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Addiction medicine specialist prefers opioid-free treatments.

We receive 53% of all Bay Area chemical dependency patients and have referrals from all over California for detoxification from alcohol and opioids and for chronic pain patients. A typical patient is a chronic pain patient on Suboxone, high-dose opioids, oxycodone, or morphine, with multiple surgeries and pain management referrals. We do not use Suboxone, Subutex or methadone (November/December 2013 issue) for any of our patients, and they leave in four or five days with less pain or the same amount of pain while off the drugs than they were when they came in.

We take all corners and do not pick and choose. Approximately 99% leave improved. We have very few patients leaving AMA. If they do, they are 20 to 25 years old and were driven in by their demanding parents.

We used to use Suboxone and it was essentially worthless when it came to ensured sobriety. What we found happening is this: Suboxone is a nasty detox because the drug stays in the system for five or six days and once the patient leaves the detox unit he suddenly will go into acute withdrawal around the fifth to 10th day and will relapse on opioids again.

Our sobriety rate is 90% in the first year for patients who finish our program. How do we do it? We don't use opioids to treat opioid addiction. We use modern science of genetics, evaluate neurotransmitter imbalances and use medications that remediate those imbalances.

Every MD who wants to be an addictio-nologist can without much fanfare get a certification to use Suboxone. That is like taking a freshman college student and giving him the right to dig for skulls without being cognizant of the destruction of the sacred site in which he plays. It angers me to a point of disgust that there is a silent injustice being done to change the opioid receptors in unknowing patients.

A South African addictionologist visited us recently and stated that South Africa has the same problem. Every MD around him has everyone on replaced opioids, and he needed direction in getting patients off opioids. We are not alone. This is worldwide.

Fred Von Stieif MD, ASAM, ABAM John Muir Health and Hospitals Creek, Calif Center for Recovery San Francisco

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Author:Stieff, Fred Yen
Publication:Addiction Professional
Date:Jan 1, 2014
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