Reporters love rapid detox

Maia Szalavitz

In what read like a paid advertisement, Britain’s Independent newspaper has become the latest media outlet to fall for the claims of the promoters of a procedure called “rapid” or “ultra rapid” opioid detox.

The Independent is in good company: Barbara Walters, 48 Hours, even Wired have promoted this treatment, which has actually led to about a dozen deaths around the world.

The Independent claims that in the world of addiction treatment everyone believes addiction is a psychological problem, but only rapid detox treats it as a medical one.

This is what happens when journalists who don’t follow a beat write about a topic without bothering to check the medical literature, let alone Google. Almost everyone in the field of addiction has been singing from the “addiction is a disease” song sheet for decades.

While I am the first to criticize the field for saying “disease,” and then turning around and treating addiction with untrained counselors or faith-based moralistic attacks, it is simply wrong to claim that most addiction treatment ignores biology. If anything, the idea of addiction as a disease affecting the brain is over-emphasized.

The main rationale for methadone maintenance is, in fact, that addiction is a medical problem and that providing an opioid makes up for a deficiency in the brain. It is the most-used treatment for opioid addiction in the UK, and, not coincidentally, the best-supported by evidence.

The key problem with the Independent’s story is that it failed to mention the most important study on rapid detox, Anesthesia-Assisted vs Buprenorphine- or Clonidine-Assisted Heroin Detoxification and Naltrexone Induction, which was conducted at Columbia University Medical Center, and published in the Journal of the American Medical Association in 2005. The study, a randomized controlled trial, compared rapid detox to two other treatment methods and found that it provided

“no benefit… over a safer, cheaper, and potentially outpatient alternative using buprenorphine as a bridge to naltrexone treatment. Taken together with the results of earlier studies, our findings suggest that general anesthesia for rapid antagonist induction does not currently have a meaningful role to play in the treatment of opioid dependence.”

Contrary to the media’s advertorials stories, and the Independent’s claim that patients wake up from the anesthesia used in rapid detox without withdrawal symptoms, the study found that withdrawal was no less severe than other less risky methods (rapid detox includes the use of anesthesia, when a patient is likely to be vomiting.)

Three patients in the rapid detox group also had “potentially life-threatening adverse events.”  But as with the fact that there have been deaths associated with the procedure, this potentially life-saving information never made it into the Independent’s story.

12 Responses to Reporters love rapid detox

  1. Great analysis. Thanks for exposing the facts.

  2. Ed Runci says:

    The Columbia study is three years old. It did not even look at Dr. Alan David Kaye’s Ultra Rapid Detox Center at Texas Tech Health Sciences Center. Dr. Kaye was Chairman of Anesthesiology and Director of the Post-Doctoral Fellowship Program in Interventional Pain Management. He’s a member of the Texas Tech HSC Anesthesia Hall of Fame,.

    Dr. Alan David Kaye (MD, PhD, DABPM) is now Head of Anesthesiology at LSU School of Medicine, New Orleans, and Chief of Anesthesiology at three fully accredited hospitals. He’s a Tenured Professor of Anesthesiology and a Professor of Pharmacology. He was named a Consumer Research Doctor of the Year in Anesthesiology and Interventional Pain Management for 2006-2007. He’s a praticing physician, Head of a Medical School Anesthesiology Department, Chief of Anesthesiology, Research Scientist and Scholar. He’s published more than 500 Articles, Abstracts and Text Book Chapters. He won the Arizona State Rhodes Scholar Competition, and was the Western Region National Rhodes Scholar Competition Runner-up.

    He is the Inventor the Kaye Method of Ultra Rapid Detox, and the Medical Director of the Kaye Clinic for Ultra Rapid Detox at Ochsner Medical Center – Kenner Louisiana. He’s been successfully performing The Kaye Method Ultra Rapid Detox procedures in a hospital Intensive Care Unit since 2000, has a 100% success rate, has NEVER had an adverse incident, and has published articles based on his research and practice in prestigious peer-reviewed Medical Journals.

    It’s time to stop looking backwards at old data, and to start looking forward at real facts and the results of actual practice by true experts in the field. If you want the REAL facts about Ultra Rapid Detox, you can come meet Dr. Kaye, email him or speak directily with him by phone. Contact me (Ed Runci) at http://www.kayerapiddetox.com, and I’ll personally arrange any of the above.

