Rapid detoxification with naltrexone

Rapid detoxification with naltrexone

By David and Joyce Djaelani Gordon

JAKARTA (JP): More people are referring to naltrexone as a
magical treatment for sakaw (drug withdrawal symptoms), and call
it "rapid detoxification" or, a newer term, accelerated neuro
regulation (ANR).

A common marketing move, yet this is simply selling an old
product under a new image. In fact, naltrexone is not magic, and
naltrexone is definitely not a cure for drug addiction.

Furthermore, naltrexone is not rapid when you consider the
naltrexone medication (pill) one has to take for three to six
months after initial treatment. Nor is naltrexone considered a
true detoxification by any respectable professional in the field
of drug abuse.

Yet, in Indonesia there are currently many doctors,
psychiatrists, institutions and clinics offering this naltrexone
treatment, to relieve drug abusers of their withdrawal symptoms
from putaw (heroin). Many of these people, in reality, understand
little about addicts, less about the disease of addiction,
correct methods of detoxification, or how a genuine process of
recovery is appropriately applied.

Most of these individuals are medical people but not trained
addiction specialists. Many are simply following a technique or
method, as to what they have been told is the correct method for
detoxification, based purely upon the medical model of
detoxification, not on a process of recovery.

Many are just naive about addiction, and believe what they are
prescribing is the correct method of treatment for
detoxification. Many are dangerously incorrect in their
assumption.

And there are those who are in the rapid money business, and
using the rapid detoxification as a rapid money printing press.

The truth is that rapid detox can often be an extremely
dangerous procedure. This warning is especially accurate with the
outbreak and epidemic of hepatitis C that has invaded the drug
addict community throughout Indonesia.

Hepatitis C can now be found in approximately 80 percent of
the injecting drug users in the Greater Jakarta area and is
spreading at an accelerated rate throughout our nation.

Naltrexone is hepatotoxic, meaning a poison/toxin to anyone
with active hepatitis or liver problems. Naltrexone is what is
known as an opioid blocker and antagonist. Simply defined,
naltrexone blocks the effects of opiates and opioids.

This means that after the initial naltrexone treatment, and
while participating with the ongoing naltrexone medication
treatment, if a person uses an opioid, the effects will be not be
felt by the user.

The effects of the opioid are naturalized by the naltrexone.
But naltrexone does nothing to block the effects of other drugs
that drug abusers and addicts often use. It does not block
methamphetamines, and neither does it block the effects of
marijuana.

Remember that most addicts are poly drugusers or people who
use more than one drug and/or narcotic. This basic understanding
of addicts, their lifestyles and patterns of behaviors
appear to escape the attentiveness of most people.

So it is very important to understand naltrexone simply blocks
or neutralizes the effects of an opiate, like heroin.

Currently, rapid detox is being used to help relieve
withdrawal symptoms during first stage drug and/or alcohol
detoxification. There are four stages of detoxification.

Also remember that naltrexone will have no effect on
individuals who use alcohol, marijuana, amphetamines, ecstasy,
LSD, Nipam (flunitrazepam), cocaine and/or other illicit drugs.

Nor does naltrexone, by itself, guide a drug abuser to change
friends, alleviate the desire to use other illicit drugs, change
habits and patterns of behavior, seek a pathway that leads to a
thorough and long-lasting recovery from drug abuse, repair damage
done to family and loved ones, offer any ongoing program of after
care, or take away the social or peer desires to be part of a
group.

Naltrexone should never be randomly used in Indonesia. It
definitely should never be used by any doctor or psychiatrist
that is not a fully trained addiction specialist.

No institution, hospital or clinic should ever use naltrexone,
unless they have a fully trained and qualified specialist on
staff. Naltrexone should never be used with young drug abusers or
addicts, if they have only been using opioids a year or two, and
are in generally good health otherwise.

Naltrexone should never be used if there is no ongoing program
of recovery and after care for the abuser and their family.
Naltrexone should never be used when anyone has active hepatitis,
or liver dysfunction.

The abuser and their family are strongly advised to carefully
read the fine print of any contract/agreement of consent
furnished by any person or organization before they sign and
commit themselves, or a family member, to undergo a rapid
detoxification treatment.

