Frequently Asked Questions

A new terminology instead of using addiction or addict to describe someone who is addicted to opioids use disorder, alcohol use disorder. According to American Psychiatric Association, Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequences. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions. Symptoms of substance use disorder are grouped into four categories: Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use Risky use: substance is used in risky settings; continued use despite known problemsDrug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance)To read more: https://www.psychiatry.org/patients-families/addiction/what-is-addiction

A new terminology instead of using addiction or addict to describe someone who is addicted to opioids use disorder, alcohol use disorder. According to the American Psychiatric Association, Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequences. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.

Symptoms of substance use disorder are grouped into four categories:

• Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
• Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use
• Risky use: substance is used in risky settings; continued use despite known problems
• Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance)

To read more: https://www.psychiatry.org/patients-families/addiction/what-is-addiction

Substance use disorder occurs when a person’s use of alcohol or another substance (drug) leads to health issues or problems at work, school, etc.

According to the Mayo Clinic, Diagnosing drug addiction (substance use disorder) requires a thorough evaluation and often includes an assessment by a psychiatrist, a psychologist, or a licensed alcohol and drug counselor. Blood, urine or other lab tests are used to assess drug use, but they're not a diagnostic test for addiction. However, these tests may be used for monitoring treatment and recovery.

Please visit Mayo Clinic for more information.

Increasing amount you drink, shaky when waking up, have the urge to drink upon waking up to feel better from the withdrawals, can’t stop drinking once you have, increase the amount needed to feel intoxicated, if you don’t have a drink you can get tremors, shakes, sweat, stomach pains. 

Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include:

• Being unable to limit the amount of alcohol you drinkWanting to cut down on how much you drink or making unsuccessful attempts to do so
• Spending a lot of time drinking, getting alcohol or recovering from alcohol use
• Feeling a strong craving or urge to drink alcohol
• Failing to fulfill major obligations at work, school or home due to repeated alcohol use
• Continuing to drink alcohol even though you know it's causing physical, social or interpersonal problems
• Giving up or reducing social and work activities and hobbies
• Using alcohol in situations where it's not safe, such as when driving or swimming
• Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
• Experiencing withdrawal symptoms — such as nausea, sweating and shaking — when you don't drink, or drinking to avoid these symptoms

Vomiting, passing out, sweats and dehydration.

According to the National Institute on Alcohol Abuse and Alcoholism, the signs are alcohol poisoning:

Critical Signs and Symptoms of an Alcohol Overdose

• Mental confusion, stupor
• Difficulty remaining conscious, or inability to wake up
• Vomiting
• Seizures
• Slow breathing (fewer than 8 breaths per minute)Irregular breathing (10 seconds or more between breaths)
• Slow heart rate
• Clammy skin
• Dulled responses, such as no gag reflex (which prevents choking)
• Extremely low body temperature, bluish skin color, or paleness

Sweats, tremors, irritable, can lead to DTs delirium tremors: a condition typical of withdrawal in chronic alcoholics, involving tremors, hallucinations, anxiety, and disorientation., shaky, depression, anxiety, dehydration, lack of appetite.

According to WebMD, Mild symptoms usually show up as early as 6 hours after you put down your glass. They can include:

• Anxiety
• Shaky hands
• Headache
• Nausea
• Vomiting
• Insomnia
• Sweating

More serious problems range from hallucinations about 12 to 24 hours after that last drink to seizures within the first 2 days after you stop. You can see, feel, or hear things that aren't there. Learn more about the timeline of alcohol withdrawal symptoms. That isn’t the same as delirium tremens, or DTs as you’re likely to hear them called. DTs usually start 48 to 72 hours after you put down the glass. These are severe symptoms that include vivid hallucinations and delusions. Only about 5% of people with alcohol withdrawal have them. Those that do may also have:

• Confusion
• Racing heart
• High blood pressure
• Fever
• Heavy sweating

According to the Healthline article, “What Are the Warning Signs of Alcohol-Related Liver Damage?” 

Feeling sick, suffering from weight loss and loss of appetite, yellowing of the eye and skin, swelling of the ankles and belly, etc.

One of your liver’s jobs is to break down potentially toxic substances. This includes alcohol. When you drink, different enzymes in your liver work to break down alcohol so that it can be removed from your body.

