Dual Diagnosis

People who use Prescription Pain Pills are often self-medicating away psychiatric and physical pain.

Pain Pill addiction often occurs when people try to “self-medicate” serious psychiatric  illnesses.  People with both Heroin Addiction and a Psychiatric Disorder are call Dual Diagnosis

• Many people use Prescription Pain to cope with psychiatric problems. Long term, this will not work, but will makes matters worse;
• This is why diagnosing and treating co-occurring psychiatric problems is so important in Addiction Medicine;
• Addiction Recovery Models , must address both the Co-occurring psychiatric issues in order to be successful.
• Kittay’s Addiction and Psychiatry Model treats Dual Diagnosis and is effective.

How Do Opioids Affect The Brain?

When opioids are abruptly discontinued, symptoms of withdrawal appear. These include restlessness, irritability, muscle and bone pain, insomnia, cramps, diarrhea, vomiting and cold flashes with goose bumps.

Withdrawal

The withdrawal from Prescription Opioid Pain Pills is exactly the same as from heroin. Those who are addicted to Prescription Pain pills and stop using the drug abruptly have severe withdrawal, known on the street as “Dope Sickness”.  The symptoms include restlessness, severe muscle and bone pain, sleep problems, diarrhea and vomiting, cold flashes with goose bumps (“cold turkey”), uncontrollable leg movements (“kicking the habit”), and severe heroin craving.  The symptoms of “Dope Sickness” are all too familiar to those who have tried to stop using without medical help.  People who try to stop using on their own usually can’t, or relapse quickly. Relapses occur in the desperate attempt to avoid feeling dope sick, chase the high, or just to feel “normal.

• Opioid withdrawal can be very uncomfortable, but unlike withdrawal from alcohol and sedatives such as benzodiazepines, it is not life threatening;
• The physical withdrawal symptoms can last anywhere from less than one week to one month, but the emotional symptoms such as low energy, anxiety and insomnia can last for several months.

Those who are addicted to Prescription Pain Pills and stop using the drug abruptly have severe withdrawal, known on the street as “Dope Sickness”.

Warning! People trying to stop on their own are usually unable and relapse quickly. Relapses occur in the desperate attempt to avoid having Dope Sickness, leading one to chase the high to just feel normal.

Our patients are safely and comfortably detoxified at home, and then maintained on medications to keep them sober, manage cravings and prevent relapse. They do not need to be treated in detox or rehabs, and unlike methadone, patients on these medicines are routinely seen monthly in our office instead of daily in the clinic.

Medications for Prescription Pain Pill Addiction

Safe and effective FDA approved Medications are available for Prescription Pain Pills detox and to prevent relapse. Pain Pill addictions can be treated using the medications such as Suboxone, Subutex, Sublocade, or Vivitrol.

These medicines prevent pain pills from producing their high and/or stopping cravings and withdrawal symptoms. Treatments are individually structured for safety, comfort and effectiveness.

The majority of our patients can be safely and comfortably detoxified as home as outpatients, and do not need to be inpatient.  Once detoxed, medications to help maintain sobriety are prescribed to manage cravings and prevent relapse. Many patients do not need to go to a rehab facility  and unlike methadone, patients on these medicines are routinely seen monthly instead of in a clinic daily.

Suboxone® , Subutex®, Vivitrol ® , and a new breakthrough medication Sublocade®  are effective in helping people stop using Pain Pills..

Suboxone® or Subutex®

• Dr. Kittay is a DEA licensed Suboxone and provider Subutex;
• FDA approved medications are used for detoxification and/or maintenance treatment of Heroin Addiction;
• Prevents opioid withdrawal symptoms and craving;
• Used to slowly detoxify from opioids over days, weeks to months in a safe and comfortable way to minimize the pain, discomfort and anxiety associated with withdrawal;
• Prescribed for maintenance treatment and may be used this way for several months to years;
• A tool to manage physical and psychological opioid dependency while a patient in working toward sustained abstinence.

New:  SUBLOCADE, In 2018, there is a  breakthrough medication for  treating Pain Pill addiction.

• Dr. Kittay is a DEA licensed Sublocade provider;
• Newly  FDA approved medication is changing the treatment of heroin addiction;
• Active ingredient is the same as in Suboxone and Subutex, but it is  given subcutaneously only monthly;
• Prescribed for maintenance treatment and may be used this way for several months to years;
• A tool to manage physical and psychological opioid dependency while a patient in working toward sustained abstinence;
• Minimal risk of misuse or diversion with its use.

Suboxone, Subutex or Sublocade Buprenorphine Treatment is NOT Replacing One Drug Addiction with Another

• Some people argue that Buprenorphine treatment is just substituting one addictive drug for another or not a positive treatment for Opioid addiction. The National Institutes of Drug Addiction disagrees;
• Buprenorphine is a highly effective and safe treatment for preventing opioid substance misuse;
• The stabilizing effects of Buprenorphine Therapy helps people enjoy a healthy life style and meet family and career commitments;
• The cycle of rush, “crash”, withdrawal, and craving which leads to increasing chemical and psychological dependency is avoided; It keeps people away from the street culture of crime and violence associated with drug use. It reduces risky and destructive addict behaviors such as IV-needle use and discourages poly drug use;
• Buprenorphine saves lives and keeps you safe.

Vivitrol®

• Dr. Kittay is a Provider of Vivitrol;
• A once-a-month Intramuscular Injection administered in the privacy of a doctor’s office. Because it is not a pill, it cannot be skipped which helps to prevent relapse and/or overdose;
• Is used as a tool to manage physical and psychological opioid dependency while a patient in working toward sustained abstinence;
• Is a FDA approved medication that prevents heroin users from getting “high” even if they use drugs by blocking the euphoric effects of these drugs;
• Is a non-habit-forming medication that can be used to treat co-occurring alcohol opioid addiction;
• The active ingredient can be taken orally as a medication called Rivia.

Medicines are also prescribed to treat any anxiety, depression, sleep of medical problems and most importantly co-occurring psychiatric illness.

The vast majority of Pain Pill addictions can be safely and comfortably treated outpatient, and do not need inpatient care.

Your  Individual Evaluation & Treatment Plan for Pain Pill Addiction includes:

• Addiction, Medical and Psychiatric Evaluation;
• Medically Supervised Home Outpatient Detoxification;
• Evaluation and Treatment of Co-occurring Medical Disorders and Poly-Addictions;
• Maintenance Treatment with Suboxone, Subutex or Sublocade to manage cravings and prevent relapse;
• Vivitrol or Rivia to prevent cravings and addiction relapse;
• Medication Management of Anxiety, Sleep and/or Co-Occurring Psychiatric Disorders;
• Cognitive Behavioral Restructuring of Stresses and Cues;
• Relapse Prevention.

Treatments are individually tailored for safety, comfort and effectiveness to minimize withdrawal symptoms and avoid medical complications. Medications are prescribed to help prevent cravings, reduce use and prevent relapse.  Medications target the brain’s reward systems, and the way nerve cells communicate restoring balance in brain chemistry. Psychiatric problems and symptoms are medically treated as necessary.