Opioids Detox 5

[4DQSAR]

I just realized that a couple of decades ago 'Detox 5' was touting itself as being able to essentially get anyone off any dose of any opioid. In the end the media caught on to the horror stories. The theory is that by using naltrexone to induse withdrawal and then using sedatives and anaesthesia to mitigate the symptoms isn't wrong, but if I remember it correctly, the centres often lacked appropriate clinical staff (anethetists) and/or it was decided by the clinician that the risk/benefit ratio meant they weren't happy to provide adequate medication. After all, if they prescribe ketamine and a patient dies, it's unclear how an anethetist could defend their choices.

I note that now they have rolled back the claims and stated that it's only suitable for some patients.

I just wondered if anyone had ever been on one of those 5 day programmes. Was it good, bad or indifferent?

 

[Deleted member 585202]

I just realized that a couple of decades ago 'Detox 5' was touting itself as being able to essentially get anyone off any dose of any opioid. In the end the media caught on to the horror stories. The theory is that by using naltrexone to induse withdrawal and then using sedatives and anaesthesia to mitigate the symptoms isn't wrong, but if I remember it correctly, the centres often lacked appropriate clinical staff (anethetists) and/or it was decided by the clinician that the risk/benefit ratio meant they weren't happy to provide adequate medication. After all, if they prescribe ketamine and a patient dies, it's unclear how an anethetist could defend their choices.

I note that now they have rolled back the claims and stated that it's only suitable for some patients.

I just wondered if anyone had ever been on one of those 5 day programmes. Was it good, bad or indifferent?

So they would induce withdrawal and then keep the person in a medically induced coma for a week or so?

That's what Jordan Peterson did to get off his clonazepam dependence, which was apparently severe. Those treatments are illegal here in the states (or there's just no doctors willing to risk their license), so he had to fly over to Russia to get the treatment. I guess it was effective for him.

I would sign up in a heartbeat. Although, frankly I think the current model of detox we have here right now is adequate. I've never really had a bad experience, but I'm sure others have.

 

[4DQSAR]

So they would induce withdrawal and then keep the person in a medically induced coma for a week or so?

Well as the name suggests, five days.

But as I hinted at, at least some clients reported that in their cases at least, it was a terrible ordeal, I seem to remember it mostly being people who were on methadone maintainance as it does appear that the long duration means that day five is ironically the worst.

I was never clear on exactly what medications were being prescribed but I recall reading that every two hours the patient had their vital signs taken and were redosed. Some suggested ketamine but my hypothesis is that midazolam is (or was) used not only because of it's huge TI and short duration of action but because in an emergeny, flumazenil could be given. Along with a long list of comfort medications known to us all.

Obviously that's placing clients into the position of being high-dependency patients so it's not without risk.

As for benzodiazepines, well, they are the very devil. Totally possible to get off even comically large intakes (1000mg diazepam/day anyone?) but you better consider it in years rather than weeks or even months. I suggest that people rush around thinking that there simply must be a 'hack' to avoiding the fact but in my 40+ years of experience, there isn't. It sucks, but it works. I can well imagine a character like Jordan Peterson being so 'smart' (as I'm sure he would be the first to say), he would fall for any scam artist promising a quick exit. Swap to diazepam, go down slowly. It works.

 

[SeekingOblivion]

I remember seeing those places, I think there were some Detroit area. It’s kind of an old idea. I read somewhere that in 1940s era morphine addicts would be sedated with large doses of barbiturates for a few days of cold turkey. Inducing precipitated withdrawals with naltrexone and then letting it occupy/dominate the receptors is the newer twist I guess. I read somewhere that Jordan Petersen went to Russia to be put in a medically induced coma to get off benzos. He says it worked, which I find hard to believe, but idk the full story.

 

[4DQSAR]

I remember seeing those places, I think there were some Detroit area. It’s kind of an old idea. I read somewhere that in 1940s era morphine addicts would be sedated with large doses of barbiturates for a few days of cold turkey. Inducing precipitated withdrawals with naltrexone and then letting it occupy/dominate the receptors is the newer twist I guess. I read somewhere that Jordan Petersen went to Russia to be put in a medically induced coma to get off benzos. He says it worked, which I find hard to believe, but idk the full story.

I can believe it, especially if flumazil was also used.

But ask any anethetist. While general anethesia is far, far safer than ever, it's not without risk. I suggest that in Russia, the people who own such facilities are essentially above the law so if a patient dies, no investigation.

Apart from ketamine, most general anasthetics are GABAgenics so maybe that is the path that chose? Also I can imagine it being possible to keep a patient in a 'twilight state' with it's attendent retrograde and anteriorgrade amnesia - so even if it was awful, the idea is you don't remember it.

 

[KurtAurelius]

Not sure if if I misread it, but in Mark Lanegans book I recall him stating his detox was being fed into a “Phenobarbital coma” so he could sleep off his Heroin habit.

