1684282?1350782543
Julia M Aharonov, DO  
Female, 51
Southfield, MI

Specialties: Addiction, Drug abuse and dependence

Interests: My family

MDS Rapid Drug Detox
888-637-6968
Southfield, MI
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Naltrexone therapy revisited

Jul 10, 2012 - 6 comments

Naltrexone drug therapy, an opiate blocker treatment, done after rapid detox treatment, is an essential component in achieving a better success rate for a drug free life style.  Three types of Naltrexone drug dosing are available:

Naltrexone Pellet
Naltrexone is an opiate blocker that reduces cravings tremendously.  At our drug detox center we administer Naltrexone pellet underneath the skin to delivers the medicine gradually over 2 months. This is a minor operative procedure. Naltrexone prevents opiates from getting back into the brain receptors and thus maintains abstinence for 2 months.  We recommend repeating the Naltrexone pellet implant every 2 months over a period of six to twelve months.  I say that because the patient’s thought process will take a few months to change to the new sober life style. The brain neurons require long time for healing. The implantable pellet is usually less expensive than the injectable form of Naltrexone.

Naltrexone Intramuscular Injection
Another form of Naltrexone post detox maintenance is an intramuscular injection of Vivitrol. The injection ensures protection from opiates for one month only. One intramuscular shot is rather expensive as it costs approximately $1200.00 per month. At MDS we include the Naltrexone pellet implant to ensure opiate blockade for two months into the cost of the rapid detox procedure. However, Vivitrol injection is, on some occasions, a preferred method of continual Naltrexone delivery as, for example, in instances of questionable compliance.
Vivitrol (extended release injectable naltrexone) has been approved by the FDA in October of 2010 to treat people with opioid dependence. It is the first and only once-monthly injectable naltrexone delivery system approved and indicated for the prevention of relapse following opioid detoxification. We are proud to be working closely with Alkermes, the pharmaceutical company that produces Vivitrol to help those patient who have and are willing to use their Medical Insurance to fully cover these injections for as long as one year after our rapid detox procedure ensuring sobriety.  For those patients who are willing to pay for injections out-of-pocket Alkermes is willing to help with substantial discounts, however it is still relatively costly.
Please, be certain you are getting Vivitrol after an opiate detox procedure, and not a compounded generic substitute, as the dose and the delivery mode may not be accurate. Such generic substitutes have been known to be used by some detox clinics.

Naltrexone Pill
The last method of Naltrexone dosing is the oral route. It is simple, but we prescribe it in rare situations. It is so easy to forget taking the pills by the post drug detox patient. We don’t want patients to be vulnerable as the mental thought process has not adapted yet for a drug free life style.



Methadone and Suboxone Deception. Are you truly informed?

May 02, 2012 - 26 comments
Tags:

methadone

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Suboxone



Several weeks ago I got a question yet again, from another pregnant young lady using opiates asking me if it OK to use them only on weekends. I gave her my usual spiel and a few days later noticed a comment to her question from another reader:
“I was in a rehab when I found out I was pregnant.  I have now been sober since Feb. 8th of this year and am 12 weeks pregnant.  They told me no drug is good to do during pregnancy. It can hurt the baby.  I have been on methadone since Feb. 8th and will be on it my whole pregnancy.  Maybe it something you can look into.  I have no cravings and the baby is growing good and healthy.”
This got me to realize how important it is for me to address this issue.  And the issue at hand is the deception that is practiced by the “Addiction Physicians” and “Rehab Clinics” that have sprung up like mushrooms throughout United States in the last twenty years.   Federal money and the deep pockets of the pharmaceutical companies are being used to finance unscrupulous pharmacists and physicians to lead innumerable unsuspecting addicts to believe that by switching their illegal habits to the daily methadone or Suboxone they, in fact, are becoming “sober”!
What they are not being told is that they are simply switching one opiate to another. In fact, both methadone and Suboxone are longer acting and more addicting then even heroin itself. I do agree that shooting heroin is extremely dangerous and can lead to horrific consequences and in some instances it is preferable to place an addict on Suboxone or methadone to avoid those risks. However, in no instance is it allowable to mislead and deceive addicts into leading them to believe that they are now “sober” or “clean”.
These medications were first thought to be used as tapering tools off of the harder or illegal opiates, but with time, as they have shown to be extremely addictive, most addiction physicians began using them as maintenance treatment or substitution for heroin or street opiate abuse.  We at MDS Drug Detox believe that the only true treatment for opiate abuse is abstinence, and the solution to it is our rapid detox and a long term Naltrexone treatment.  Naltrexone treatment, however can only be initiated once a person is already opiate free, and that is hard to achieve without help.
During opiate use, central nervous system makes more and more opioid receptors and the brain anatomical structure is physically changed.  It causes the user to crave more and more drugs as they have less effect on the multitude of the opioid receptors. The Naltrexone therapy allows the central nervous system to return to its normal pre-opiate state, thus allowing the brain and the person to regain their normal function.
Human body was created to function without outside endorphins, it is a marvelous machine that will function beautifully if we only take good care of it, treat it well, feed it healthy food and keep it intellectually, physically and spiritually occupied.
We, as physicians must treat our patients with respect and being honest with them is part of our relationship with them. Every patient signs a document called “Informed Consent” prior to starting any treatment. If a patient thinks that they are sober on methadone or Suboxone, their “consent” was NOT “informed”.


