Dr. Coleman & Dr. B Talk Naltrexone vs Suboxone: Part 2

Dr. Coleman & Dr. B Talk Naltrexone vs Suboxone: Part 2

In part 2 of Dr. Banimahd and Dr. Peter Coleman’s interview, they discuss how you can detox off opioids with naltrexone as medication-assisted treatment (MAT) versus using Suboxone.

If you missed part 1, you could read up on a brief history of Dr. Coleman here.

Explore the recap of Dr. Peter Coleman’s YouTube video, “Dr. B interviews Dr. Coleman about the Coleman Method for Opioid Detox and Naltrexone MAThere.

Opioid Crisis

Dr. Peter Coleman
When the opioid crisis came back in the late ’90s, many people started to use heroin. It was very potent and coming in from Columbia. A lot of people lost their lives. And if you look at success rates with other opiates and heroin, it’s terrible.

Almost everybody relapses unless they use some form of medication-assisted treatment (MAT). Then, you see people go to jail for three months or six months, or six years.

And if they don’t get treatment, they’re back using again as soon as they get out.

It makes no sense.

And there were a lot of overdoses and death, so it was a significant need. So I thought, “well, what can you do?”

More like this: Medication-Assisted Treatment (MAT): Higher Success for Recovery

Long-Acting Naltrexone

Dr. Peter Coleman
I realized that naltrexone is a drug that’s been out since about 1982 as a tablet. But it doesn’t work well as a tablet because people just take it for one day, and then they can get high the next day. So then I heard about this implant. So you could put this naltrexone implant and insert it into the person’s subcutaneous (fat tissue).

Dr. Banimahd
This is the early 90s, correct?

Dr. Peter Coleman
98.

Dr. Banimahd
98.

Dr. Peter Coleman
Yeah.

The naltrexone implant would last six to eight weeks.

So as soon as you put it in, people are like, “Wow, my cravings have gone.” Because their opiate receptors are blocked by naltrexone, they can’t get high even if they try; a lot of them try but can’t get high, and they love it because their cravings are gone. They’re like, “I got my life back. This is amazing.”

The Coleman Network for Addiction Medicine has been using naltrexone implants for 21 years.

Our biggest challenge is how do we get them detoxed? Patients need to be entirely off drugs to use them. To solve this, we developed the Accelerated Opioid Detox. Which is now being offered in Orange County.

Needing to Find Another Doctor

Dr. Peter Coleman
So we were looking for another doctor, we can across your name,

You were our first choice out of the seven or ten doctors we interviewed. We’ve had a great working relationship ever since and have continued to provide treatment.

Using Naltrexone in the 90s

Dr. Banimahd
The feeling is mutual.

Let’s go back to when you started offering treatment. In the late 90s, when you came across naltrexone, you were like, “this could work!?”

Dr. Peter Coleman
Yes.

Dr. Banimahd
Your next hurdle was, “how do I get them to the state where they could take it, correct?”

Dr. Peter Coleman
Exactly.

Dr. Banimahd
You mentioned you were not happy with using the daily 50-milligram pill every day because it wasn’t effective in the long run?

Dr. Peter Coleman
Yes, it was a challenge.

Dr. Banimahd
So that is where the implant came in. It was more stable and held patients accountable for their choices, right?

How did the treatment develop? You told patients to stay clean for a few days; then you should start them on the implant?

Dr. Peter Coleman
Yeah.

The Coleman Method

Dr. Banimahd I admire the fact that you give patients a choice. I do have a few methadone patients who think it is a joke. But I tell them, “I am very good at it. Well, maybe not as good as Dr. Coleman.” It is ingenious, the way you approach it. In the beginning, how did you handle asking patients to stay clean for a few days? Dr. Peter Coleman We tried it. None of the patients could do it. There came the need to get them off of everything. I look at it when people see that they’ve got the drug sitting on their brain’s receptors. So we have to get them to zero before starting them on the naltrexone. Because as soon as you start them on it, they’ll go immediately to zero in just a few minutes instead of over days. This is very hard for the body to handle.

Risks of Anesthesia Detox

Dr. Peter Coleman We tried hiring an anesthesiologist to perform anesthesia detox for the first three years. After that, patients would be asleep for a few hours. Dr. Banimahd Wow. Dr. Peter Coleman The anesthesiologist would put a tube down into their stomach; we would crush up naltrexone and give it to them. We could see that their body would enter a state of horrible withdrawal, But they were out, so they didn’t know what was going on. However, when they woke up, they still felt awful. They hadn’t recovered. They were clean, and the drugs were gone off their receptors, but their brain and body hadn’t healed yet. The next few days for them were horrible. They would be confused and agitated. It was dangerous. Dr. Banimahd And there are side effects and other issues associated with going through the anesthesia procedure, right.

Accelerated Opioid Detox

Dr. Peter Coleman That’s right. I learned techniques that Australians performed back in 2022. I took that learning and combined it with other things I had been working on. That is how we came out with the outpatient procedure. We didn’t use anesthesia and spread it out over three or four days. And our success rate was still around 100%. Today we have a 97% success rate. In Boston last week, we spoke to insurance executives, and they’re going to start covering our program. So I was like, “We’ve gotten good at this.” We know how much and when to administer the medicine. Patients are relieved and can’t believe it is over. More like this: Accelerated Opioid Detox: Explained Using the Coleman Method Dr. Banimahd That’s great. Dr. Peter Coleman The detox isn’t for everybody. It can be tough on some. Genetically, some people seem to be more set up to have a tougher withdrawal than others. Dr. Banimahd We’ll get more into this topic in the next article.

Conclusion

Stay tuned for Part 3 of Dr. Peter Coleman and Dr. Banimahd’s interview on the Coleman Network for Addiction Medicine on Facebook and Twitter. Looking for the rest of the webinar series? Check out parts 1 and 3-6 below.

Recovery Starts With Finding The Right Detox Option For You.

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