Supervised Phenobarbital Home Detox

Posted on May 9, 2012 by BillC

When should Phenobarbital be used for detox?

How safe is Phenobarbital when it is used for detox?

Executive Home Detox recently had reason to use Phenobarbital for a medical detox. A middle aged male recently contacted Executive Home Detox. He had decided to quit drinking alcohol and used benzodiazepines* to assist with his withdrawal. However he continued to use benzodiazepines that were used to detox him from the alcohol and he eventually misused the benzodiazepines and he became dependent on benzodiazepines.

Benzodiazepine withdrawal can be difficult, very uncomfortable and can also be dangerous. The precipitous discontinuation of benzodiazepines can cause seizures.

Consideration was given to the use of long acting benzodiazepines to manage withdrawal symptoms from his benzodiazepine dependency, however there were questions about exactly how much benzodiazepine he was taking. A decision was made to use Phenobarbital as a detox agent. Phenobarbital is a barbiturate that will assist with withdrawal symptoms (anxiety, tachycardia, agitation, sleeplessness) and is also a very effective anti-seizure medication.

The danger of using Phenobarbital is primarily respiratory depression. The use of Phenobarbital as a detox agent in an outpatient setting has to be supervised. In this case, a qualified nurse provided 1:1 on site supervision. The nurse administered the Phenobarbital per a qualified physician’s order and then assessed the efficacy of the dose of Phenobarbital. The nurse also monitored the pulse, blood pressure, and respirations of the client. The nurse made the use of Phenobarbital safe.

This Benzodiazepine home detox was a nine day detox. The length of time for a Benzodiazepine detox can vary greatly and is partially dependent on how quickly the client wants the detox to occur. Generally a Phenobarbital managed medical detox will take up to fifteen days.

Executive Home Detox also assisted the client to create and follow through with an aftercare plan that increased the likelihood of sustaining sobriety from alcohol and benzodiazepines.

Benzodiazepines include: Xanax (Alprazolam), Ativan (Lorazepam), Clonopin, Klonopin (Clonazepam), Valium (Diazepam) and many others.

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Anheuser-Busch Response to NY Times Editorial

Posted on May 9, 2012 by BillC

Nicholas Kristof, writing an editorial for the New York Times, essentially accused Anheuser-Busch of caring much more about profits than caring about an entire Indian / Native American community in Nebraska. Below is A-B’s response which was published in the NY Times this morning. I pose a question to A-B at the end of this post.

Re “A Battle With the Brewers,” by Nicholas D. Kristof (column, May 6):

We care about the tragic problems of tribal members on the Pine Ridge Indian Reservation and are greatly concerned about alcohol abuse there and anywhere. When our products become associated with a problem, it is damaging to all of us as parents and members of communities, and to us as a company; it’s the last thing we want for our consumers or our products.

Mr. Kristof asserts that we have a business model based on violating tribal rules. That is simply not the case. Beer producers are prohibited from selling beer directly to retailers or consumers in Nebraska, and we obey all laws wherever we operate or sell beer. We cannot control the actions on the tribe’s reservation, yet that in no way diminishes our desire to end these problems.

We take seriously our role as a leader in alcohol responsibility and support countless efforts with our wholesalers across the country to reduce problem drinking, including under-age drinking and drinking and driving.

This problem involves deeply complex, societal, cultural and sometimes physiological issues that are often heightened during difficult economic conditions.

Making real progress requires people to come together, share solutions and support those who need it. We care about the people of Pine Ridge and hope that together we can make a difference in addressing these problems.

LUIZ F. EDMOND
President, North America
Anheuser-Busch InBev
St. Louis, May 7, 2012

Mr. Edmond. Your response says all the right things. You stated “Making real progress requires people to come together, share solutions and support those who need it.” That’s the talk. Are you willing to walk the walk? I humbly request you ask Mr. Kristof to join your board of directors and participate in creating a solution to the fact that your product is causing immeasurable harm and measurable death to this community. This would demonstrate true transparency.

Executive Home Detox assists clients in New York with private addiction services.

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Reflections on twenty five years of sobriety

Posted on April 25, 2012 by BillC

It’s been twenty five years since I had a drink of alcohol.  I would like to say this accomplishment is really not a big deal, however to be honest, my sobriety has been a very big deal. Here’s why:

1. My continued drinking would have escalated. It’s a better chance than not I would have killed or maimed someone while under the influence, or killed or maimed my self.

2. My marriage would have been over. My immediate family non-existent. Instead my wife and I celebrated 25 years in 2010 and my twenty-three year old son is spending a year with us prior to going to Grad School out west.