  3. This is a response from writer Maia Szalavitz:

    In searching Medline, I find two articles by Kaye on rapid detox. One was a review– which claimed that opioid detox can be fatal without anesthesia, a claim that is not supported by data– and was done *before* the JAMA article appeared. The other made claims about rapid detox being safe and effective, but was not a randomized controlled trial and was followed up by an editorial note “Editorial expression of concern regarding: Kaye AD, Banister RE, Hoover JM, et al. Chronic pain and ultrarapid opioid detoxification. Pain Practice 2005;5(1):33-42.”

    It’s nice to have qualifications but qualifications do not trump data and given that he doesn’t seem to have any published peer-reviewd controlled data comparing level of withdrawal symptoms following his detox to level of withdrawal symptoms following safer alternatives, I remain unconvinced that rapid detox has advantages over other detoxes. The key advantage is supposed to be patient comfort: if they can’t even prove that– which JAMA debunked pretty conclusively– all other points are moot. No controlled trial has found advantages in long-term recovery, so why add the risk?

  4. Ed Runci says:

    Come see us at Ochsner Medical Center – Kenner, Trevor, and talk with Dr. Kaye one on one. Then decide.

  5. michael says:

    We perform Medical Rapid Detoxification, using medications including Clonidine and Naloxone. The withdrawal process is accelerated, under anesthesia, to help people addicted to opiates/narcotics and overcome most of the bulk of physical addiction. The procedure lasts 8 hours under anesthesia and 28 hours of immediate recovery.

    Safety: Treatment is administered one-on-one by a Board-Certified Anesthesiologist.

    Experience: Rapid Detox Medical Director, 18 year experience in Cardiac Surgery Anesthesia, Intensive Care Unit & 13 years experience in Pain Management.

    Facility: Our Clinic is located on Campus across the parking lot Emergency Entrance of the Hospital.

    Hospital: State of the Art and Accredited by the Joint Commission of Accreditation.

    Our Las Vegas location: Offers convenience, security from paparazzi and discretion. No one back home needs to know what you actually did in Vegas. What Happens in Vegas, stays in Vegas.

    Cost: Is $12,000 and not covered by most insurance companies.

    Post Operation Care: Patients have the Choice.

    Affiliates: Rehabilitation centers and staying there might be covered by some insurance companies or our Affiliate Hotel.

    Most cases: Patients rather be at the hotel, recovering with our Nurse.

    Chief Nurse: 13 years of experience, has patience, with Patients in hospital, medical surgical unit, emergency room, intensive care unit, triage, mental, psychiatric health, medical clinics, convalescent, assisted living homes, retirement homes, private duty, sports medicine, case management, celebrities, and Home Health.

    V.I.P Care: one-on-one with the Chief Nurse, on-call 24/7 close will be adjacent to your room, and will be very happy to assist you, by re-assurance, empathy, post-operation instructions/questions/answers, and anything you need to feel safe, secure, and provide medications, as needed.

    Priority: We treat you like Family, because you’re a Very Important Patient. Maintenance follow-up call made after a month, to hear about any changes in condition.

    Transportation: available to Airport. Then patients go home for out-patient services in their area for follow-up.

    Call today: (800)276-7021 or (702)308-6353

    Email: info@rapiddetoxlasvegas.com

    Medical Director: Board-Certified by American Board of Anesthesiology 1994, former chief of cardiac anesthesia, University of Nevada School of Medicine.

    Board-Certified by American Board of Pain Medicine 1997, Clinical Assistant Professor University Nevada School of Medicine.

  6. michael says:

    Alternative Names Withdrawal from opioids; Dopesickness

    Definition:

    Opiate withdrawal refers to the wide range of symptoms that occur after stopping or dramatically reducing opiate drugs after heavy and prolonged use (several weeks or more).

    Opiate drugs include heroin, morphine, codeine, Oxycontin, Dilaudid, methadone, and others.

    Causes:

    About 19% of the population is believed to misuse opiates over the course of their lifetime, including illegal drugs like heroin and prescribed pain medications such as Oxycontin.

    These drugs can cause physical dependence. This means that a person relies on the drug to prevent symptoms of withdrawal. Over time, greater amounts of the drug become necessary to produce the same effect.

    The time it takes to become physically dependent varies with each individual.

    When the drugs are stopped, the body needs time to recover, and withdrawal symptoms result. Withdrawal from opiates can occur whenever any chronic use is discontinued or reduced.

