Happy Father’s day to Me! I’m not usually this Narcissistic, however this is one of my favorite days of the year. I value being a father as much as any role in my life. Of course I have warm wishes for my own father, Robert, who passed away in 2004 and my father in-law, Michael, who passed away last year, this is our first year without my father in-law. I wish them both a posthumous father’s day.

Happy Father’s day to Me! My son, Michael, is twenty-five years old and has never seen me have a drink or seen me under the influence of alcohol. This is the gift I have been given, and in my ongoing attempt to remain health, I have given to myself.  I’m an alcoholic that cannot drink in safety. The concept of having one drink is anathema to my being. My last drunk was pretty ugly and I really don’t want to ever experience that again.

Fatherhood is a wonderful role, even in my imperfections as a father – which have been many – I have wonderful memories and look forward to many more. There is no doubt, none at all, that my role would have suffered immeasurably had I continued to drink.

So, as I celebrate another Father’s day, I celebrate another sober father’s day. This is the greatest gift I can continue to receive. Being ready and available to assume my role as a father if and when my son reaches out. I also want to impart home to any father struggling with the use of alcohol and / or drugs that a move toward sobriety can be a move toward a healthy relationship with children.

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How does “Gin and Tonic”, the U.S. Open and my own golf game fit in with this blog about home detox and recovery?

My mother in-law encourages me to think about (or recite) “Gin and Tonic”. And with the U.S Open being played this weekend  and as an homage to the U.S. Open – I guess I will step out of my comfort zone and share the benefits of “Gin and Tonic”.

The U.S. Open is the most prestigious golf tournament in the United States. Anyone can qualify if they are good enough. I personally enjoy watching the U.S. Open because the course is designed to challenge the great golfers. An even score or “Par” is usually good enough to win.

As one might expect, I do enjoy golf. And as many remember, I used to enjoy having a Gin and Tonic. My last Gin and Tonic was over 26 years ago but thanks to my mother in law, I have it on my mind almost every time I play golf. Timing is very important in Golf and Gloria has often suggested I recite Gin and Tonic as a way to pace my backswing and subsequent Forward Swing. I have tried this method and it usually works well.

Being a ‘good recovering alcoholic’ I have tried many other phrases to create the pace to temper my swing, unfortunately nothing works better than “Gin and Tonic”.

The benefits of Alcohol left me many years ago, alas the benefit of “Gin and Tonic” remains … even for a recovering alcoholic

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EHD has a home detox; for Alcohol, Opiates, Benzodiazepines, and Barbiturates.

Home Detox for Alcohol: This is usually a seven day treatment episode. The focus is on the medical detoxification of alcohol due to alcohol dependence. The assessment includes observation, Vital Sign monitoring, and the use of a CIWA (Clinical Institute Withdrawal Assessment for Alcohol) scale. Medication management is usually always needed. Most alcohol detoxes can be done in 3-5 days. A seven day treatment model is requested to set up a basic aftercare program to sustain sobriety. Home Detox for Alcohol may be useful for Alcohol Dependence related to Vodka, Whiskey, Gin, Rum, Wine, Beer and other alcoholic beverages.

Home Detox for Opiates: Opiates include: Heroin, Oxycodone, Oxycontin, Percocet, Roxicet, Roxies, Roxy’s, Oxy’s, Dilaudid, Hydromorphone, Morphine, Opana, Hydrocodone, Vicodan, Lortabs, Fentanyl, Fentora and others. Opiate Detox for relative short-acting opiates is usually a seven to ten day treatment episode. It is best if the client can agree to a ten day treatment program. The focus is on the medical detoxification of opiatesl due to opiate dependence. The assessment includes observation, Vital Sign monitoring, and the use of a COW scale (Comprehensive Opiate Withdrawal Scale). Medication management is often helpful, unfortunately attempts to go “cold turkey” too often result in serious relapse. Opiate detoxes can be done in 4-5 day using “comfort medications”, or 7-10 days using a Suboxone Taper.  . A ten day treatment model is requested as the best outcomes have been with a ten -twelve day detox. Home Detox for Opiates may be useful for Opiate Dependence related to Heroin, Oxycodone, Oxycontin, Percocet, Roxicet, Roxies, Roxy’s, Oxy’s, Dilaudid, Hydromorphone, Morphine, Opana, Hydrocodone, Vicodan, Lortabs, Fentanyl, Fentora and others.

Home Detox for Opiates; A home detox for dependence on Buprenorphine, including Subutex and Suboxone, and a home detox for dependence on Methadone would require a longer, more protracted medical detox.

