Procedure in PC Evromedika:
-> Reception of a patient
First personal contact, an interview, making an anamnesis
-> Preparation for detoxification
A. Bodily preparation
a. – laboratory examinations: blood test; HVB, HVC and HIV tests; hepatitis test;
b. – abdominal ultrasound examination; lungs X-ray; ECG;
c. – internist examination;
d. – additional examinations if necessary.
B. Psychological preparation
Types of experts treatment: During this period (7-14 days), the client undergoes a psychiatric and psychological individual treatment on daily basis, and if a member of the family is present, a family therapy is applied. The aim of this treatment is to provide support with psychiatric and psychological preparation for detoxification and drug-free life.
Premedication: After the reception, the patient is stabilized with a methadone or buprenorphine treatment until he/ she stabilizes (7-14 days). Premedication with other non-opiate drugs: antidepressants, tranquilizers, alfa agonists, ant emetics, anticholinergics and other symptomatic therapy.
Definition
Ultra Rapid Detoxification under deep sedation means to abstain from taking opiate (heroin, methadone etc.) in the period of one day. This is taken as a human and painless method of overcoming the temptation. It is used to alleviate and to shorten the period of withdrawal crisis.
Inciting abstinence crisis, under controlled conditions and permanent medical supervision, as well as its overcoming in a couple of hours, which is a human method of helping to persons who are addicts.
This is a part of a wide-range programme for treating addiction, and should not be taken as means for treating the addiction itself.
Indication
Ultra Rapid Detoxification (URD) is above all applicable to people who have strong abstinence crisis, and/ or those who do not want to consider that he/ she should abstain from taking drugs, which is often the only obstruction to start the treatment, and therefore they cannot be defoliated by using one of the classical ways.
Those who want to be defoliated by using the ultra rapid detoxification should be previously, physically and psychologically examined, so as to specify indications for URD and the further psychiatric treatment. Also they take active participation in the preparation of the programme for getting well, which is carried out for each individual separately, and we begin with it before detoxification.
The choice of the therapy depends on the individual characteristics and abilities.
-> After detoxification
Detoxification is the most significant preliminary in the long – term psychiatric treatment, concerning the opiate addiction. In other words, it is a step of seven miles that the individual must take in order to start with the treatment of the psychological addiction and prevention from repeated relapses in the period of 3 to 5 years, the period in which the drug addiction is taken as outdone.
• When detoxification is carried out and the abstinence crisis is outdone, professional support is inevitable in overcoming psychological problems as well as individual remobilization. Due to that, prolonged psychiatric and psychotherapeutic, individual, family and group treatment is realized.
It is a long-term process, lasting from three months to year and a half.
It is statistically supported that in the first month after the detoxification 50 % of the individuals relapse into taking drugs, after the third month 25% of them have a relapse, and after the sixth month of abstinence 12% of them have their repeated relapse.
• The use of opiate antagonist NALTREXONE
The Naltrexone is suitable for any addict to opiates (heroin, methadon, tramadol, etc.) who makes his/ her best to abstain from taking opiates, but never succeeds till the end. It is also suitable for people who think that they are not strong enough by themselves or together with psychiatric counseling to sustain their decision in not taking opiate drugs.
The Naltrexone is not a remedy which can affect either the mood or the process of thinking, therefore it should be used together with the psychiatric treatment and counseling.
The Naltrexone is used for the first time after a certain period of abstinence, depending on the method of detoxification that was previously carried out. If the Naltrexone is used in this way, there are just few undesirable effects, and none of them is serious.
But in case the individual is an addict to heroin or other anesthetics and takes Naltrexone, this will result in serious abstinence symptoms in couple of minutes.
-> Period of intensive psychiatric, medical and psychological treatment from 3 to 30 days
The treatment lasts from one week to six months.
• Treatment from seven to 30 days: Premedication, ultra rapid detoxification, recovery of at least 72 hours and continuation of the treatment in Your country in an institution with which a contact has been previously established. In this context are held one to two meetings a day. According to previously agreed plan meetings are held with psychiatrist, social worker or psychiatric nurse.
• Treatment from one month to six months which includes extended treatment to overcome psychological, social and medical problems.
English will be official language for communication, while there will be possibility for people with Slavic origin to communicate in their mother tongue (Serbian, Croatian, Bulgarian, Bosnian or Macedonian).
Routine checks for presence of opiates in the client’s body will be performed at the reception, as well as during the treatment with classical detoxification, in order to follow the cleansing of the body from the opiates, after which an opiate antagonist will be implanted or applied “per os”. The application of the opiate antagonist for people on URD is not prevented (counter indicated) by the presence of opiates in the body.
-> Subcutaneous implantation of opiate antagonist
An opiate antagonist – Naltrexone pellet – which lasts for three months and six months is implanted during the URD or immediately after it.
There is also a possibility for multiple implantation of an opiate antagonist, each of which would last for three months.
