Benzodiazepines reduce anxiety. However, when someone has been using them for an extended period, they often find that they need a higher and higher dose to achieve the same effect.
This is because prolonged use makes the special receptors in the brain which detect benzodiazepines less sensitive. As use increases, the severity of associated withdrawal symptoms increases in tandem. For individuals who wish to stop taking benzodiazepines, we have found that it is possible to comfortably overcome those symptoms with an infusion of flumazenil.
Flumazenil can be thought of as a benzodiazepine blocker. It moves the benzodiazepine molecules off the benzo receptors in the brain.
By using a low dose flumazenil protocol developed by Dr. O'Neil, the benzodiazepine receptors in the brain are thought to ‘reset’, and there is a reduced urge to take benzodiazepines. Research has demonstrated that flumazenil also helps reduce anxiety and physical symptoms associated with withdrawal.
The dose of flumazenil is very low and is administered through a very fine needle placed just under the skin in the abdominal area. The flumazenil is mixed with a small amount of saline and placed into a portable infusion device, an inhouse product, invented and developed by D. O'Neil. The device delivers the flumazenil in a continuous flow. The amount that is given is set at the time of infusion and is monitored twice daily.
The procedure typically takes 4 days, but can be extended in severe cases.
The dose of flumazenil offered is not high enough to prevent benzodiazepine overdose, either during or after treatment. You must not think of this treatment as protection from overdose. It is a method which eases or eliminates withdrawal symptoms for people stopping benzodiazepine use.
Short Acting Opiates and Buprenorphine
Since the invention of the O’Neil Long Acting Naltrexone Implant, implant naltrexone has become our preferred treatment for opiates.
If a patient has been using opiates in the days leading up to treatment, naltrexone can facilitate an accelerated detoxification. Withdrawal symptoms will be of significantly shorter duration, which means our medical staff can monitor the process and medication can be administered to reduce the symptoms.
Detoxification can still cause significant discomfort, therefore we strongly advise that patients reduce their opiate use leading up to treatment.
Alternatively patients can discuss a kinder detox option using ibogaine, with one of our counselors, should they prefer.
All patients who undergo detoxification of any type need to be very careful if they choose to start using opiates again.
Detox from methadone can be more difficult than from other opiates. We recommend that methadone users go through a two week process of changing to buprenorphine before having a naltrexone implant.
Dr O Neil has used this method for about 10 years, even for users who have found it too difficult to come off high dose methadone (about 100m/day). Users are encouraged to skip their methadone dose the day before swopping, and again on the day they arrive for treatment. We prescribe a course of buprenorphine treatment that lasts up to 14 days. Medications to control detox symptoms may also be prescribed. Two weeks after the first detox a naltrexone implant is inserted.
Again patients can discuss kinder detox options that are avaiilable with one of our counselors should they prefer.