    Some people even withdraw from opiates after hospitalization for painful conditions without realizing what is happening to them. They think they have the flu, and because they don’t know that opiates would fix the problem, they don’t crave the drugs.

    Symptoms of withdrawal include:

    * Abdominal pain * Agitation * Diarrhea * Dilated pupils * Goose bumps * Nausea * Runny nose * Sweating * Vomiting

    Exams and Tests

    Your doctor can often diagnose opiate withdrawal after performing a physical exam and asking questions about your medical history and drug use.

    Urine or blood tests to screen for drugs can confirm opiate use.

    Treatment Options:

    Treatment involves supportive care and medications. The most commonly used medication, clonidine, primarily reduces physical symptoms.

    Buprenorphine (Suboxone) has been shown to work better than other medications for treating withdrawal from opiates, and can shorten the length of detox. It may also be used for long-term maintenance like methadone.(not recommended, Suboxone & Methadone is a legal form of an opiate and morphine/heroin)

    People withdrawing from methadone may be placed on long-term maintenance. This involves slowly reducing the dosage of methadone over time. This helps reduce the intensity of withdrawal symptoms.

    Rapid Opiate Detox. Such programs involve placing you under anesthesia and injecting large doses of opiate-blocking drugs, with hopes that this will speed up the return to normal opioid system function.

    Support Groups:

    Support groups, such as Narcotics Anonymous and SMART Recovery, can be enormously helpful to people addicted to opiates.

    Outlook (Prognosis)

    Withdrawal from opiates is painful, but not life threatening.

    Possible Complications:

    The biggest complication is return to drug use. Most opiate overdose deaths occur in people who have just withdrawn or detoxed. Because withdrawal reduces your tolerance to the drug, those who have just gone through withdrawal can overdose on a much smaller dose than they used to take.

    Longer-term treatment is recommended for most people following withdrawal. This can include self-help groups, like Narcotics Anonymous or SMART Recovery, outpatient counseling, intensive outpatient treatment (day hospitalization), or inpatient treatment.

    Those withdrawing from opiates should be checked for depression and other mental illnesses. Appropriate treatment of such disorders can reduce the risk of relapse. Antidepressant medications should NOT be withheld under the assumption that the depression is only related to withdrawal, and not a pre-existing condition.

    Treatment goals should be discussed with the patient and recommendations for care made accordingly. If a person continues to withdraw repeatedly, methadone maintenance is strongly recommended.

    When to Contact a Medical Professional:

    Call your doctor if you are using or withdrawing from opiates.

    OPIATE ADDICTION VIDEO

    RAPID DETOX VIDEO

    DONT WORRY, HELP IS ON THE WAY PAINLESSLY

    V.I.P. RAPID DETOX LINK

  7. How to detox says:

    You’re bang on the money about journalists picking up on the hype and simply writing content to generate interest in their newspaper. Particulalrly in the field of health, far too many stories are given columninches in abid to sway and attract readership without a thought for the consequences of what they are saying. They are the biggest culprits for creating hype and misinformation.
    Kym

  8. how to detox says:

    Too many “advertorials” like this make in into main stream news purely for the purpose of pushing some new system or product without any (or very little) concern for the people it affects. Just a shame the Indepenedent has decided to jump on the bandwagon.

  9. Seems there’s big money to be made by these “journalists” in promoting the lastest fad technology. Drugs are becoming more of a problem (regardless of the government may try to tell us) and consequently detox centres like these are set to make a lot of money if they promote their services – just ashame the nespapers and magazines don’t actually do any real journalism to get the facts before publishing the advertisement (er, sorry, I mean story!)
    Julianne

  10. CompleteScam says:

    I think that anything claiming a “100% success rate” is clearly a scam.

    That such an amazing, revolutionary treatment CANNOT get published in a respectable medical journal shows that clearly this is exploitation of already vulnerable people.

    Given the inherent risks associated with anesthesia, you’d have to be mad risking your life to such unproven treatment from a bunch of people that are more concerned about profit rather than patient safety.

  11. Downtamun says:

    hi i am just wondering but can 12 year olds take the rapid detox or is it too strong for them?

  12. DetoxDiet says:

    I personally think that rapid detox is a bit too harsh on the body. The name rapid say it itself. Anything “rapid” is not easy for the body to cope with.

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