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LVRC's pain recovery program consists of two distinct phases. The first phase, lasting anywhere from three to ten days, consists of medically managed detoxification from any habit-forming medications. Our dedicated professional team evaluates each patient and creates an individualized treatment plan. No two patients are alike, and treatment is tailored to each patient's specific needs. LVRC is one of the few residential facilities nationwide licensed to dispense methadone as part of detox treatment. We are experienced in detoxification from high doses of methadone, which we have found responds best to rapidly weaning off methadone. We also have the ability to prescribe buprenorphine (Subutex) to ease the symptoms of withdrawal. Opioids are used only through the detoxification phase. Each patient who enters our recovery program will be free of all opioids and other mood-altering/habit-forming drugs, including sedatives, hypnotics, stimulants, and alcohol.

What to expect during detox

Symptoms of withdrawal from opioid pain relievers include increased pain, anxiety, sleep disturbance, agitation, muscle cramps, diarrhea, nausea, and vomiting. Because of the physical dependence induced by opioids and other substances, other drugs are often used to facilitate withdrawal safely, but the key to successful detoxification for any individual is personalized assessment. This is accomplished by a multidisciplinary clinical treatment team and closely monitored by our expert medical and nursing staff under the supervision of our Medical Director, Mel Pohl, MD, FASAM.
Medical treatment begins with a thorough evaluation by our medical staff. Blood will be drawn and analyzed for drug-induced medical complications, such as liver problems, blood count abnormalities, and other potential health issues. Individuals who are experiencing withdrawal need rest, nutrition, and especially fluid replacement.

Medications are used to manage withdrawal in order to minimize symptoms and physical suffering while keeping the client safe. Typically, treatment involves administering enough medication to decrease the symptoms of withdrawal and gradually decreasing the dosages of these medications over the next three to ten days. Some drug withdrawal may last longer if the drugs are those that stay in the system longer, such as Oxycontin or methadone.

Decisions and protocols for detoxification are made by the medical staff and will be adjusted daily or more frequently depending on the symptoms experienced by the client. Since clients react differently to the process, dose adjustments are individualized based on each client's experience. LVRC provides this level of care in a safe, confidential, clinical environment with around-the-clock supervision by nursing and medical staff. We can accommodate the most complex and difficult cases, including dependence on all types of opioids (narcotic painkillers), sedatives (sleeping pills), anti-anxiety drugs (nerve pills), stimulants (cocaine and methamphetamine), alcohol, and marijuana. Our program offers individualized detoxification protocols that can include a variety of medications, including the short-term use of methadone or buprenorphine (Subutex) for opioid detoxification when indicated. Clients are emotionally supported and their physical symptoms are minimized whenever possible with support of medications, counseling, and continuous nursing care.

Based on the individual needs of each client, the following services are included during this phase of the program:

Medical Services (see table below for frequency)

• Addiction assessment (including history and physical exam)
• Intake lab/blood work, urinalysis
• Urine toxicology
• TB assessment and screening, chest X-ray if indicated
• EKG if indicated
• Nutritional assessment by registered dietitian if indicated
• Twenty-four hour nursing care to include scheduled Clinical Opiate Withdrawal Scale (COWS), Clinical Institute Withdrawal Assessment (CIWA), and pain assessments
• Medications for detoxification included (other non-formulary prescriptions are not included, please request a complete copy of our formulary)
• Twenty-four hours a day medically supervised treatment
• Daily visits with medical staff

Clinical Services (see table below for frequency)

• Initial admission assessments
• Bio-Psych-Social assessments
• Assessment using American Society of Addiction Medicine (ASAM) Patient Placement Criteria, IIR
• Addiction Severity Index (ASI)
• Educational videos and group sessions
• Counselor assessment based on family (collateral information) and patient interviews

At the conclusion of the detox phase, and once the client is medically stable, our multidisciplinary team will make recommendations regarding the necessity for further treatment in preparation for the pain recovery treatment program.

Prescription pain medications commonly seen in our Medically Managed Withdrawal & Detoxification Program.