I have been working as a Nurse Practitioner in the field of addiction medicine for 13 years now. When I started in this specialty, our patients most often came to us for help getting off of heroin, prescription painkillers, or methadone.
Our Accelerated Methadone Detox program has remained pretty consistent throughout this period. It is an 8-day outpatient procedure. Because of methadone’s long half-life, the Coleman Method requires a bit more time to “nudge” the methadone off the receptors with micro-doses of naltrexone than it does with shorter-acting opioids like oxycodone. Suboxone® or other buprenorphine products also typically require 8 days.
What Is the Timeline for a Fentanyl Detox?
Our detox procedure typically takes 3-4 days for a person taking up to about 200mg daily of short-acting pain medicines like hydrocodone or oxycodone. We increase the duration for people on higher doses or with certain co-occurring medical conditions.
The same was true for heroin for many years. A lot of patients started using heroin when their doctors stopped their opiate prescriptions, or their tolerance to the prescribed medication had grown so that they craved stronger drugs. Heroin was simple to find and fairly cheap, especially when compared to buying pills from a drug dealer. We used to offer 3-day detox for people who wanted to get off heroin, and for the great majority of our patients, this time frame was perfectly appropriate using our special protocols.
The Heroin Impact on Fentanyl Detox
However, the situation began to change a few years ago. Articles began appearing in newspapers about multiple people overdosing at the same time and location. People would come in ostensibly to detox from heroin, but they would have uncomfortable reactions to the micro-dose naltrexone that helps speed up the withdrawal and healing processes. The detoxes became increasingly challenging. We didn’t have a test for fentanyl at that time, but that’s exactly what was going on: fentanyl was being mixed into heroin at a growing pace, and our patients were suffering.
Fentanyl is a powerful synthetic opioid analgesic. It is 50 to 100 times more potent than morphine. First used in the 1960s as an intravenous anesthetic, it is legally manufactured and sold in the US as a Schedule II prescription drug and is used to manage severe pain such as the following surgery. Sometimes it is prescribed to people with chronic pain who are physically tolerant to other opioids.
Customized Regimen For Suspected Fentanyl Addiction
Although we did not encounter many patients on covertly made fentanyl back in 2011, the DEA reports that is when the deaths from fatal overdoses started increasing. According to the Centers for Disease Control and Prevention, fentanyl analogs were involved in roughly 2,600 drug overdose deaths in 2011 and 2012. The years following this saw dramatic increases in these numbers. In 2018, 31,335 deaths were attributed to illicit fentanyl and synthetic opioid overdoses! This is completely consistent with what we observed at the Coleman Network for Addiction Medicine.
We adjusted our protocols to take into account the growing presence of fentanyl in street drugs. Every patient with known or suspected fentanyl addiction receives a customized regimen with multiple comfort medications and a slightly longer time period to complete the detox. This keeps our patients safe and as comfortable as possible.
If you or a loved one would like to learn more about detoxing fentanyl at one of our offices near you, please schedule a call. Detoxes using the Coleman Method are available at a number of offices nationwide, including Atlanta, Austin, Dallas, Denver, Orange County, Phoenix, San Francisco (Burlingame), Seattle (Bothell), and Tampa (Largo).