We view the detoxification programme as a Physical, Psychological and Spiritual process and use a variety of interventions.
The use of prescribed medication from our Specialist General Practitioners is only part of this service. Our basic principles are to use a holistic approach to treatment, underpinned by proven research based methods and updated to enable us to offer best practice to our Service Users and staff development.
Below we have listed the various medical interventions used.
Thiamine – This helps to stimulate appetite, help repair the central nervous system, elevate short term memory loss and help to rebalance to body’s vitamin loss.
Carbamazapine – This is given as a precaution, to reduce possible alcohol related fits in individuals whose alcohol intake is extremely high.
Chlordiazepoxide – (Librium) – This is a tranquiliser which helps to reduce withdrawal symptoms. Some Service Users have liver damage and are unable to tolerate Chlordiazepoxide, on these occasions, we would use Diazepam.
We use a variety of back up medication if needed i.e. Alcohol Dependent Service Users often need sleeping medication in the early stage of detox and Opiate Service Users need it towards the end of their detox. All medically assisted detoxifications are carried out following clinically indicated detoxification protocols.
This is often dependent on the Service Users pattern of use before admission and is negotiated between, Service User, doctor and Livingstone House staff. Although we prefer to use Subutex and Lofexidine some Service Users request a Lofexidine detox in conjunction with Lofexidine.
Methadone – if the Service User is admitted on a high dose, we will stabilise them before beginning the reduction. The reduction is carried out following a blind detoxification method. We will introduce Lofexidine to manage withdrawal. Ideally, we prefer to reduce Methadone to 30mls daily following a blind reducing regime and introduce Lofexidine and on Day 4 discontinue Methadone and increase Lofexdine to manage withdrawal.
Heroin, DF118 and other Codeine properties – Again, we are open to negotiation on the detoxification with these substances, but would encourage titration to Subutex.
Subutex – Although this is a more expensive drug, in our experience, it is cost effective because Service Users experience little or no discomfort, sleep is less likely to be disturbed and there are alert and more able to function in the full programme. The transition into the house community, group work and clarity of mind helps to ease them into the treatment programme.
Having has extensive experience in the use of Subutex over many years, we find it beneficial to initiate Subutex on a higher dosage than recommended. We feel that by preventing (or at least, vastly reducing) fear of, or actual pain, this treatment option enables the Service Users to engage in the therapeutic programme quickly. After all, one of the main reasons they continued to use their drugs, was to prevent or avoid the pain of withdrawal.
Cocaine, Crack Cocaine and Amphetamines – Although it is said that there is no direct physical withdrawal affect from these substances, we would tend to disagree. Just giving up caffeine will certainly show certain physical withdrawal ranging from the mild discomfort to real distress. For this reason, we prescribe a short course of hypnotics such as Promazine, Diazepam or Mirtazipine.
We transfer to Diazepam equivalents and where compliance is an issue (liquid medication). As the dose reduces we may introduce Carbamazapine to prevent the Service User from fitting.
We believe that it is important to nourish the body in order for it to be able to heal itself and to help with this process we offer a balanced, healthy nutritious diet. Service Users as part of communal living share this responsibility.
Livingstone House is a 12 Step Rehabilitation Centre. Prayer has been proven to help many conditions over thousands of years. This is offered as a choice at Livingstone House and consent is always obtained beforehand.
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