The reason professionals ask individuals and families to sign
a consent form, mostly without proper counseling and appropriate
information on the pros and cons of naltrexone, is because rapid
detoxification is a dangerous procedure.

And professionals do not wish to be blamed or held
responsible in the end should anything go wrong with the initial
procedure, or problems, including a relapse, are incurred after
the procedure with the ongoing medication the patient is told
they must use for months after the initial treatment.

Another warning is most professionals and institutions that
are using this rapid detox treatment method are presently not
doing thorough blood testing/screening, or thorough physical and
mental health examinations before the abusers/addicts are
admitted for naltrexone treatment.

Thus, the professional or institutions have no real idea or
data about the actual physical or mental health condition of the
patient at the time of treatment.

This could prove to be extremely dangerous for anyone
undergoing a rapid detox treatment. And most of these treatment
centers have no ongoing, follow-up or drug treatment programs.
This means that the relapse rate using some drug or substance
shortly after a naltrexone treatment is nearly 85 percent within
the first 60 days after release from the center, because there is
no solid monitoring, ongoing services, recovery program or
aftercare programs.

Now it is accurate to point out that naltrexone does, for an
extremely expensive price, assist in blocking the effects of an
opiate, like heroin, during first stage detoxification.
Naltrexone does alleviate the withdrawal symptoms in six to 12
hours.

That is what naltrexone is specifically used for, to relieve
withdrawal and craving symptoms. It should be understood that
addicts facing withdrawal will take anything to help relieve the
pains of withdrawal symptoms. Any fast-acting pills, medication
or treatment that allows relief from withdrawal symptoms are
always welcomed by most any addict seeking first stage
detoxification.

The body's natural process of detoxification from heroin
usually takes approximately four to six days.

The initial treatment of naltrexone is most often done in a
hospital or clinic setting, and the patient must undergo general
anesthesia.

The use of general anesthetics is now frequently avoided by
many surgeons and medical authorities worldwide. Knowledgeable
medical authorities most often opt for local anesthetics whenever
possible, since many now understand that the use of general
anesthetics can be potentially damaging to brain cells.

Yet, the use of general anesthetics for six to twelve hours
is customary for someone undergoing a rapid detox treatment.

Naltrexone is a substitute treatment for helping drug
abusers/addicts overcome the first uncomfortable states of opiate
and alcohol withdrawals only.

Naltrexone must never be seen as a cure, or a program of
recovery from addiction.

Drug addiction, and recovery from drug addiction, is new to
Indonesia. Hepatitis C and HIV/AIDS are also new to Indonesia.

True recovery is a fourfold process: physical, mental,
emotional and spiritual/religious.

There are no shortcuts to achieving a life without drugs or
alcohol for an alcoholic or drug abuser/addict. Never let anyone
tell you otherwise.

Never randomly trust any rapid detox method, and never
randomly trust anyone who is selling this kind of expensive
method and procedure.

Rapid detox procedures should only be used in rare cases where
there are years of long term bouts with chronic addiction and
relapse, or there are mental and/or physical indications or
complications that absolutely require this kind of procedure
and/or treatment.

There are no drugs in the known world that have yet managed to
create a sense of local amnesia, that induces drug abusers and
addicts to forget about drugs.

For many reasons, the relapse rate is just as high, with or
without naltrexone. Because the drug abuser/addict cannot feel
the effects of heroin after a naltrexone treatment and ongoing
medication, they usually just switch to methampethamines, alcohol
or other drugs to get high.

After a period of time, most just stop using the naltrexone
medication and return to their drug of choice. Urine tests for
heroin would, of course, yield a negative test result for
opioids, giving people a false sense of security that the addict
treated with naltrexone has not relapsed.

However, it is rationally wise to randomly monitor new
recovering individuals for other substances after a rapid detox
treatment.

The cost of a natural detoxification process is approximately
Rp 100,000 to Rp 300,000, while a naltrexone treatment package is
approximately Rp 15 million to Rp 20 million. Naltrexone does not
change a person's behavior or pattern of thinking.

Without a viable drug recovery program and family after care
program, detoxification from drugs is usually wasted hopes and
money. And wasted hopes and money is just that: wasted hopes and
money.