When you drink more than your liver can effectively process, alcohol and its byproducts can damage your liver. This initially takes the form of increased fat in your liver, but over time it can lead to inflammation and the accumulation of scar tissue.

The early stages of alcohol-related liver disease often have no symptoms. Because of this, you may not even know that you’ve experienced liver damage due to alcohol.

If symptoms are present, they may include:

• swelling of your liver, which may lead to discomfort in the upper right side of your abdomen
• fatigue
• unexplained weight loss
• loss of appetite
• nausea and vomiting

According to the American Addiction Center and According to the National Institute on Alcohol Abuse and Alcoholism, in 2012, an estimated 7.2 percent of American adults aged 18 and older, approximately 17 million people, had a diagnosable alcohol use disorder. Men have alcohol use disorder almost twice as often as women; of the estimated 17 million affected adults, 11.2 million were men and 5.7 million were women. Adolescents are not immune. In 2012, an estimated 855,000 young people between 12-17 years of age had this disorder.

Signs and questions to ask: 

• Is your tolerance getting higher?
• Are you drinking more than average?
• Do your hands shake when you wake up?
• Do your friends and family tell you there’s a problem with your drinking behavior and patterns?
• Have your friends and family approached you about an intervention
• Are you dehydrated?
• Are you dependent upon alcohol as a source of happiness?
• Are you using the alcohol to treat an underlying condition?

No, drinking alcohol does not kill viruses in your system. It in fact, weakens your immune system. For more information, click on this WebMD article and the CDC for more information on guidelines.

Yes, alcoholism is a chronic disease such as diabetes or high blood pressure. If you or a loved one suffers from alcohol use disorder, please call us for help. 

According to Hazelden Betty Ford Foundation, Alcohol addiction is a complex disease with psychological, biological and social components, and like other chronic illnesses, addiction often involves cycles of relapse and remission. Some people can drink alcohol—and even over-indulge on occasion—without it becoming an issue. For others, drinking can turn into mild, moderate or severe "alcohol use disorder," the term doctors and clinicians now use instead of alcoholism, alcoholic or alcohol abuse.

We are not a clinic, we are a private practice. We will detox people off of alcohol, oxys, heroin, in the comfort of your home. We don't' encourage rehab, we encourage a home-detox where the patient is comfortable in their own setting. 

Yes heroin is an opioid. From the National Institute on Drug Abuse, opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.  Learn about the health effects of prescription opioids and read the DrugFacts on Fentanyl, Heroin, and Prescription Opioids. Common Names Happy Pills, OC, Oxy, Oxycotton, Percs, Vikes

No, Xanax is a benzodiazepine.  According to the drugabuse.org, every day, more than 136 Americans die after overdosing on opioids.1 However, between 1996 and 2013, the number of adults who filled a benzodiazepine prescription increased by 67%, from 8.1 million to 13.5 million.2 The quantity obtained also increased from 1.1 kg to 3.6 kg lorazepam-equivalents per 100,000 adults. Combining opioids and benzodiazepines can be unsafe because both types of drug sedate users and suppress breathing—the cause of overdose fatality—in addition to impairing cognitive functions. Unfortunately, many people are prescribed both drugs simultaneously. In a study of over 300,000 continuously insured patients receiving opioid prescriptions between 2001 and 2013, the percentage of persons also prescribed benzodiazepines rose to 17 percent in 2013 from nine percent in 2001.4 The study showed that people concurrently using both drugs are at higher risk of visiting the emergency department or being admitted to a hospital for a drug-related emergency.

When you take prescribed medication such as: oxycodone, percocets beyond what is prescribed and to a point where if you stop you start withdrawals. According to Hopkins Medicine Opioids are a class of drug that includes both prescription pain medicines and illegal drugs such as heroin. Though opioids can be prescribed by a doctor to treat pain, their misuse may lead to a dependency or addiction (what is known in medicine as an “opioid use disorder”). Anyone prescribed an opioid should follow their doctor’s orders carefully, making sure to only take the medication as prescribed.