3. A couple of my friends, my friends’ family members, and my own family members have reached out and talked with me about problems they are having with substances. I’m glad I can give them a perspective from a health care provider with first hand experience of recovery and sobriety.

4. The past ten years of my professional life has been very rewarding and would not have occurred if not for my sobriety and recovery experiences. My work at CAB Boston Treatment Center 2002-2005 was extremely gratifying. I loved the people I worked with and the people I worked for. The creation of Executive Recovery Coach, Inc. and Executive Home Detox in 2007 was the culmination of my career and the ongoing growth of Executive Home Detox has been one invigorating challenge after another.

6. My participation in the International Nurses Society on Addictions (IntNSA) and my work with their charitable foundation, the Foundation for Addiction Nursing (FAN) provides additional purpose to my life.

6.  I’m sure there are innumerable other reasons to say twenty-five years of sobriety has been a big deal but to recap: I’m alive, haven’t killed anyone, I have positive family connections with my wife and son, and have been able to make positively healthy connections with friends and family members related to addiction and mental health issues. My professional life has been very rewarding and I have purpose in my life.

Thank you to many who have contributed and supported my recovery.

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Wall Street Journal: Hand Sanitizer joins household goods that contain Alcohol

Posted on April 25, 2012 by BillC

Shirley S. Wang of The Wall Street Journal reports today that drinking hand sanitizer, is one of the latest fads of teenagers.

Medical experts from the Children’s Hospital Los Angeles are warning parents about another household substance that is potentially dangerous to their children: hand sanitizer.

EHD has blogged in the past about household goods containing alcohol that can be misused, not only by adolescents, but by adults struggling with alcohol. We will continue to add to this list of products.

Other alcohol containing products include but are not limited to hand sanitizer, cooking wine, vanilla, rum cakes, cordials, colognes, perfumes, and “non-alcoholic” beer. Ideally, it is best to have all alcohol removed from the environment, at least for a negotiated amount of time, and this includes the above products. Removal of these products does not have to take away from enjoyment. There are alternatives:

  • Vanilla: There is now non-alcoholic vanilla. My wife assures me the non-alcoholic vanilla is as good as the original, and she happens to be the world’s best cook!
  • Mouthwash: There are good alternatives for Alcohol Free mouthwashes; Listerine Zero, Crest, Cepacol, Oral B, Binaca, and a number of natural rinses.
  • Hand Sanitizer: A quick Google search of non-alcoholic hand sanitizers produces many alcohol free alternatives. Additionally, soap and water is still the best way to kill germs and clean hands.
  • Cooking wine: Pomegranate molasses, Balsamic vinegar, and different juices.
  • Cologne: Secret original aerosol body spray. A number of colognes and perfumes are available on the Internet.
  • Rum cakes: Lots of alternative desserts out there.
  • Non-Alcoholic Beer: First, there is no such thing, all “non-alcoholic” beer contains alcohol. One of my clients likes to try different types of beer; Ginger beer and Birch Beer.

Many clients ask “Do I really have to get rid of all alcohol and alcohol containing products”. While this is a personal decision by the client and sometimes the decision of significant others, I positively, absolutely suggest and encourage all my clients remove the alcohol in their environment, at least for 30 – 90 days.

Executive Home Detox not only provides private and discreet in-home detox, but we also provide early recovery coaching and assist in developing aftercare plans to improve the odds that sobriety will be maintained.

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Alcohol Home Detox: Why consider an Alcohol Home Detox?

Posted on April 22, 2012 by BillC

Executive Home Detox provides in-home detox support to clients primarily interested in medical detox from alcohol or opiates*. Approximately 60% of our clients detox from Alcohol and about 40% detox from opiates.

Why consider detoxification from alcohol at home? I thought a small review of the reasons previous EHD clients requested a supervised at-home detox from alcohol may help others to make a decision to consider at home detox versus inpatient detox. All clients below demonstrated withdrawal symptoms that necessitated medication assisted detoxification.

Tom: Age 44 years. Retired executive. Alcohol Home Detox. Preferred privacy and convenience. Tom preferred having some control over his environment.

Gino: Age 55 years. Stock Exchange Trader. Alcohol and Opiate Home Detox. Confidentiality was a primary concern.

Allan: Age 62 years. Bank Executive. Alcohol Home Detox. Privacy and convenience were the determining factors. Allan also is used to a high level of service. EHD is a concierge level service with a high degree of clinical competence.

