By Thomas Yee, MD
Clinical Assistant Professor
University of Nevada School of Medicine
Medical Director of Las Vegas Rapid Detox Center
What is Opioid Withdrawal?
The withdrawal syndrome is what holds people back from quitting addiction to narcotics or opioids. It is not that a person addicted to Oxy-Contin or Heroin not desiring a life without opioid drugs, rather it is the painful withdrawal syndrome that makes them so apprehensive that they refrain from trying. The syndrome resembles an extremely severe case of the flu, and uncontrollable tearing, nasal discharge, yawning, sneezing, anorexia, lack of appetite, nausea, vomiting, stomach cramps, diarrhea, itch, and aches. For patients who are debilitated or dehydrated, there could be serious complications.
What is Rapid Detox?
Traditionally, without the help of any medications to temper the effect of opioid withdrawal, patients go through an extremely difficult 5 to 6 days of withdrawal when they try to quit narcotics “cold-turkey” fashion. The extreme discomfort prompts most patients to give up before the can quit the addiction. By some definition, “oral medication rapid detox” is a 3 to 5 day course treatment using primarily pills, such as Clonidine and Naltrexone. Patients still experience significant opioid withdrawal. Ultra Rapid Detox, also known as Rapid Detox, actually is a one day treatment where patients receive intravenous naloxone medication under deep sedation or general anesthesia. Essentially, Rapid Detox concentrates 6 days of narcotic withdrawal into 10 hours. The discomfort would be too great for an awake patient to bear, thus the general anesthesia. The advantage is that patients wake up from the anesthesia and the Naloxone intravenous infusion, with most of the physical component of the addiction eliminated.
Possible complications for the true Rapid Detox or Ultra Rapid Detox:
Rapid heart rate, hypertension, diarrhea, aspiration, pulmonary edema, and post-procedure feeling of exhaustion lasting 7 to 10 days.
Prevention of complications related to Rapid Detox:
In order to prevent the complications related to rapid detox, it is imperative that the procedure be performed by a board-certified anesthesiologist with more than 10 year experience in giving general anesthesia to patients with multiple medical problems. Also the doctor should have more than 10 year experience in pain management with knowledge of narcotic medications and their effects.
Treatment of post rapid detox exhaustion:
Intra-muscular injection of vitamin B12 and other B vitamin would offer a longer term effect in reducing the subjective feeling of exhaustion. Vitamin B and C complex pills, taken 3 times a day, are also recommended. Further, Green Tea Extract pills are recommended to patients. In addition, daily exercise, hot-shower, hot-bath, rich meals are highly recommended for the 2 weeks following rapid detox.
Rapid Detox (Ultra Rapid Detox) can be performed with high degree of safety if it were conducted by physicians who are board certified in both anesthesiology and pain medicine with more than 10 year of experience in each. The complications are related to general anesthesia and magnified opioid withdrawal, as well as the medication Naloxone. Only experienced anesthesiologists who are used to dealing with sick patients undergoing long courses of general anesthesia and ICU patients should perform the procedure. Further, the post-treatment feeling of exhaustion experienced by patients can be reduced with a few simple techniques.