Pregnancy and Addiction

Feb 14, 2012 - 13 comments
Tags:

Pregnancy

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Addiction

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Meconium drug testing

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Drug Testing

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Having a healthy pregnancy



One day, while doing one of my medical school rotations at St. Barnabas Medical Center in Livingston, NJ, where, incidentally, I gave birth to my three children, the hospital was abuzz with the news that the amazing Whitney Houston was having her baby on the top floor in the VIP suite.
I must confess that I, being a lowly medical student in 1993, did not get to lay my eyes on the famous singer, but I did feel a common bond with her. We were the same age, and I had a baby in this same hospital less than two years before her.
What I feel now is deep sadness for her and, especially, for her 18-year-old daughter, whom she had while I was just a few floors below her. Whitney’s death is just so senseless, so painfully early. She was a mother who left her child an orphan, and being a mother was so important to her, as it is for most every woman.
We dream of being a mother while still little girls; we play with dolls, we cradle them in our arms, we dress them and we pretend to feed them. We grow up dreaming of one day carrying little ones under our hearts, and nursing them at our breasts.
But what happens if we make mistakes along the way? What if a woman gets addicted to drugs or alcohol while she is young and foolish? Can she still have a healthy pregnancy and a healthy baby? I get asked these questions very often from concerned women who either want to get pregnant or are already pregnant and want to know the consequences of their mistakes.
We all know that our actions must bear consequences, but our children should not be the ones bearing the brunt of them. So we must be careful how to treat our bodies prior to getting pregnant and, certainly, even more so once we are expecting. Most women start taking prenatal vitamins months before getting pregnant, so how much more important would it be to start taking care of your body by getting off whatever drugs you are on way before you conceive? Did you know that drugs are not only harmful to you, but are readily transferred though the placenta and will harm an unborn fetus, even before your know you may be pregnant? For instance:
Benzodiazepines like Valium, Xanax and Ativan have been shown to lead to lip and palate malformation such as split lip.
Alcohol consumption leads to Fetal Alcohol Syndrome.
Pain pills, heroin, methadone and Suboxone, if not tapered during pregnancy, will leave the baby addicted at birth.
Cocaine use can lead to insufficient blood supply to the baby and death of the fetus in the womb.
If you quit before you are pregnant, none of these will be a concern. You will not have to worry about telling anything to the obstetrician or midwife, and you will not have to worry about what they may suspect. There are things you should know about pregnancy and drug testing. There are no uniform laws throughout the states and most physicians do not know the ins and outs of those laws.
There are laws that obligate a health provider to notify authorities whenever there is a suspicion of neglect or potential of abuse.
You may be able to refuse a drug test for yourself, but if any of the staff has any suspicion, they still have a right to test your newborn.
Your baby’s meconium (first stool) can show your drug use as early as the 20th week of pregnancy, and it will show practically every illicit drug you have put into your body.
If you have not been truthful and cooperative with your healthcare team, many states grant them lots of leeway in what they can do with this newly obtained information. No state wants to separate children from their parents, but if you are not showing them that you are on the side of your own good and your baby’s best interest, they do have the power to do things that you may not want!
So, what is the best course of action?
First, get clean before you get pregnant, or as soon as you think that you are. I know this is hard, but trust me, this is not the first hard thing you will be doing for your child, nor the last.
If you are unable to, or find out too late into pregnancy that you are expecting, get prenatal care as soon as possible. Talk to your obstetrician or midwife, and start off with being honest and totally cooperative. Come up with a plan of action that will get you clean and sober as quickly as possible, so that when the baby is born, both of you are healthy and ready for meaningful bonding.
We want to see our children grow up unencumbered with our problems. To give them the best chance of a healthy life, we must be at our best, ourselves. Some of us, like Whitney Houston, seemingly have it all – beauty, talent and wealth – yet we are unable to give our children what we owe them, which is a healthy, happy, clean and sober version of ourselves. If we can commit to give them that, we have a chance to be there for them when they get married, and to babysit their children and their children’s children, as well. Is it not what we owe them? Not to leave them orphaned at 18 with only a song that says that we will always love them.