Opioid use disorder is a medical condition defined by not being able to abstain from using opioids, and behaviors centered around opioid use that interfere with daily life. Being physically dependent on an opioid can occur when someone has an opioid use disorder, and is characterized by withdrawal symptoms such as cravings and sweating. However, people can misuse opioids and not have physical dependence. When a person has physical dependence, it can be particularly hard to stop taking opioids, and that dependence can interfere with daily routines, including personal relationships or finances.

Opioid use disorder may be diagnosed by a doctor. Someone struggling with opioid use disorder may not display symptoms right away. However, over time, there may be some signs that they need help.

Common Signs of Opioid Addiction

• The inability to control opioid use
• Uncontrollable cravings
• Drowsiness
• Changes in sleep habits
• Weight loss
• Frequent flu-like symptoms
• Decreased libido
• Lack of hygiene
• Changes in exercise habits
• Isolation from family or friends
• Stealing from family, friends or businesses
• New financial difficulties

According to Drugabuse.org, effective medications are available medications, including buprenorphine (Suboxone®, Subutex®), methadone, and extended release naltrexone (Vivitrol®), are effective for the treatment of opioid use disorders.

• Buprenorphine and methadone are “essential medicines” according to the World Health Organization.
• A NIDA study shows that once treatment is initiated, a buprenorphine/naloxone combination and an extended release naltrexone formulation are similarly effective in treating opioid use disorder. However, because naltrexone requires full detoxification, initiating treatment among active users was more difficult with this medication. Once detoxification was complete, both medications had a similar effectiveness.
• Medications should be combined with behavioral counseling for a “whole patient” approach, known as Medication Assisted Treatment (MAT).

MAT Decreases opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission. After buprenorphine became available in Baltimore, heroin overdose deaths decreased by 37 percent during the study period, which ended in 2009.

MAT Increases social functioning and retention in treatment. Patients treated with medication were more likely to remain in therapy compared to patients receiving treatment that did not include medication.

Treatment of opioid-dependent pregnant women with methadone or buprenorphine Improves Outcomes for their babies; MAT reduces symptoms of neonatal abstinence syndrome and length of hospital stay.

We at Mitchell Medical offer two successful treatments options for opioid addiction. Suboxone and Vivitrol.

SUBOXONE® (buprenorphine and naloxone) Sublingual Film (CIII) is a prescription medicine used to treat adults who are addicted to (dependent on) opioid drugs (either prescription or illegal) as part of a complete treatment program that also includes counseling and behavioral therapy. Suboxone is one of the treatments we use. The patient has to be in the beginning stages of withdrawal before starting. Suboxone is a partial agonist opioid that is used to treat opioid addiction. 

Vivitrol Shot: a 3-4 week injection that is used for people with opioid use disorder and alcohol use disorder. 

For Opioid Use Disorder: VIVITROL is an antagonist that blocks opioid molecules from attaching to opioid receptors/ blocks the mu receptors and blocks the effects of opioids, such as heroin or opioid pain medication so that the patient cannot get high with the vivitrol shot in their system. 

Vivitrol for Alcohol Use Disorder is a once a month treatment that helps reduce heavy drinking days in alcohol dependent patients.  From the vivitrol website:

THINGS TO KNOW ABOUT VIVITROL1:

Opioid blocker

• Must be administered by a healthcare provider
• Once-monthly injection
• Used with counseling
• Non-addictive and not a narcotic
• Requires opioid detox of 7–14 days prior to start of treatment

100%. Suboxone does not get you high, it keeps the urges away and allows you to function in society. Allowing you to function normally at work, home or any social function. 

The American Addiction Centers site says:

Buprenorphine, a main ingredient in Suboxone, was approved for clinical use by the FDA in 2002. According to SAMHSA, this medication differs from methadone treatment in that it can be prescribed in physicians’ offices, while methadone is only available through specially designated facilities. This allows a greater number of people to receive addiction treatment aided by medication.

