Treatment of Opiate Dependency in Young Adults in Sorrento Valley

I have something to celebrate this month - 32 years free from an opiate addiction.

Given opiates for a pain problem that became chronic, I was hooked for 10 years on codeine.  As I write this, I recall how grateful I am to be free of the destructive power opiates had over my thoughts, emotions and quality of life.

Drug addiction to opiates in San Diego County continues to be a growing problem.  The first time users are usually young men and women, who like myself, are emotionally sensitive and who find reducing emotional and physical pain with opiates quite intoxicating.  The euphoria and increased sense of well-being by using the drugs, draw the user back into the illusion that all their emotional and relationship problems related to fear, anxiety and anger, will magically disappear...forever.  We are chemically lulled into sleep, thinking that life is, indeed, very good.

However, young women and men, living in all areas of San Diego, including La Jolla, Del Mar or Encinitas, who use opiates begin to realize after a short time that they want more of the drug (the craving has begun, and it is hoped that taking more will make the drug experience better, just like the first use) only this time the drugs do not bring the same positive effects.  Instead they feel drowsiness, disorientation and dulled senses.  The  motor coordination in these young users  is effected, and they may prefer to just lay around. Life starts to become depressing.   It is not unusual that people begin to use different drugs and perhaps alcohol to try and get the chemical high through mixing substances.

Judgment about important decisions related to work, school money, relationships or family are impaired. People lose jobs, relationships, money and family.  By this time, which could be 3-4 months or a couple of years, the positive effects of the drug are no long present, the negative effects of the opiates are dominating the person's life and living revolves around obtaining the drug to avoid the physical withdrawal symptoms. Withdrawal symptoms include feeling sick, vomiting diarrhea, poor appetite, stomach cramps, dry mouth, restlessness, headache, fainting attacks, stiffness, muscles twitching, fatigue, or tiredness, muscular tension, aches and pains, weakness and insomnia.

Feeling these same withdrawal symptoms for about 6 months, I'm glad I chose to withdraw from the opiates anyway,  breaking  my dependency on this drug.   For 10 years I carried those little white pills in the brown plastic bottle, day and night.  I couldn't remember what it felt like without them, and I was willing to give it a try. It had to be better than what I was feeling and the way I was living.

Today, 32 years later, I still know it was the best decision I ever made.  I feel great most days and have the opportunity to help others who suffer from addictions.

Our medical director, Michael Markopoulos, MD can help you detox from the opiate/withdrawal wheel with the use of Suboxone. It isn't a long term answer, and it will help you reduce the early symptoms.  You don't need to suffer withdrawal for 6 months.  After a detox from the opiates you will benefit from entering an outpatient treatment program where you will learn how to stay clean and discover healthy way to meet life's opportunities.

Get the help you need today.  Call us at 858-453-4315.

Judy Saalinger, Ph.D., MFT, CAS

Alcohol Detox in San Diego County

Do you ever feel sick of drinking alcohol and want to stop. Are the symptoms of withdrawal so uncomfortable that in the past you gave up and went back to drinking and hating yourself for it?
Be  motivated to go through the detox and achieve recovery! You are worth it. And you can do it.

Adequate detoxification is important to beginning the longer process of complete physical and psychological withdrawal from alcohol.  The proper management of this first stage will maximize your chances of lasting rehabilitation, by providing a net of safety and reduction of harm during alcohol or drug withdrawal.  You deserve to have a new beginning.


How do you know if you are already in withdrawal from alcohol or just suffering a bad hangover?  The onset of alcohol withdrawal usually occurs between 6 and 24 hours after the last drink, and an uncomplicated withdrawal usually lasts between 1-4 days.


The first thing to do is decide if you or your loved one will need an outpatient or an inpatient detoxification. The greater the amount of alcohol consumed in a day and the longer the period of time of drinking or ingesting drugs in the body, the greater the  chances of a complicated withdrawal, which means an inpatient detox would be safest.


To determine if you or someone you love is suitable for an outpatient detoxification which usually lasts from 1-4 days, look at the following list:
      1.  Not severely dependent
      2.  No previous complicated withdrawal (no seizures, disorientation, confusion or hallucinations)
      3.  No concurrent illness, injury or recent surgery
      4.  No significant use of other psychotropic drugs that could aggravate withdrawal
      5.  You are motivated to achieve abstinence
      6.  A reliable caretaker is available.




Daily drinking by men of more than 6 standard drinks (1.5 ozs)  a day, and women more than 4 a day, places a person at high risk for a complicated withdrawal. Weekly drinking of 42 standard drinks of alcohol for men and more than 28 for women places a person high risk. Other individual, drug and factors in the environment can effect the level of risk for alcohol related problems.


A simple withdrawal, manageable in an outpatient detoxification can begin by seeming like a hangover or a case of the flu, and usually occurs between 6 and 24 hours after the last drink.  Some symptoms include:
     --tremulousness
     --perspiration
     --increased pulse
     --increased temperature
     --nausea, vomiting and diarrhea
     --restlessness, agitation
     --anxiety
     --insomnia, sleeping disturbance
     --fears
     --depression
     --headaches


If you would like more information on our detoxification program for alcohol, drugs or prescription drugs, including Suboxon, give us a call. We can help you 7 days a week.


Judy Saalinger, Ph.D., MFT, CAS

Suboxone Treatment for Opioid-Addicted Youth in San Diego County

Short-term detoxification coupled with individual and/or group therapy in either a residential or outpatient facility for a few weeks or months is the current treatment as usual for opioid-addicted youth. Except for treating withdrawal during detoxification the typical program does not use agonist medications like suboxone on young addicts. Relapse rates for the current treatment as usual is quite high.

In a recent study in JAMA, Woody and his colleagues reported the results of a randomized trial that compared a 14-day outpatient detoxification using suboxone (detox) vs 12 weeks of outpatient treatment with suboxone (extended treatment). The study was open to young people between the ages of 14 and 21 years but less than 18% of the participants were below the age of 18; no 14 year-old and only one 15 year-old was enrolled in the study. The typical participant was about 19 years old. In addition to receiving suboxone, participants were scheduled for one individual and one group therapy session per week for 12 weeks.

The participants in the detox group had poorer outcomes than the participants in the extended treatment group. Less than 20% of the detox participants completed the study vs 70% of the participants in the extended treatment group. The detox participant on average attended 5 counseling sessions while the extended treatment participants attended 12 counseling sessions. The detox participants also had poorer post treatment outcomes at 6, 9 and 12 month follow-up. Among the detox participants between 17 and 28% produced negative urine tests for opioids, while 29 to 52% of the extended treatment participants produced negative tests.

Woody and colleagues noted that the small study size and the short study duration made it impossible to estimate the number of participants who actually recovered, which they defined as a "voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship." Their study suggests that higher rates of true recovery may be possible with longer use of effective medications coupled with longer and more intensive psychosocial treatment.

Reference: Woody GE, Poole SA, Subramaniam G, et al. Extended vs Short-term Buprenorphine-Naloxone for Treatment of Opioid-Addicted Youth: A Randomized Trial. JAMA. 2008;300(17):2003-2011.