Julia M Aharonov, DO  
Female, 56
Pontiac, MI

Specialties: Addiction, Drug abuse and dependence

Interests: My family
Advanced Rapid Detox
Pontiac, MI
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Rapid Drug Detox Risks vs Benefts

Oct 21, 2013 - 8 comments

rapid drug detox


drug detox





There is nothing better, nothing more satisfying for a physician than to see a patient succeed. And when it happens over and over again, it is just so fulfilling. When a young lady who looked awful a few months ago comes into our clinic looking like a model, full of energy, vitality and health, there cannot be a better feeling for a doctor.  
So when I see our type of detox method questioned in print because of some other physician doing a poor job or doing something he should not have been doing at all, it bothers me. Dr. Sunjay Gupta, the one who apparently knows it all, put it on his medical news channel, that because of several poor outcomes in a clinic in NY, rapid detox under anesthesia is just too dangerous. Why doesn't the press come and see what we do on weekly basis in our clinic, safely and effectively for hundreds and hundreds of patients, but brings to everyone’s attention someone’s failure?  
The fact is that the failures do exist.  Medicine, even good medicine is fraught with failure. Patients die, even in the best of circumstances and the best of hospitals. Even the best physicians sometimes fail to stop the inevitable. Medicine is a very risky business.  And the medicine of rapid detox that only few doctors know how to do seems to be riskier yet.  But with all the hype, we are still talking a few deaths, however tragic and possibly avoidable.
According to CDC, 17,000 people die each year from opiate overdoses; more than quadruple the number of a decade ago. Almost one-third of prescription painkiller overdose deaths involve methadone. Six times as many people died of methadone overdoses in 2009 than a decade before and methadone is supposed to be the “addiction treatment of choice” .  Suboxone has also been involved in numerous overdose deaths.  
In medicine, everything should be a balance of risk and benefit. Before undertaking any medical procedure risk and benefit ratio must be carefully examined and assessed.  Questions must be asked such as:
Is the procedure necessary?
Is the patient healthy enough to undergo the procedure?
Is patient medically optimized and prepared for the procedure?
Is the doctor knowledgeable and experienced in this particular procedure?
How many has s/he done?
What is the doctor’s success rate?
If after thorough examination everyone is satisfied that the benefits outweigh the risk (even though the risk is never zero), the procedure can go on in as safe a manner as possible.  That is what we strive for in our clinic, MDS Rapid Detox.  The safety and successful outcome of each of our patients are our top priorities.
So when the press judges rapid drug detox “dangerous” based on someone else’s lack of knowledge, experience and ethics it really does a disservice to all those who can be helped and potentially saved by what we believe is a life changing and transformative treatment method. All we ask is that you talk to our patients and see our clinic for yourselves.

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by abderamane126, Oct 28, 2013
hello how are you you are good luk for you work and for your life
;;;you are welcome o  desert nomade moroccin

Avatar universal
by RubyRose30, Oct 31, 2013
Hello Dr. Aharonov.  Thank you very much for your article.  I find that all too often certain treatments are demonized based on a few bad apples.  For example, as someone who suffers from chronic pain, I have seen how difficult it has become to receive proper treatment for pain because of doctors who knowingly over-prescribe to anyone who walks through their door.  That can make the legitimate pain management specialists hesitant to adequately treat the pain of REAL patients. And also, as someone in recovery who has seen the good that methadone can do, I have seen it receive negative press because of overdoses that involve methadone (generally in people who are abusing it on the street, not stable on a dose from a clinic)... we all know that addiction kills, so I hate to see ANY treatment written off by people because of a few bad experiences.  Any time an addict walks through the door of any type of treatment program, it is a GOOD thing and will potentially save their life, so I hate when any treatment is demonized.  It happens to methadone, to suboxone, to rapid detox, and even to twelve-step programs... all based on a few bad experiences that are generally anomalies.  Anyone who cares about helping addicts needs to try to point them in the direction of treatment- ANY treatment- instead of attacking certain treatments. We need every type of treatment that exists because recovery isn't a one-size-fits-all deal- the same thing will not work for every addict... nor will every addict have access to every type of treatment.  For example, I live in a large city and the majority of addicts I know are poor and living on the streets at the time that they are seeking treatment... for those people, rapid detox or long-term inpatient rehab or Suboxone are generally not options. Their only option is what the city will pay for- here, the only option given to opiate addicts is methadone- mostly at a clinic, but some are given the option of inpatient rehab where they will be stabilized on methadone before being released to a clinic.  I have seen it work wonders for many people- like the patient you described at the beginning of your article, its amazing to see those kinds of transformations. I love seeing the improvement in people, seeing them start to live normal lives (many for the first time ever, as life was far from normal even before their addictions began)... and I feel that it saved my life, without a doubt.  I haven't used heroin since day one of methadone treatment.