A study published by the Taylor and Francis Group found that Suboxone could be safely administered in unsupervised settings, was well tolerated by most people, and was effective in promoting abstinence from opiate drug use. The application of Suboxone in nonresidential treatment settings makes this medication highly beneficial, because it is one of few addiction recovery medications that can be safely self-administered. The Journal of Community Hospital Internal Medicine Perspectives reports similar findings; participants of the study who remained in treatment long-term saw benefits to their overall health and wellbeing, and abstinence from illicit drug use, while being treated with Suboxone. A study published in BioMed Central found that Suboxone was an effective medication in the reduction of buprenorphine abuse. While Suboxone lessened withdrawal symptoms, participants in the study reported they did not experience the same “high” while using Suboxone as they would abusing illicit opiate drugs. This lack of a “high” discouraged misuse and overdose of Suboxone, making it a safe and effective method of recovery from addiction. The Journal of Addiction Medicine reports that in a study exploring the effectiveness of Suboxone treatment, compliance with treatment was excellent. A majority of participants in the study were successful in abstaining from opiate use during treatment with Suboxone. No safety issues or misuse of Suboxone was detected during the study.

Medically assisted treatment is any medication used to treat a substance use disorder such as: using  suboxone, methadone for opioid use disorder. According to SAMHA, Substance Abuse and Mental Health Services Administration, Medically Assisted Treatment (MAT)  Medication-assisted treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Medications used in MAT are approved by the Food and Drug Administration (FDA) and MAT programs are clinically driven and tailored to meet each patient’s needs.

Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery. MAT is also used to prevent or reduce opioid overdose.

Learn about many of the substance use disorders that MAT is designed to address.

MAT is primarily used for the treatment of addiction to opioids such as heroin and prescription pain relievers that contain opiates. The prescribed medication operates to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative and euphoric effects of the substance used.

Sinclair’s method is a scientific approach that uses a medication called naltrexone to reduce and monitor alcohol consumption within normal limits. 

According to an article posted by The Mayo Clinic, drinking alcohol in moderation generally is not a cause for concern. According to the National Institute on Alcohol Abuse and Alcoholism, drinking is considered to be in the moderate or low-risk range for women at no more than three drinks in any one day and no more than seven drinks per week. For men, it is no more than four drinks a day and no more than 14 drinks per week.

Those guidelines are based on standard-size drinks, which contain about 14 grams of pure alcohol. That equals 5 ounces of wine, 12 ounces of beer, 8 to 9 ounces of malt liquor and 1.5 ounces (one shot) of 80-proof spirits or “hard” liquor.

Please click to make an appointment to learn more about the effects of the Sinclair Method.

Intramuscular extended release Naltrexone is a medication approved by the Food and Drug Administration (FDA) to treat both opioid use disorder (OUD) and alcohol use disorder (AUD) as a medication-assisted treatment (MAT) option. Naltrexone can be prescribed and administered by any practitioner licensed to prescribe medications, and is available in a pill form for Alcohol Use disorder or as an extended-release intramuscular injectable for either Alcohol and Opioid Use disorder. A Risk Evaluation and Mitigation Strategy (REMS) is required for the long acting injectable formulation to ensure that the benefits of the drug outweigh its risks. The pill form can be taken daily for AUD, but the extended-release injectable formulation is approved for the treatment of OUD. The pill form is taken daily and the extended-release injectable is administered every four weeks, or once a month, by a practitioner.

Naltrexone is one component of a comprehensive treatment plan, which includes counseling and other behavioral health therapies to provide patients with a whole-person approach. Naltrexone is not a recommended MAT option for anyone younger than 18 years of age, or for patients experiencing other health conditions.

How Naltrexone Works

Naltrexone is not an opioid, is not addictive, and does not cause withdrawal symptoms with stop of use. Naltrexone blocks the euphoric and sedative effects of opioids such as heroin, morphine, and codeine. Naltrexone binds and blocks opioid receptors, and reduces and suppresses opioid cravings. There is no abuse and diversion potential with naltrexone.

Naltrexone for Opioid Use Disorder

To reduce the risk of withdrawal symptoms, patients should wait at least 7 days after their last use of short-acting opioids and 10 to 14 days for long-acting opioids, before starting naltrexone. Patients taking naltrexone should not use any other opioids or illicit drugs; drink alcohol; or take sedatives, tranquilizers, or other drugs. Patients should notify their practitioner about all medications they are currently taking as well as any changes in medications while being treated with naltrexone. While the oral formulation will also block opioid receptors, only the long acting injectable formulation is FDA approved as MAT and requires REMS. Patients on naltrexone, who discontinue use or relapse after a period of abstinence, may have a reduced tolerance to opioids. Therefore, taking the same, or even lower doses of opioids used in the past can cause life-threatening consequences.

