By Thomas C. Yee, MD
September 7th, 2009
Board-Certified Anesthesiologist (1994) and Board-Certified Pain Management (1997)
Las Vegas Rapid Detox Medical Clinic
Studies published by psychiatrists claiming either the excessive danger or ineffectiveness related to “rapid detox” or “ultra rapid detox” procedures have often ignored 3 salient points in the grand discussion of helping people quit opiate addiction. These missed points of comprehension are:
(1) Rapid Detox is an anesthesia procedure and should be performed and evaluated by well-trained, expert-caliber, board-certified anesthesiologists, not by psychiatrists. When psychiatrists evaluate the safety of a complex anesthesia procedure such as Rapid Detox, they lack the expertise to properly evaluate the risks and benefits associated with the procedure. A family practice doctor is not the right person to evaluate the safety and efficacy of neurosurgery. A psychiatrist or psychologist is not the right person to evaluate the safety of an anesthesia procedure.
(2) Rapid Detox is not a replacement for psycho-therapy, substance-abuse rehab, counseling or 12-step group therapy. Rather, it is merely the first step in the long journey of recovery for an opiate drug addict. When done properly, it obviates the pain and physical suffering attendant to withdrawal, and delivers the patient, free from physical addiction or withdrawal, to the mental health professional’s office for the necessary and integral 6 to 12 months of follow-up therapy to repair the psychological and social facets of the patient’s overall addiction problem. Rapid Detox ideally should increase the patient flow to all mental health professionals who help treat addiction problems because it will bring forth those potential patients who are too afraid to go through the gate of hell of physical withdrawal before reaching the temple of successful psychotherapy. Psychiatrists need not fear that Rapid Detox will one day rob them of the patients who now attend rehab centers.
(3) Rapid Detox is not standardized. What exactly happens in the treatment rooms of various rapid detox centers might be wildly different. The techniques, the medications, the personnel, the monitors, the treatment duration and expertise are vastly different from center to center. In our rapid detox procedure, these features set us apart from many other centers:
[A] We are located in a major, full-service hospital that is the top hospital in Las Vegas for cardiovascular diseases and surgeries. Hospitals come in many different grades and flavors; Desert Springs Hospital in Las Vegas is a major hospital with great reputation. The long-time Las Vegas residents know it as “The Heart Hospital.”
[B] Patients undergo 8 to 10 hours of anesthesia while receiving high-dose Nalaxone; this is longer than any other center in the country. It is done so because the opiate molecules, once displaced from the opiate receptors, do not spontaneously disappear. They need to be eliminated from the blood stream by the liver and the kidneys. That process takes time. The 8 to 10 hours are the shortest necessary duration to achieve adequate of the opiate molecules from the systemic circulation.
[C] Continuous one-on-one to three-on-one care. During the 48 hours in the intensive care level stay in the hospital, our rapid detox patients never have fewer than one-to-one care. This instant bed-side immediate human responsiveness to any need or complaint of the individual patient gives great psychological comfort to a patient in the emotional vulnerable post-detox period.
[D] We pretend it is an open-heart surgery level of anesthesia procedure, deserving that high level of monitoring and continuous one-on-one attention by expert anesthesiologist for the whole 8 to 10 hours. Our expert anesthesiologist does not administer the treatment to more than one patient at a time or hand over the care to a nurse once the anesthesia has been initiated; he stays with that one single patient for the whole 8 to 10 hours, with a nurse or anesthesia tech also present.