Anyway, I was just trying to say that I share your frustration at seeing any type of treatment attacked because I fear that those attacks may steer people away from treatment... and this is a serious disease so a missed chance at treatment could mean death.  I also think that what you do is awesome and must be incredibly fulfilling.  I have found it to be incredibly rewarding to work with other addicts through twelve-step programs and other counseling situations.  

I also wanted to ask you a question about rapid detox.  Is it offered to patients on methadone?  As I said in the beginning, I suffer from chronic pain due to a spinal injury, so, at this point (after many years clean), I am only staying on methadone for pain management reasons.  I fear the amount of pain I would have to endure during the long, drawn out process of tapering off of methadone.  I would rather be able to get off of it quickly and then see where I am as far as what I need to do to manage my pain.  I ask if it's offered to methadone patients because it is much longer-acting than most opiates-of-abuse.  Is it possible for it to get out of your system completely after one day?  Also, does being on a high dose make a difference?  I am on 285mgs of methadone a day and have been on this dose for ten years (it took a year to get to this dose, so I've been on methadone for 11 years total)... I'm a 30 year old female, btw.  Is rapid detox even an option for chronic pain patients?  I mean, what if the person wakes up after detox and finds their pain level to be severe?  That is my biggest fear... with any kind of detox.  Anyway, thanks for all that you do to help addicts and for taking the time to read this.  :)

Avatar universal
by civilc, Nov 02, 2013
so would u recomend this to someone who is just starting methadone treatment and scared of getting hooked on that too. Ive been using opietes for three years straight and have two young kids I want to take care of and i thought this may be the way out

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by ivgirl, Nov 03, 2013
In patients who have a chronic pain condition with a disease like sle and migraines tmj and vasculitiess associated with hep c the methadone treatment would it be better for them? I have been on all sorts of pain killers for over twenty years I cant see how I would cope with the pain I injured myself at work. It was a repetative motion from the hammer and strain on the wrist from the snippers used as well as neck injury due to the heavy lifting and the muscle attached to the spine the trapizious muscle that was injured. On the onset I awoke doubled over in pain but of course had to work so I was on tylenol 4. Then one day I lifted something onto the truck and the pain was insane. I could not even ride in a car. Any jarring of me was crazy bad. They controlled it then with that stupid oxy. That dosage was increased to 360mg plus a morphine breakthrough. I got a narcotic bowel. I weaned off on my own. However the pain never goes away. Now I am on hydromorphone. I am also taking mirtazapine for my stomach which seems to have resolved the immense stomach pain.I was without pain meds for a shrt time but could not manage.They are sending me to a pain specialist and I am afraid they will take me off the pain meds. This combination seems to be the one that works for me. I think I may be able to take on a part time job now. I say that because it takes so long for me to start feeling well i feel my beset at night..Is methadone a way for me to go?

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by ivgirl, Nov 03, 2013
I mean if that is what the pain specialist wants to do take me off the narcotics. I know I have a dependence as I have been on them for some time.I just wanted to know the effects of methadone on the bowel and the brain. I also have the teeth grinding issue and have high anxiety. Any advice would help.

Avatar universal
by RubyRose30, Nov 04, 2013

I am sorry for all of the pain that you are experiencing... I know what it's like to live with chronic pain, and it's not easy.  It's also so difficult to know what the right thing to do for your pain is when you hear so many different opinions.  It sounds like your pain is being managed fairly well at this point if you feel like you could start part time work again... for me, if I got to that point, I wouldn't want to change a thing about my pain management regimen.  Just share exactly how you feel with the pain specialist- that you are fairly happy with the meds you are on and want to stick with that.  The pain doc may have some treatment options for you- cortisone injections, etc- that could help to reduce your pain, even temporarily.  I would definitely give him/her a shot.  I've seen a number of pain specialists over the years and some have been wonderful and extremely helpful and others have been fairly useless... so it can't hurt to get their opinion.  