Learn more about OUD.

Naltrexone for Alcohol Use Disorder

When starting naltrexone for AUD, patients must not be physically dependent on alcohol or other substances. To avoid strong side effects such as nausea and vomiting, practitioners typically wait until after the alcohol detox process before administering naltrexone.Naltrexone binds to the endorphin receptors in the body, and blocks the effects and feelings of alcohol. Naltrexone reduces alcohol cravings and the amount of alcohol consumed. Once a patient stops drinking, taking naltrexone helps patients maintain their sobriety. Naltrexone MAT treatment lasts for three to four months. Practitioners should continue to monitor patients who are no longer taking naltrexone.

Learn more about AUD.

You can get drunk but it stops the reward mechanism so the patient does not get the urge to continue to drink

From information provided by SAMHSA, Naltrexone binds to the endorphin receptors in the body, and blocks the effects and feelings of alcohol. Naltrexone reduces alcohol cravings and the amount of alcohol consumed. Once a patient stops drinking, taking naltrexone helps patients maintain their sobriety. Naltrexone MAT treatment lasts for three to four months. Practitioners should continue to monitor patients who are no longer taking naltrexone.

Information from drugs.com: 

While naltrexone may block the feelings of intoxication (the “buzz”) from alcohol, it does not block the impairment you might have, such as reduced coordination or reflexes, or poor judgement.

• Even though you may not feel drunk, this can make driving or other activities dangerous. You may still suffer a loss of motor coordination, decreased response time, and slowed rates of thinking.
• Do not use naltrexone so that you can drive or perform other activities under the influence of alcohol

No, but you will get sick. According to the American Addiction Center.

According to the National Council on Alcoholism and Drug Dependence, general withdrawal symptoms may include:

• Shakiness
• Digestive upset or loss of appetite
• Headaches
• Sweating
• Anxiety
• Insomnia
• Fatigue
• Depression and irritability

These symptoms can vary in intensity based on the level and length of the addiction. You can die from heroin overdose. Information provided from the CDC, In 2018, nearly 15,000 people died from a drug overdose involving heroin in the United States, a rate of almost 5 deaths for every 100,000 Americans. However, also in 2018, heroin-involved overdose death rates showed a decline, decreasing 4.1% from 2017 to 2018. More than 115,000 Americans died from overdoses related to heroin from 1999-2018. 

Once a patient gets over the withdrawals of heroin, in our practice, they live safer lives. t sick. 

Yes, if you stop suddenly from alcohol withdrawals you can get a seizure and die. From a Harvard Health Publishing via Harvard Medical School, Alcohol withdrawal is the changes the body goes through when a person suddenly stops drinking after prolonged and heavy alcohol use. Symptoms include trembling (shakes), insomnia, anxiety, and other physical and mental symptoms. Alcohol has a slowing effect (also called a sedating effect or depressant effect) on the brain. In a heavy, long-term drinker, the brain is almost continually exposed to the depressant effect of alcohol. Over time, the brain adjusts its own chemistry to compensate for the effect of the alcohol. It does this by producing naturally stimulating chemicals (such as serotonin or norepinephrine, which is a relative of adrenaline) in larger quantities than normal. Via an article by healthline, these are the symptoms of alcohol use disorder to look out for:

Initial symptoms

Initial symptoms can happen as early as several hours after your last drink. They can include things like:

• tremors
• trouble sleeping (insomnia)
• nausea or vomiting
• feeling on edge or restless
• anxiety
• headache
• sweating

In people with milder levels of alcohol dependence, these may be the only symptoms they experience.

Typically, initial symptoms get worse after they first appear. They usually reduce over the next day or two.

More serious symptoms

People with more severe levels of alcohol dependence may experience more serious symptoms.

Hallucinations

Hallucinations can be:

• visual
• auditory
• tactile (touch)

They often appear within 24 hours of having your last drink.

Withdrawal seizures

These seizures are generalized in nature. Like hallucinations, they often appear within 24 hours after your last drink.

Status epilepticus

Of those who develop seizures, about 3 percent may have a more serious type of seizure called status epilepticus. This is medical emergency that can lead to disability or death.