Of course, he doesn’t go into profound detail about any other drugs, what doses and regimen, much to the dismay of my autistic brain that would have loved the exact details, just the phenobarb mention.

He then wakes up and doesn’t really say he feels bad, but just “raw” in an emotional sense, having more feelings than he can remember after years of Heroin and Crack.

I’m not saying it doesn’t work but I’ve been interested with this discussion as I guess I was naive to think before that it would be a near perfect option for someone without a GABA dependence to knock them selves out for a good few days and be over the worse of it.

As pointed out, if you’re on a drug with a longer half life, no bueno aside from the other risks with inducing a coma.

 

[4DQSAR]

Yeah - long ago the idea of using barbiturates to render people unconscious for days was an accepted protocol. Wasn't Amytal nicknamed 'Blue 88' and used to treat shell shock, bipolar disorder and other things?

I know Spike Milligan recieved such treatment and right into the 1960s, when his bipolar got bad, he would set up a camp bed in his office and take barbiturates to knock himself out for days at a time. Sad to say his secretary wrote a book on Spike's life and said that while it MAY have helped with the shell shock, it made the bipolar WORSE.

BTW as someone who HAS been blown up so can genunely say I know what shell shock is like, I can so easily imagine just being able to stop the flashbacks for a few days would have been a HUGE help. But I suspect that all it does is kicks the can down the road. I tried it with benzos and woke up in hospital. Nobody would believe me when I said suicide wasn't the intent - being unconscious was what I sought. They did not understand.

 

[helpingout]

I posted an article about a center in the United States doing this exact thing in the present day.

 

[4DQSAR]

I posted an article about a center in the United States doing this exact thing in the present day.

Interesting. What medication(s) are being used to place patients into a 'twilight state' or indeed to produce surgical anesthesia?

 

[kongoman]

Like 10 or 15 years ago this kind of detox was done in private hospitals for H detox. Im not sure but I think it was a 24 hour detox, they called ultra speed detox or something like that. I know it was naltrexone + anesthesia but dint know wich one. Im gonna look if it is avalaible nowadays. I imagine clonidine could be there too.

Ive done twice without anesthesia, only with clonidine but in a week or two. I cant remember. The first time the doctor was private and cost me 6000 euros allmost 20 years ago( well they were my parents who pay it) and he knocked me out with diazepam, quetiapine, flunitrazepam and something more I cant recall. I remember very well that I was a zombie and even pee in the bed one time or two. And tapered with despropoxiphene or methadone. I was taking like 2gr of bad H intranasal a day. It was horrible when I got home i couldnt walk for sone weeks. I stayed in bed I dont know why. At the moment I had never taken benzos and AP, and he prescribed me a taper of them. Second time was in a public hospital but it was incredible. I think it was 2 weeks but i was not sedated at all, could sleep and when got home I was feeling very nice and only prescribed 1mg lorazepam if needed at night. Was taking the same of H more or less and it was like 2 years after. But my girlfriend was at home and I asked for H and she didnt want to give me but finally snorted again the same day.

So it doesnt make anysense for me this kind of detox, because psycological addiction is there and you will crave as you get home. Imagine in 2 days or 5.

 

[kongoman]

AI answered this:

Ultra-rapid detoxification from opioids in Spain is primarily carried out in hospital settings, using deep sedation under intensive monitoring [4]. This treatment, which can be completed in as little as 24 hours, aims to eliminate opioids from the body and suppress dependence, allowing patients to begin abstinence without experiencing traditional withdrawal symptoms [1][3]. The procedure typically involves deep sedation with drugs such as midazolam, propofol, or ketamine, followed by administration of an opioid antagonist like naltrexone to block opioid receptors and eliminate drug cravings [2][4].

Studies and reports indicate that this method achieves success rates close to 100% in initial detoxification, with few reported medical complications [5]. However, an important criticism exists: although detoxification is effective, no direct relationship has been found between this procedure and long-term recovery outcomes, suggesting that detoxification must be accompanied by ongoing psychological, pharmacological, and social treatment to prevent relapse [4]. Furthermore, protocols vary between centers, indicating a lack of standardization in the techniques used [4].

In Spain, six centers (30%) perform only ultra-rapid detoxifications, while another 14 centers use alternative methods, such as methadone detoxification, alpha-2-adrenergic agonists, or combinations with naltrexone [4]. The HLA Montpellier Clinic in Zaragoza has implemented this treatment successfully, particularly in patients with chronic headaches dependent on opioids such as tramadol, achieving disappearance of drug cravings and significant improvement in mood without withdrawal symptoms during the post-treatment period [3]. Follow-up care is crucial, including medical, psychological, and pharmacological support to ensure patient stability after hospital discharge [3].

I can say that there are tons of clincs doing detox with methadone and others meds, not only 14 like AI says.

Estimated cost is 5.000 -10.000€ for 24hours ultra rapid detox.