Maura: Age 50 years. Retired rancher. Alcohol Home Detox. Maura has disturbing memories of previous forced treatment. She also has specific medical issues that she was worried would not be addressed in an inpatient setting. Lastly, she did not want to leave her beloved cats.

[EHD is focused on privacy and confidentiality, identifying information is doctored to preserve a client's identity]

EHD is an alternative for many clients who would benefit from a 1:1 Nurse Supervised in home detox from alcohol. EHD supports inpatient treatments and inpatient rehab but recognize that for some, inpatient treatment is not an option.

EHD is happy to provide free consultation to determine if a supervised outpatient treatment model is a possibility for you or your loved one.

Opiates include: Heroin, Oxycodone, Oxycontin, Percocet, Roxicet, Roxies, Roxy’s, Oxy’s, Dilaudid, Hydromorphone, Opana, Hydrocodone, Vicodan, Lortabs, Fentanyl, Fentora and others.

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Wall Street Journal Video: Alternative ways to manage the “War on Drugs”.

Posted on April 21, 2012 by BillC

The Wall Street Journal (WSJ) has an interesting video in it’s week-end digital edition. Mark Kleiman, a professor of public policy at UCLA makes a number of suggestions and points related to the way we, as a society, manage our war on drugs. Much of his focus is on alcohol misuse and the incarceration of those violating our laws geared toward drunk driving and illicit drug dealing.

Professor Kleiman cites programs that do not jail DUI offenders. Rather they offer the person a choice of jail versus breathylizer monitoring twice a day. Those that choose the breathylizer option and remain sober do not go to jail. This is a lower cost to society and allows the individual to remain a functioning member of our society…. and it helps the individual to practice living a sober lifestyle.

Another program targets the non-violent drug pusher / dealer.  It also gives the drug pusher an option to avoid jail by closing down shop and answering to the community. Of course further infractions will result in jail time.

The above examples demonstrate “thinking outside the box”. Executive Home Detox was created by thinking outside the box as well. EHD offers an alternative to inpatient medical detox. We travel to the client and assist in the alcohol or opiate medical detox in the home. This home detox is uniqe. We actually live with our clients 24/7 for as long as the detox requires.

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Wall Street Detox

Posted on April 14, 2012 by BillC

Wall Street Detox: Time is a precious commodity for most executives. You, or a person you are close to, may be in trouble. You need help, but you can’t afford to take time away from work and you don’t want anyone to know about your problem. Executive Home Detox may be one solution. EHD will create an individualized plan to provide a comfortable and private medical detox with a minimum disturbance in the work schedule.

EHD can work with the client to set up a home detox or a hotel based detox that minimizes time away from work. An example of an alcohol detox may be:

  • A Friday start day. The client leaves work and meets the private duty clinician in their home or in a hotel near Wall Street. A highly qualified physician meets with the client as well. A plan of care is established and medication is ordered.
  • The client begins a medical detox under the supervision of the private duty clinician, a nurse specializing in detox. The nurse remains with the client (in an accompanying room) at all times. Monitors the client’s vital signs and uses standardized scales to assist in the comfortable management of alcohol withdrawal.
  • The medical detox continues through the week-end. Medications will be considered that may sustain the client’s sobriety after the detox is complete.
  • The medical detox continues through the week-end with a goal the client will return to work as early as Monday for four hours. The private clinician nurse will remain within five – ten minutes of the client at all times in case he or she is needed. The client returns home or to the hotel and the medical detox continues through Monday night. An aftercare plan is discussed with the client, the nurse clinician and the physician.
  • A goal of a return to work Tuesday for six to eight hours as above. The nurse remains available. The client’s medical stability is assessed by the nurse and the physician to determine recommendations going forward.

EHD can give examples of opiate or benzodiazepine detoxes as well. We can also give an example and timeline of a Suboxone Induction if that is preferable.

This treatment model is intended to eliminate a barrier to treatment. EHD would be highly recommending a continuing aftercare plan that may sustain sobriety. This would include treatment with a physician, therapist, and consideration of an early recovery group and / or involvement with a self-help program.

EHD has provided private and confidential services to many executives: See Executive Detox.

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Job Security versus Preventive Medicine

Posted on April 13, 2012 by BillC

Two recent stories / events in the news has piqued my interest, both from the Today Show on NBC.

  • The Today Show reported today that men who have a couple beers do better on word association tests compared to sober men.
  • The Today Show often, almost daily, demonstrate drinking alcohol in the morning.

