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Posted 5/18/2003 10:04 PM

'Rapid Detox' Breaks Drug Habits Quickly

Errol Dodson's drug addiction began with a prescription for Vicodin to help treat pain in his shoulder, knees, ankles and ribs caused by weightlifting and wrestling injuries.

A few years later, Dodson realized he was hooked. He was spending $400 a week buying Vicodin, Lortabs and OxyContin on the black market. In the morning, he felt like he had the flu until he popped a pill.

"I hated myself for letting this happen," says the 33-year-old industrial mechanic from Greenwood, Ind. "I was so ashamed. I was isolating myself from friends and family. I knew I had to get help."

Dodson checked himself into a two-week drug detoxification center. A few days after getting out, he gave into his cravings and started taking the painkillers again.

In February, Dodson decided to try a new and controversial drug treatment called "rapid detox," which promises to get you through drug withdrawal in a mere 48 hours. It also promises far less pain and discomfort because you're under general anesthesia during the worst of it.

Rapid detox is touted as a way to kick opiates, including heroin, morphine and methadone, as well as opiate prescription painkillers such as OxyContin, Percocet, Vicodin and Lortabs. Practitioners estimate there are about a dozen rapid detox centers around the country.

"I have detoxed attorneys and doctors on a Friday and they are back at work on a Monday and seeing patients or clients on Tuesday," says Dr. Rick Sponaugle, chief of anesthesiology at Helen Ellis Memorial Hospital in Tarpon Springs, Fla. and director of Florida Detox, located in the hospital. "We take them through the detox in a more humane way and what I believe is a less dangerous way."

While advocates say the procedure is highly effective, skeptics caution that little research has been done comparing the effectiveness of rapid detox versus traditional methods.

Critics also point out the high costs of the procedure — Dodson paid about $10,000 — which is not covered by most insurance companies, and the risk posed by general anesthesia.

"Rapid detox is providing a service which has some dangers, so it's kind of hard to justify something that is so expensive," says Dr. Michael Miller, medical director of the NewStart Program at Meriter Hospital Program in Madison, Wisc.

Here's how rapid detox works:

At Florida Detox, the patient is admitted into the hospital, where they undergo psychological testing and a urine test to determine what drugs are in their system.

The client is then given general anesthesia for about three hours, during which time he or she is given a dose of Naltrexone, a non-addictive drug.

When a person takes opiates, the drug attaches to receptors in the brain, leading to the feeling of being "high." Naltrexone, known as a narcotic antagonist, blocks the opiates from attaching to receptors.

Patients are then given a sedative intravenously to help them sleep through the night. By the following afternoon, they are usually ready to go home, though Sponaugle often keeps them in the hospital for another day.

After the detox, patients continue to take Naltrexone tablets daily for several weeks to two years. Sponaugle highly recommends that patients get involved with a 12-Step program or other therapy to help them remain drug-free.

"Ongoing psychological treatment is so important," he says. "Unless they receive that spiritual healing, they will probably relapse."

During the six years Florida Detox has been in business, Sponaugle has detoxed about 400 patients. According to company information, about 75% of patients stay drug-free for six months. About 50% to 60% stay clean for one year or more.

After the rapid detox, Dodson, like other patients, felt somewhat achy and nauseous, but the withdrawal symptoms weren't nearly as severe as in traditional detox.

In traditional detox, a drug addict often has to endure two to 10 days of abdominal pain, tremors, vomiting and severe muscle aches that comes with drug withdrawal.

Dodson recalled two weeks of sheer agony. "It was a horrible experience," he says. "It felt like snakes were trying to crawl out of my body. I had uncontrollable leg movement. I couldn't get out of bed."

Miller, secretary of the American Society of Addiction Medicine, says that not every addict undergoes so much discomfort. There are new drugs to take the edge off during ordinary detox — drugs that cost significantly less and are less risky than Naltrexone.

Naltrexone has been known to cause side-effects including delirium and confusion in some people. And there is always some risk when a person is put under general anesthesia.

But Miller says is the more important issue is not the detox method, but what kind of treatment people are able to access afterwards to help them stay off drugs.

"Detox is only the first step, and detox in and of itself resolves no cases of addiction," he says. "The controversies which surround rapid detoxification methods miss the basic point, that regardless of the method of detoxification used, patients with opiate dependence face great challenges, and they need to have their addiction treated not simply their withdrawal treated."

After two days in Florida, Dodson returned home to Indiana feeling more hopeful than ever. Since he had the procedure done in early February, he says he's had no desire to take drugs.

Sponaugle says he would like to eventually wean him off the Naltrexone, because the drug interferes with the ability to experience a "natural" high from the body's own endorphins.

"If you have the willingness to put the drugs behind you and bury it, then rapid detox will work for you," Dodson says. "Rapid detox saved my life."

 

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