Delirium tremens

Delirium tremens is the most serious symptom of alcohol withdrawal and can lead to death. It often occurs two to three days after your last drink. Symptoms can include:

• feeling disoriented or confused
• having hallucinations
• rapid heart rate
• increased breathing rate
• high blood pressure (hypertension)
• low-grade fever
• profuse sweating
• feeling agitated
• stupor
• loss of consciousness

Alcohol and benzos.

According to American Addiction Centers, alcohol should not be stopped cold turkey.

Hazards of Alcohol Withdrawal

About half of all people who are dependent on alcohol will suffer from withdrawal symptoms when they stop drinking. The New England Journal of Medicine (NEJM) warns that 3-5 percent of individuals will struggle with grand mal convulsions, delirium (significant confusion), or both. This severe form of alcohol withdrawal is called delirium tremens, or DTs. In addition to confusion, agitation, hallucinations, and tremors, individuals may also experience dangerously high fevers. Grand mal seizures, hyperthermia, cardiac arrhythmias, and complications related to co-occurring medical or mental health disorders can make DTs fatal if swift medical care and attention aren’t provided.

Alcohol withdrawal symptoms typically begin within about eight hours after the last drink and peak in about 2-3 days, the National Library of Medicine (NLM) publishes.

In the case of DTs, symptoms may not appear for up to three days after stopping drinking, making them even more potentially dangerous since people may believe they are in the clear and not have medical care accessible.

The extent and severity of the side effects from alcohol withdrawal are related to how significantly dependent a person is on it. In general, this means that someone who drinks heavily on a regular basis for a long time will suffer the most. Also, mixing other drugs, particularly central nervous system depressants like benzodiazepines (e.g., sleep aids, anti-anxiety medications), with alcohol can increase levels of dependence and further complicate withdrawal. The presence of any underlying or co-occurring mental health or medical issue can increase the hazards and intensity of withdrawal as well.

Again, according to the American Addiction Centers, The dangers of Quitting Xanax Cold Turkey, Individuals can really shock their systems if they try to stop taking Xanax altogether without weaning off it. When a person is abusing this drug, the body becomes accustomed to the effects it causes, and without the drug, the body doesn’t know how to respond. As a result, it goes into overdrive trying to compensate for the loss of GABA activity, and it tries to reset the brain’s normal neurotransmitter production levels. When people are addicted, they cannot escape Xanax without enduring withdrawal. The Washington Post reports 10-20 percent of individuals who use benzodiazepines like Xanax for prolonged periods of time will end up tolerant to the drug’s effects and dependent on them. Withdrawal can begin to set in as soon as five hours after the last dose of Xanax, possibly even sooner for those who are accustomed to using it more frequently.

Just as abusing Xanax can bring serious side effects, stopping that abuse suddenly can bring a stream of side effects that are hard for the body and mind to handle. Convulsions, seizures, psychosis, paranoia, mood swings, and mania can occur due to withdrawal. These symptoms appear quickly and can be quite hard to handle. Just when they start to wane and individuals feel some relief, they often return and will continue to ebb and flow for some time.

Xanax withdrawal is even more dangerous if individuals are home alone when these events occur. In fact, benzodiazepine withdrawal has been linked to death in some cases. In one case, a female who had used 200 mg of Xanax over the course of six days and then abruptly stopped using it died four days later; it was determined her death was the result of withdrawal from benzos, as reported by the American Journal of Forensic Medicine and Pathology.

A 3-4 week injection that is used for people with opioid use disorder and alcohol use disorder. It blocks the mu receptors. The patient cannot get high with the vivitrol shot in their system. Vivitrol is effectively used for both alcohol dependency and opioid dependency According to the Vivitrol website: 

VIVITROL® (naltrexone for extended-release injectable suspension) is a once-monthly treatment proven to help reduce heavy drinking days in alcohol-dependent patients when used with counseling.

VIVITROL and counseling help reinforce recovery for one month at a time while you work on the psychological aspects of addiction through counseling.

Before starting VIVITROL, you must be opioid-free for a minimum of 7–14 days to avoid sudden opioid withdrawal.

Patients should not be actively drinking at the time of initial VIVITROL administration.