As far as methadone, it doesn't sound like you're abusing your meds or have an addiction issue... anyone on long-term opiate treatment will develop a dependence, that's just how our bodies work, but that's a completely different thing from addiction.  Although, I think, to some, it can look similar when you suffer from chronic pain- NEEDING your pain meds because you are IN PAIN can make some people think you're addicted, but that's just because they can't relate to living with constant, debilitating pain.  Anyway, yeah, I don't think that methadone is an option for you as far as at a methadone clinic... they'll make you sit through addiction group therapy for nine hours a week plus weekly individual substance abuse counseling and having to attend seven days a week just to get your medication. That's not ideal for someone with chronic pain... nor is a once-daily dose of a medication.  The methadone will keep you out of withdrawal fro 24 hours or more, but it will not relieve pain for that length of time.  That is my biggest problem- getting my methadone once a day only helps to control my pain for part of the day and I'm just screwed for the rest of the day and all night. I want to leave the clinic and go to a pain management doc but it's hard to find one who wants to treat me given my addiction history (it's been over ten years now).
But it you are thinking of methadone as far as using it for pain management THROUGH your pain doc, that is definitely a viable option.  Many pain doctors are using methadone now to treat pain... and if you do have a doctor who wants to try that for you, make SURE they know what they are doing as far as starting you out on it.  There have been cases of doctors who have not properly understood methadone dosing and killed patients, so I'd make sure any doc interested in prescribing it has experience with it.  I think it's always hard to say which narcotic med will work the best for pain- it seems to be a very individual thing, finding the best combo of long-acting med and a breakthrough pain med.  Methadone can definitely work for pain.  As far as the effects that you asked about- it causes constipation like any other narcotic, but it does improve as you adjust to your medication.  I have experience with all kinds of narcotics- from codeine to heroin- and I would say that methadone is not as bad as many others as far as constipation.  I was ok, from the beginning, with just colace sometimes.  As far as the brain, methadone is less likely to cause a "high" feeling or any kind of fuzziness, once you're on a stable dose, than many other narcotics, which is one of the reasons it is used to treat addiction. As I said, I've been on any opiates, and I find that I can function completely normally with methadone and don't feel any different when I take it.  
I'm not a doctor, of course, but just sharing my own experiences... I hope that helped to answer some of your questions.  But it really comes down to what you and your doctor decide is the best medication to treat your pain.  If your doctor wants to try methadone for pain, it's worth a shot. If you have any other questions, feel free to message me.  Best of luck with your new doc and your pain treatment.  :)

Avatar universal
by Markyboi, Dec 03, 2013
I've done anesthesia detox in tarpon springs Florida. I've been on opiates for 15 yrs and severely the last. 6 or 7.. I've also done 5 day in hospital detox twice. In my opinion the rapid detox isn't for everyone, but no treatment is. It's probably best for the true pain patient who wants off but can't afford physically or mentally to go through withdrawls. As for the true addict, I feel this is the worst treatment possible. It's a very expensive "free ride". If your an addict and you go through withdrawls it is awful and u remember and it helps u from ever wanting to go that low and dark again. With rapid detox u go to sleep ( VERY DEEP SLEEP) wake up and your done. Not fair;) lol.. Remember this is just my opinion.  Currently I am on my 11 month of 8 mlgrm a day of either subutex or suboxone. I've read horror stories of the detox and I've talked to people who have been on it and don't remember it being so bad. Anyway I start my taper next month, and all I know is it saved my life. Since the first dose I have never thought of or craved opiates since. Not one treatment plan works for everyone. We are all so different. Oh and btw some people take up to 32 mlgrm a day of subs and have for years. I hope I can finish this stage of my recovery smoothly and onto the next chapter.. At the time I started subs I  was taking 8, 30 mlgrm  oxycodones & 5 ,10 mlgrm Percocet  plus 3 soma and 3 klonopin a day... Ughh. Gross... I have not relapsed once. I never even think about it. Thank god....

Avatar universal
by yudao1990, Dec 30, 2013
Dear doctor, I really need help, I am a week ago with classmate dinner, I feel that someone want to harm me, but I don't know who it was, in give me food poisoning, today I have loose bowels, and I feel whole body have no energy, I feel very panic, I'm really afraid, could you tell me if really toxic, what is the poison, what kind of check, what should I do I really need your help, I hope you will reply me after see, really thank you! I wish you a happy life! (I am a anxiety depression)

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