What To Do If You Relapse Back Onto Fentanyl

What To Do If You Relapse Back Onto Street Fentanyl

Mark returned to our office last week for a naltrexone implant. He had detoxed off street drugs that turned out to be primarily fentanyl 2 ½ months ago. He was a few days late coming in for his naltrexone implant, and he began to get anxious as his appointment got closer.

To no one’s surprise, Mark’s wife has found it difficult to trust him recently.  As Mark describes it, he started to get a “f*** it” attitude after a recent disagreement with his wife. He ended up calling an old contact, buying some crack and some heroin, and—for the first time in 2 ½ months–used some opiates.

Naltrexone Therapy To Block Relapse

Mark realized that his opioid receptors were likely still fully blocked by naltrexone, which caused some contradictory feelings.  When he was arguing with his wife, he knew deep inside that he was actually preparing to use again. 

He felt like a third-party observer watching a scene play out: antagonizing his wife so he could blame her for not understanding him, storming out of the house, reaching out to a person he only called when he wanted to use — a person who happened to always agree with him when he complained about his wife.  Mark said it was like Groundhog Day–a never-ending loop–and one that he didn’t want to leave at that particular instant.

He wasn’t completely surprised when he didn’t get high. The long-acting naltrexone still blocked his opioid receptors, just as intended. This is around the time that he started feeling a bit stupid and embarrassed about recent decision-making.

When Mark came to our office to get his naltrexone implant, he tested positive for cocaine, fentanyl, and THC. 

Because he had only used opioids a single time and the naltrexone was obviously still working, we were able to give him his implant without having to worry about sending him into precipitated withdrawal.

Relapsing Is Not Failing

It made me incredibly happy that Mark returned to see us. Our whole staff had been entertained by his sense of humor and big personality during his detox. His wife obviously cared deeply for him, even though she sometimes rolled her eyes at his jokes. Mark used heroin for a few years when he was younger, before having a good run of over 10 years without using. 

Unfortunately, following a back injury three year ago, his physician prescribed opiates, which sent him spiraling toward using daily and buying drugs from a dealer. He kept it secret for as long as he could, but his daughter and his wife eventually caught on. Fortunately, they encouraged him to seek treatment and promised to be supportive.  He called us and started his detox 3 days later.  

The Coleman Method for outpatient opioid detox helps people stop using not only street drugs like heroin, but also prescription pain medications like Percocet®, Dilaudid®, hydrocodone, Oxycontin®, or tramadol. We know it can be challenging. Our unique program helps our patients to quickly and safely get off of addictive substances and transition to naltrexone.

Little To No Withdrawal When Stopping Naltrexone

Unlike methadone or Suboxone®, naltrexone is a non-addictive blocker. While the other two medications are also proven Medication-Assisted Treatments for Opioid Use Disorder, naltrexone is the only one that does not cause physical dependence. When someone wants to stop using naltrexone, they do not have to go through withdrawal at that point. 

Dr. Coleman and his colleagues in the Coleman Network for Addiction Medicine have specialized in using long-acting naltrexone treatment for over 20 years. Among the many reasons to use long-acting naltrexone–and even more advantageous during COVID–is that patients can avoid daily clinic visits like the ones often needed to start methadone, and the weekly or bi-weekly clinic visits for buprenorphine products. 

Dedicated to Recovery

Mark received an implant and pledged to return after 2 months. He also decided to start meeting with a local therapist that our physician recommended. I couldn’t help but think about a quote I’d just seen about Kintsugi, the Japanese art of putting broken pottery pieces back together with gold — which embraces the perspective that you can build a more resilient and more beautiful artwork by embracing an object’s flaws. 

As Andrea Montovani has written,  “The kintsugi approach makes the most of what already is, highlights the beauty of what we do have, flaws and all, rather than leaving us eternally grasping for more, different, other, better. In other words, the experiences you have, and the person you already are, suffice. You may occasionally chip and break and need repairs. And that’s fine. But reality is the best and most abundant material on the planet, available to anyone, comes for free, and we can all use what we already have — including our flaws — to be even more beautiful.”

If you want to learn more about the Accelerated Opioid Detox process at any of the offices who are part of the Coleman Network for Addiction Medicine, please schedule a callback below.

Recovery Starts With Finding The Right Detox Option For You.

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