Home detox for Benzodiazepines: Benzodiazepines include: Diazepam (Valium), Alprazolam (Xanax), Clonazepam (Clonopin), Lorazepam (Ativan), Chlordiazepoxide (Librium), and a number of others. A benzodiazepine detox can take anywhere from a week to months. Technically, the benzodiazepine detox can take place in a relative short period of time, however the post acute withdrawal for benzodiazepines can be especially difficult for some people. There are many clinicians who recommend a very  slow taper from the Benzodiazepine, some recommend a taper over a full year. This can be effective but arduous and is fraught with successes and failures. EHD can offer a ten to fifteen day supervised medical detox under a physician’s supervision. The result would be a successful “medical” detox, and a plan to sustain recovery. There may be a residual post acute withdrawal syndrome that would need to be addressed on an ongoing basis.

Home Detox for Barbiturates: Barbiturates or Barbiturate like substances would include Carisoprodol (SOMA), and Butalbital (Fiorcet / Fiornal). Barbiturate dependence is relatively rare but it does happen and if often secretive. A individuated plan for a safe supervised withdrawal with medication would be discussed and undertaken. Variables that will effect the length of time of the safe withdrawal include the amount the person is taking and the length of time the person has been taking it.

EHD provides Home Detox for alcohol and drugs causing dependence and possibly addiction. EHD is a concierge level treatment model. One nurse, a specialist in medical detox, comes to the home and remain in the home or remain with the client 24/7 for as long as the medical detox requires. EHD respects privacy and confidentiality. We always attempt to set up an aftercare plan that will sustain recovery.

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Yesterday I blogged about the first signs of alcohol withdrawal. The blog focused on craving and tremors. Another sign that may accompany craving and tremors may be ‘dry mouth’. Waking up in the morning or after a prolonged nap with a dry mouth may be related to the amount of alcohol a person is consuming.

Dry mouth and alcohol consumption are related. Dr. Thomas P. Connelly, a dentist, has blogged about dry mouth and alcohol:

“There are several causes of dry mouth. Drinking alcohol, especially in any kind of quantity, will definitely give you dry mouth. Have you ever gone to bed after drinking a solid amount of booze? You woke up with severe dry mouth, didn’t you?”

The National Institute of Health (NIH), in it’s page related to Alcoholic Liver Disease cites the correlation between dry mouth and alcohol.

Dry mouth, after ingesting a significant amount of alcohol, is a result of the redistribution of fluids in the body. It is a sign that the person is dehydrated and signals the person to drink water or other fluids that will replenish the body. Consistent dry mouth related to alcohol intake is also a sign of problem drinking. We suggest the person experiencing dry mouth on a consistent basis listen to their body and consider cutting back on their alcohol intake or consider stopping altogether.

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Alcohol withdrawal can encompass many signs and symptoms. A full list of Alcohol withdrawal symptoms can be found on the EHD site. But what are the first signs of alcohol withdrawal a person may experience? This blog will focus on two symptoms; Craving for a drink and hand tremors.

Craving for a drink: This symptom can sneak up on a person. A period of daily drinking over multiple days can eventually produce alcohol dependence. When the body becomes dependent on alcohol then the brain sends messages that encourages the person to continue to drink, to satisfy the dependence.  One of these messages is: “I need a drink” or “I want a drink” or “I could use a drink”.  The thought just enters into the mind, if the person takes a drink then the thought leaves them, if the person postpones the drink, then the thought may get stronger.

An associated symptom is when a person begins to drink earlier than usual. A five o’clock cocktail hours becomes a four o’clock cocktail hour. The craving governs the earlier drink.

Tremors: Fine hand tremors. This is a classic and often troubling symptom of alcohol withdrawal and one of the first signs of alcohol withdrawal. The person dependent on alcohol notices a fine tremor in their hands. The tremor is most noticeable when holding objects such as drinking glasses or toothbrushes. Hand tremors often occur upon wakening due to the time between the last drink and time spent in bed. The dependent person may require a drink of alcohol to stop the hand tremor.

A needed drink in the morning to satisfy craving or stop a tremor is often the troubling symptom that leads to a request for help.

Craving for a drink and / or tremors can be the first signs of alcohol withdrawal. These symptoms, while troubling, can lead a person dependent on alcohol to see a health care professional and begin the process of healing the body and initiate a plan for sobriety.

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The New York Times has an article in it’s Sunday edition titled; “The benefits of church”. I got alerted to this article due to the keywords: Alcohol and mental illness. The Times article makes some interesting observations. These observations coincide with a number of my previous posts in this blog site. That is, positive human connections are the most important aspect of sustaining sobriety.

