I can say from experience now that this has helped me in ways I never even expected what it looks like each day as you come in and the beautiful Arroyo Grande day, they check your vitals and they give you a little infusion and throughout the day it’ll be dripping.
It could take anywhere from four to maybe eight hours depending on how you take it and you have this feeling inside of your body where, at least for me, I felt like a heaviness, but it just felt extremely healthy. I felt like I was getting out of a steam room or something of that sort. So after doing it for a few days, now I can tell it’s definitely progressive as I’m feeling better each day, I have an increased curiosity like into when I was 16 years old and everything seems fresh, everything seems new, and I highly recommend this to anybody and everybody was able to do it as I’m feeling great, better than ever before. So I think Dr. Starr and the whole staff here, it’s been a great experience.
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Speaker 1: (00:02)
Speaker 2: (00:08)
Hey Dr. Ken Starr here, I want to answer the question for you. When can I get Vivitrol? This is important and I’m talking about for opiate dependence, not alcohol use disorder, which is a different topic altogether. You can only get Vivitrol when you are fully detoxed off of opiates. Okay. A lot of patients who come to the clinic are a little bit confused about the difference between Suboxone and Vivitrol and so forth. If you are on an opiate, whether it’s a pain pill or heroin or fentanyl or methadone or Suboxone or buprenorphine, if you have that in your system, you take Vivitrol or naltrexone that binds that receptor so it’s a much stronger magnet than any of those other substances. Much stronger magnet, much less activity precipitated withdrawal. No bueno, nosuper sick, right? If you’re on Vivitrol or you’re on naltrexone, you’re stable on it and then you use opiates, then it’s a blunted response.
Speaker 2: (01:01)
Now obviously it depends on the dose, but in general those receptors are occupied and there’s a cover over them. So if you use opiates, then it’s, it’s blunted and you have less effect. Um, sometimes even no effect. So the manufacturer’s recommendations, seven to 10 days, lots of drug and alcohol doctors will do it shorter than that, but the patients have to know that there are risks for precipitated withdrawal. If you’re considering this, you might want to do a test dose of a small amount of naltrexone first, but it’s enough that when you stop using opiates on your own, you have a natural slow kind of off-gassing of opiates at your system. That’s why withdrawal is days and days and days. If you were to take Vivitrol too early or naltrexone too early, it just super sick right away precipitated withdrawal. That’s what you want to avoid.
Speaker 2: (01:50)
All right, so the question is when can I get Vivitrol? Wait, as long as you can wait, as long as you can maybe have your provider give you a test dose of Narcan or naltrexone, which is a shorter-acting version of the same, and then you can do it. Now if you get a Vivitrol shot, remember that it doesn’t even work for several hours and it doesn’t get to a high level, a peak level for seven days or longer. So keep that in mind. But it’s great medicine for early recovery. It’s a great insurance policy if it’s something you’re thinking about and you’re motivated. Do I love it when my patients do a Vivitrol shot every month, then I don’t need to worry about them. I said, 28-day life insurance policy. They like it, their family likes it. Um, it’s great, but just don’t get it too early, lots of patients that we’ve seen over the years have had precipitated withdrawal. That’s it for now. Okay. Be careful with naltrexone. Be careful with Vivitrol. Make sure your detox before you take it. Thanks.
My name is Pam, I am an alcoholic. I’m sober over 60 days right now. And I just wanted to tell you how fabulous my experience has been at Ken Starr and the addiction center. My treatment here has been fabulous. Everybody from reception to counseling to setting up my… my direct experience has been wonderful. And what’s been really great is I know that I’ll get lifelong support for my sobriety and everything else that the program has done that I can continue that.
The great change in me… well, first, I’ll tell you, I just went to Betty Ford for 45 days for pain and alcoholism. That was a great experience. I didn’t think I could possibly feel better after that, because I thought I was 100%. But when I came here, my… all of my parameters from physical pain, anxiety, depression, craving to drink, all of those on a scale of 1 to 10 are 0 right now, which is a huge thing for me. I drank for 7 years, and so this is a huge change.
The other thing that has really changed for me is the ability to experience great joy. So, I wake up every morning, I’m joyful and happy. My sleep has improved since I’m here; that helps a lot. And I, not only do experience joyfulness, I’ve had that spiritual awakening since I came here. I became open to that. And this is the best I’ve ever felt with my conscious contact with God, my serenity, my sense of calm, my sense of purpose.
When I came here, I had an irrational fear of relapsing. I don’t feel that anymore. It’s just a huge improvement for me. And I can’t tell you enough about the support, the group support here, the individual counseling and therapy, developing a relapse prevention plan and exit plan for what I do out in the real world once I finish this. So, I can’t tell you enough how great this experience has been for me, knowing I can come back for any future needs that I have, and that’s really reassuring.