Patient's Journey: Oxycontin to Tramadol to Suboxone to MDS (Continued)

Nov 06, 2011 - 4 comments
Tags:

Oxycontin

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tramadol

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Suboxone

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staying clean

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Staying healthy

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Addiction

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rapid drug detox



This is a continuation of the blog by a recent patient the beginning of which was first posted about a month ago. I thought you would enjoy an update. If you did not catch the first installment, you can find it in my blogs. Well, here it is:

It has now been a month since I checked in to MDS for withdrawal from Suboxone and it is hard to believe that I am the same person. Every day life seems to get better and I experience the joy of life free from opiates. I have been very careful to follow the instructions I was given by Dr. George, Dr. Aharonov and everyone at MDS. I figure that my best thinking got me in the mess I was in, so maybe it’s time to take some direction for a while.

For the first two weeks after my procedure, I called Dr. George several times. After the procedure, I got wonderful instruction and guidance, but when I got home and real life kicked in it was a huge comfort to know that I could call and speak to him at any time if I had questions. The majority of the calls were related to medications. On every occasion, Dr. George answered my calls immediately and was always compassionate and helpful. There has never been a time that I felt that I was on my own and, at this point, I am off all the medications that were initially prescribed. I know that at least once I called just to get the reassurance that I was doing the right thing and he was always there to help.

After the first couple of weeks, I began to realize that I would need to do a little more than just sit and wait for my life to put itself back together. For that reason, when Dr. Aharonov suggested that I begin to put exercise and a healthy diet into my daily regime, I did just that. This has made a monumental difference in the way I feel. I began to go to my local gym and to walk in my neighborhood. I often get up at 5 am and go out and walk before I go to work. I feel so good and this has also helped me with my sleep and overall sense of well being. I have also worked to change my eating habits and am in better shape than I’ve been in years. It just keeps getting better.
For the past several years, because of the opiates, I slept and went to work. There was not much more to life than that for me. My joy was gone and I was depressed all the time. It is amazing how much joy has returned to my life and my family and friends love seeing me so happy. I laugh, I mean really belly laugh, all the time now. I just feel so wonderful and being around people is fun again. My kids make me laugh all the time and people want to be around me again. I cannot explain how much all this means to me because I had become a shell of a person who was sad, depressed, and depressing to be around.

I still speak to Ann every now and then. She is such a wonderful, caring person. It is awesome to know that I am more to them than just another patient. She, Dr. Aharonov, Dr. George, and all the wonderful people who make up MDS are genuine and truly care about me as a person. Although I have gotten to the point that I don’t need them as much on a daily basis, it is so very comforting to know that they are as close as a phone call away. I feel that I have a friend in Ann now and love what a precious person she is.

I am writing this for one reason only – to encourage and give hope to anyone who still suffers with the weight of opiate addiction. God knows if there had been any way that I could have stopped on my own, I would have done so. I tried for over two years and things only got worse. MDS literally saved my life and I believe that God sent me to them. Now, on the other side and free from that heavy, heavy weight, I can attest to the fact that life is so much more and can be so much better. I can only expect things to continue to get better, as long as I remain drug free. As I said before, I follow directions and things just keep getting better. If you feel alone and without hope, give Ann a call. That’s the best decision I’ve ever made and the best money I’ve ever spent. It was not easy coming up with the time and the money necessary to take the step toward having this procedure done, but I look at it like this; I would have done just about anything to make sure I had my drug on a daily basis because it was my lifeline. I just had to make a decision that I would do just about anything to become drug free. After that, there was no looking back. I had a choice. I could sit and feel sorry for myself and make excuses as to why I could not take charge of my life, or I could get to work, take the necessary steps, and, as the Nike slogan goes, just do it. No more excuses, no more “poor me”, no more victim, I am now a strong, sober woman, filled with joy and hope! Life is wonderful…….if you are hurting, please make that call!