Going to church fulfills at least two necessary components to sustaining recovery:

1. The process of going to church (or a religious or spiritual event) provides structure. It fills in time. The act of getting ready, traveling to, engaging in, and returning from church fills in time. Structure is important in early recovery. 
2. As noted above, going to church can foster positive human connections. The process of greeting others, acknowledging others, offering to assist others all fosters good feelings in people.

A particular interesting finding noted in the Times article stated that those who attended a church in which the Deity or God was forgiving and loving tended to live longer and to rebound from illness quicker than those who attended a church in which the Deity or God was remote or unloving.

Positive Human Connections have a profound effect on our brain and brain chemistry. These connections help elevate the mood, decrease anxiety, and give hope. The process of going to church is one more way to develop positive human connections.

EHD provides a supervised home detox and a whole lot more. We pride ourselves on fostering positive human connections with the client, family, treaters, and significant others surrounding the client.

Do the benefits of church include sobriety?

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Is Alcohol Home Detox Safe? In the vast majority of cases, a medically supervised Alcohol Home Detox is safe. A medically supervised alcohol home detox with a 24/7 one:one on-site expert nurse increases the chances of a safe detox considerably.

An alcohol detox occurs when a person is physically dependent on alcohol. When a person “needs” an alcohol detox and goes into alcohol withdrawal it becomes a medical condition. An Alcohol detox is a medical procedure that ranges from a mild withdrawal to a severe life-threatening alcohol withdrawal.

Is Alcohol Home Detox Safe? EHD focuses on Safety and Privacy. A safe and private alcohol detox allows the client to decrease their stress and address lifestyle changes that may be needed to sustain sobriety.

EHD’s Focus on Safety: An expert nurse is on-site with the client from the beginning to the end of the alcohol detox. The nurse assesses the physical condition of the client on an ongoing basis. An inpatient setting may assess the client every 2-4 hours, an EHD nurse assesses the client continuously. The EHD nurse is expert in assessing the client by observation and by measurement tools. These tools include measuring the Blood Pressure, Pulse, Respirations, Temperature, and Oxygen level.  The measurement tools also include assessing the CIWA scale and the COWS scale. The EHD nurse manages the prescribed medication and continuously assesses the effectiveness of the medication.

EHD’s Focus on a Private Detox: EHD assigns one nurse to provide Private-Duty Nursing throughout the medical detox. One nurse assigned to the client enhances privacy as only one nurse is involved in the care of the client.

Is Alcohol Home Detox Safe? This is a legitimate question. An alcohol withdrawal and detox can result in very uncomfortable side effects, and adverse effects. Adverse effects include seizures and delirium tremens (DT’s). A one:one on-site expert nurse providing private duty care increases the likelihood that an Alcohol Home Detox is safe and effective.

For further reading: Here is an article comparing alcohol home detox to a hospital based outpatient alcohol detox. This further suggests alcohol home detox can be safe. Home Detox vs. Hospital Based OP Detox

EHD is a high-end private pay private treatment model.

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What is a Home Detox Doctor?  A Home Detox Doctor is a physician who agrees to use their expertise to assist with an alcohol, opiate, benzo, or other drug detox while the patient stays at home. The term Home Detox Doctor is very broad. The many experiences of Executive Home Detox has shown a wide range of expertise and a wide range of dedication when working with a home detox doctor.

While there is a broad array of what one can expect from a home detox doctor, there are also many many doctors who refuse to be part of or assist in a home detox and who refuse to demonstrate any interest at all in a patient’s substance use history. This is a shame as a home detox can serve as a significant risk reduction for most clients engaged in problematic alcohol and drug intake.

This writer has been involved in over 100 private in home detoxes for alcohol or drugs. A “home detox doctor” has also been involved in every one of these detoxes. EHD does not work without a qualified physician or practitioner, the doctor is a key member of the Home Detox Team. The Home Detox Doctor has varied in the following ways:

• Example One: The physician knew the patient already and phoned a prescription in to the pharmacy, the physician elected not to talk with the on-site nurse at all.
• Example Two: The physician knew the patient already, met with the patient in his or her office, and met with the nurse clinician to review the plan of care.
• Example Three: A physician met with the client in the client’s home and visited him every day until the medical detox was complete. The physician communicated with the on-site nurse daily.
• Example Four: A physician met with the client in the physician’s office, examined the patient and prescribed medication. The physician kept in touch with the nurse on a daily basis as needed and made medication adjustments according to the nurse’s observations.

These are some basic examples of a Home Detox Doctor. There are wide variations between the four examples above, however the dominant examples of a physician willing to do a home detox are examples Two and Four.