So, I hope you’ll consider coming here. I will come back if I have any problems. I know they’re here for me emotionally, spiritually, in terms of cravings, if that should come up, physical pain. And I know that I… you know, I always can come back for that. I’m really excited. I hope you’ll consider coming here.
The program is fantastic!
I was very skeptical coming into it you know, not knowing too much about it considering I’ve been through traditional detox before for opiate addiction and I am floored by the results!
I feel so much better after a 10 day detox than I would if I had gone anywhere else.
My cravings are at a minimum and my withdrawal symptoms were almost non-existent throughout the entire process.
A while ago I wrote a blog about Lofexidine ( Lucemyra). I basically said that there’s not a ton of data but what seemed clear is that it’s crazy ridiculous expensive and really not any better than Clonidine. At a 1000X higher price. Well, I proved to be right.
Dr. David Juurlink MD Ph.D. from Sunnybrook Health Sciences in Toronto, Canda wrote a terrific summary of the most complete, robust up to date study on lofexidine. Just published in the May/June 2019 edition of the Journal of Addiction Medicine. ” Safety and Efficacy of Lofexidine for Medically Managed Opioid Withdrawal: A Randomized Controlled Clinical Trial” Fishman MD, Tirado MD, Alam MD.etc. al.
This was a multicenter Double-blind placebo-controlled study of 603 patients at 18 different US Centers. Keep in mind two of the authors are paid consultants to the manufacturer of Lofexidine. What did we learn?
- Lofexidine does slightly reduce withdrawal compared to placebo.
- As mentioned in my previous blog, Lofexidine and Clonidine are pharmacologically and structurally similar
- A review of all randomized trials comparing lofexidine with clonidine in patients suffering opioid withdrawal have shown the reduction of withdrawal symptoms are the same.
- The benefit of lofexidine on withdrawal is maximal by day 2. No difference from placebo is evident by day 7.
- Clonidine has slightly more side effects such as light-headed, dizzy and drowsy.
- 7 days of Lofexidine in the US is about $1700 compared to $1 for Clonidine
” In short, lofexidine can be viewed as a slightly safer version of clonidine that offers patients with opioid withdrawal marginal clinical benefit for perhaps a few days, at a cost of more than $3000o over a typical 2 week treatment period.”.
Drug company price gouging for a “me too” drug for the most desperate and vulnerable of patients.
Ken Starr MD
This weeks blog comes to us from our guest Bethany at Preventaddiction.info
Anyone who’s ever struggled with a drug or alcohol problem knows that checking yourself into rehab and maintaining sobriety is only half the battle. Getting your life back on track can be even more daunting. But before getting started, it’s important to release the shame of the addiction itself, or it can be impossible to have the confidence and fortitude to move forward. Once you let go of shame, it’s time to focus on repairing your life. Here are the key things that should be on every recovery survivor’s to-do list. (more…)
Despite that fact that substance abuse has been defined as a chronic, relapsing disease, we don’t treat it the same as we do other conditions such as diabetes or obesity. And yet the parallels are clear: Imagine for a moment that you are obese. You’ve struggled with it for years, your family and friends give you a hard time about it, your doctor warns you about it. It’s not clear why this is a problem for you— is it genetics? Behavior? Underlying depression? Why is it that other people can eat as much as they want without gaining weight? Physically speaking, you shouldn’t be overweight and yet you are, despite your best efforts otherwise. It’s costing you your health, your happiness, and taking years off your life. Well consider this: how is drug abuse any different? Food addiction is real, just as alcohol addiction and opiate addiction are real. (more…)
You will soon hear about an “amazing” new drug called Lucemyra (Lofexidine). It was just approved (fast tracked even) to treat patients with opioid withdrawal. Wow! This is just what we need, an amazing breakthrough drug that will allow tens of thousands of patients to get off opiates. This is the first non-opiate FDA approved drug to treat opiate withdrawal. This will surely end the opiate epidemic we struggle with today. Right? (more…)
The Rehab Industry Needs Rehab
This past week John Oliver took an in-depth look at the rehab industry. As a former Medical Director for a residential program, I appreciated his critical analysis of the industry. Like all businesses, there are both good and bad players. But when your business model thrives on your customers failing and needing your services again, we need to look critically at their motivation. I can summarize the motivation of the rehab industry; bill insurance as much as possible, for as long as possible. There you go, I said it. This is what I saw when I was a medical director and this is why I’m not doing it anymore. There is fraud, insurance abuse and lack of oversight in this industry. (more…)