In some ways I feel indebted to the celebrities on the Today Show. These reports seem to mean job security for those of us in the alcohol home detox, addiction, and recovery industry. However the clinician in me wants to do something to prevent the blossoming of an alcohol dependence with subsequent alcohol withdrawal.

There are literally thousands, and I suspect hundreds of thousands, of individuals that are either questioning if they have an alcohol problem or having others question if they are having an alcohol problem. The drinking that occurs on the Today Show and the sporadic reports about the benefits of alcohol consumption gives the problem drinker rationale to ignore their own concerns or the concerns of others. Certainly I am not blaming the Today Show for a burgeoning alcoholic’s behavior, however I am stating they can contribute to a healthier society by role-modeling healthy behavior (morning alcohol consumption is not healthy behavior).

I blogged on the Today Show drinking yesterday and share a report from Guyism.com below regarding the word association testing.

The story is reported on and somewhat lampooned in the cut and paste below. Thank you to Guyism.com

Psychologists at the University of Illinois have just added another dart to your crossbow of pro-alcohol knowledge. Through a series of tests, they have proven that beer makes men smarter.

think better when youre drunk 183x214 Researchers prove that beer makes men smarter40 men participated in a series of brain teasers involving being given three words and finding the link between them. Half of them drank two pints beforehand and the other unfortunate souls were stone sober.

The example used in a Telegraph article was “coin, quick and spoon” with the connecting word being silver. I’ll bet it took you a second to come up with an answer. Be honest, even after reading it you still had to think about quicksilver for a second didn’t you? Well, have a couple beers, and see where that gets you!

It is thought alcohol hinders analytical thinking and allows ‘creative’ thoughts that might otherwise by stifled to take root, allowing test subjects to come up with more imaginative solutions.

OK, so it seems that smarter may not exactly be the right term, but are you going to argue semantics when you are looking for an excuse to have a few beers on a Wednesday night? No, I didn’t think so. We’ve all spewed all sorts of non-sense when we’ve had two or twelve too many drinks, but now you can claim that it’s all in the name of creativity!

The most important thing that I took from this study is that I should really start drinking more. It would be better for you the reader as well as me the writer. I’ll do my best to sober up before actually putting together the articles, but the ideas will all be drunkenly conceived.

Sooooo, Job Security versus Preventive Medicine. I think it would be nice if my services were never needed again.

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Home Detox: We come to you

Posted on April 12, 2012 by BillC

When a person does a search for “Home Detox”; quite a few options appear. Alcohol and drug detox programs that actually do provide care in the home, detox programs to rid a house of certain items (chemicals, odors ….), different body detoxes including gastrointestinal and foot detoxes, and also programs that have nothing to do with a home detox.

Executive Home Detox is a program that comes to you, the client. We travel to where you are located. Our travels have taken us to 18 states and internationally to three countries. We have responded to the client within hours and have set up a planned medical detox a month in advance. We have remained on-site with our clients from five days to 35 days.

The key message here is; We Come to You! We travel all over the United States, EHD is not based in one community, or one state, or one region. We come to you wherever you may be.

Feel free to contact EHD to discuss our unique program of providing a fully supervised alcohol or opiate medical detox in the comfort of your home or current living quarters.

Thank you.

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Is the Today Show promoting drinking in the morning?

Posted on April 12, 2012 by BillC

I wrote the following to the Today Show via their contact form:

I notice that your staff often have a drink of alcohol to compliment the meals being prepared. Of course I am sensitive to the subject, however I question the message this gives to your viewers. I’m not aware of any health professional that feels it is beneficial to drink alcohol in the morning. The Today show often focuses on health and often focuses on the destruction of alcohol and drugs, yet your on-air staff consume alcoholic beverages in the morning. I think it is appropriate to identify complimentary alcoholic drinks with each prepared meal, however I don’t think it is appropriate to drink the alcohol that early.

I am told the two hosts, Kathie Lee Gifford and Hoda of the 10AM EST segment often have a glass of wine while doing their segment. This message is especially disturbing. The two celebrities are role models for women throughout the U.S. If they are drinking this early then it must be OK for the viewers to be drinking as well. Why not promote health as opposed to the promotion of morning alcohol use and abuse?

A quick Google search identified other’s have found the alcohol consumption on the Today show to be disturbing as well. Use keywords: Alcohol, today show, wine consumption, …

Executive Home Detox provides in-home detox of alcohol or opiates to clients who prefer privacy or convenience. About forty percent of our clients are women and the majority of women are wine drinkers and include wine consumption in the morning.

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