EHD is more than willing to work with the patient / client’s primary care physician. Our treatment model helps to decrease liability for the doctor willing to engage in an outpatient detox. EHD is also willing to find a physician to assist the client if he or she does not want to use a personal physician. EHD has developed working relationships throughout communities in the United States with many doctors willing to assist with a home detox.

EHD has worked with physicians in the following communities: New York; NYC, Manhattan, Brooklyn, Westchester County, Connecticut; Greenwich, Hartford., Massachusetts; Boston, Belmont , Rhode Island; Providence, Newport, Westerly, Illinois: Chicago, Highland Park, Tennessee;  Nashville, Florida;  Miami, Boca Raton, Fort Lauderdale, West Palm Beach, Tampa, and Jacksonville, Texas; Dallas, Houston, Lubbock, North Carolina; Raleigh / Durham, Nevada; Las Vegas, Henderson, Boulder City, Arizona; Phoenix, Scottsdale, Utah; Salt Lake City, Park City, California; Los Angeles, Santa Barbara, These are just a sampling of communities EHD has working relationships. We are usually able to access home detox physicians in every community a client has requested.

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A Vodka Detox is needed when a person becomes physically dependent on the Vodka. Vodka is a mixture of water and ethanol. Traditional Vodka, without impurities or flavorings, is the closest thing to pure alcohol. It is not uncommon for many people to shift their drinking from other alcoholic drinks to Vodka. It is relatively odorless, colorless, and the drinker knows what to expect from Vodka.

A Vodka detox may be needed due to physical signs and symptoms of alcohol dependence or it may be needed due to interpersonal or lifestyle difficulties that often occur when a person is drinking Vodka on a daily basis. A Vodka detox may be accomplished in a hospital setting or in an outpatient setting. A Vodka Home Detox is possible to begin the process of recovery.

Physical signs and symptoms of Vodka dependence may include:

• Nausea and Vomiting: Especially in the morning upon awakening.
• Shakes or Tremors in the hands. Shakes or tremors may be more apparent after a period of decreased drinking or a period of abstinence.
• An Elevated Pulse or Chest Palpitations: Often relieved by a drink
• Sweating: Sweats often occur during the night necessitating a change of clothes or sheets.
• Physically unsteady
• Memory problems
• Concentration problems.

A Vodka detox supervised by a medical professional over a period of 4-5 days relieves the symptoms of alcohol withdrawal. A Vodka detox properly done, will make the client feel much better and start the client on the road to recovery.

Interpersonal or Lifestyle difficulties related to daily Vodka use may be:

• Arguments or disharmony with a spouse or partner
• A tendency toward isolation from family or friends
• Neglect of important tasks or activities
• Disharmony with business associates or Neglect of business responsibilities
• Legal problems

A Vodka detox supervised by a medical professional will assist the client to begin addressing interpersonal or lifestyle difficulties. The client, within a week or two of the medical detox, will be able to assume almost all the responsibilities he or she had been neglecting.

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A private detox at home was the primary reason EHD was created. There was never a question that a small subset of alcohol and drug users wanted help but felt the hospital or a rehab was a barrier to treatment rather than a viable option for treatment. EHD can be as private as the client wants. The different levels of a private detox at home include:

• Ultra Private Detox at Home: Only the client, the prescribing physician, and the nurse clinician know about the detox. No one else is aware that a medical detox is taking place.
• Family Level Private Detox at Home: The client, the prescribing physician, the nurse clinician and family members know about the detox. Extended relatives and business associates are totally unaware that the alcohol or drug detox is taking place.
• Personal Circle Private Detox at Home: The client, the prescribing physician, the nurse clinician, family members, and some personal friends and possibly business associates know about the detox. The more people who know about the detox the less private it becomes. At the same time, the more people that know about the detox the more support the client can gain from people who are important to him or her.

EHD has assisted a number of clients with an ultra private detox at home. The client was able to safely and effectively detox from alcohol, opiates, or benzodiazepines in the privacy and comfort of their own home. There is a drawback to the ultra private detox at home. The client has few supports that are available to help with aftercare. EHD promotes privacy and we also promote positive human connections to support and sustain sobriety. We suggest a balance for these clients.

EHD can assist with a highly private detox for alcohol, opiates, or the combination.

Of Note: The Substance Abuse and Mental Health Services Administration support the concept of a Home Detox. They write in Tip 45: “Patients should be treated in those settings that least interfere with their civil rights and freedom to participate in society.” For this select subset of clients, treatment in the home may be essential to the beginning of their recovery.

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