Joe can talk freely and objectively about his addiction to heroin.

The tough native of the Bronx can talk about his addition, its symptoms and the treatments he's been through. But the subject of his family and personal life is clearly the weak brick in the dam that holds back his emotions.  At the mere mention of his family, this 30-year-old -- the youngest of three children in a Puerto Rican American household -- is overcome with emotion. He covers his face and is unable to speak. His shoulders slump and tears flow, showing just how much his addiction has beaten him down.

"Your family suffers," Joe said, struggling unsuccessfully to hold back his grief. "The one you love -- your wife, your girlfriend -- suffers a lot. You keep saying to yourself you don't want to put them through it. "I really don't like to make the people in my life suffer." The drug changed his personality -- made him loud, violent and aggressive.

"You don't come home," he said. "You know the pain that it does, but you keep doing it." Despite all the compelling reasons Joe had to change, it wasn't enough to fight the addiction that had become a physical disease.

Joe -- who asked that his last name be withheld -- is one of the first dozen patients being treated at The Institute in College Hospital. The Institute, founded by Dr. Andre Waismann of Israel, helps opiate addicts kick their habits through a revolutionary treatment. Waismann has treated 7,000 patients worldwide with neuro-regulation -- a procedure that helps addicts overcome their physical and psychological addiction in as little as 24 hours. College Hospital is home to his first treatment center in the U.S.

Waismann said his treatment reverses the addiction and also eliminates withdrawal, one of the biggest obstacles to recovery. He describes the treatment as a "simple procedure" in which doctors using neuro-regulation treat the addiction as a physical illness.

"We have an extensive intake to explain to the patient what opiate addiction is," Waismann said. "What happened to this patient could have happened to anyone else. You explain to the patient he's not to be blamed. He was never properly treated." As a doctor in Israel in the early 1990s, Waismann held a heroin-addicted newborn in his arms and was told to give it a methadone injection.

Waismann, a surgeon and trauma specialist who had devoted his life to healing, was amazed, although the procedure was considered a routine treatment.

"I thought, 'Why should I poison the brain of this newborn?'" Waismann said. "'Why can't we reverse this condition?'" In 1992 during the Lebanese War, Waismann found himself treating soldiers in Israel who became addicted to morphine while being treated for war wounds. After leaving the hospital, the soldiers often found themselves looking for the drug on the street, leading to years of struggle with the addiction, Waismann said.

Waismann became determined to find a humane way to treat what is considered in the medical community a "chronic illness." "Opiate dependency is not a chronic illness," Waismann insists. "It became chronic because we, the scientific community, could not reverse the condition."

THE ADDICTION

Joe began using heroin at 18, while he was a freshman in college. At first, he used the drug only during weekend trips to the city. He found that heroin broke through his shyness. He was able to talk to women. Soon it became a daily habit.

"My second year in college, I started realizing I was hooked, but I was still enjoying it," Joe said.

Before he left college, he began methadone treatment, with many relapses since.

The majority of heroin addicts use this outpatient detoxification treatment, which provides addicts with methadone prescribed by a physician, said Bill Edelman, division manager for the county's Health Care Agency Alcohol and Drug program.

The treatment is overseen by state and federal agencies, Edelman said. Many addicts under methadone treatment lead productive lives, Edelman said. And to an extent, the same can be said of Joe. He finished college and has held jobs in the marketing field. He eventually married and now has a 2-year-old daughter.

But the drug has its side effects.

"I haven't been able to function normally," Joe said.

The drug causes drowsiness, weakness and intense sweating. Joe has lied to a good number of employers to cover up for the problem because he said he is ashamed of his addiction. There have been other treatment methods, such as quitting cold turkey and other "rapid detoxification" programs.

Withdrawal is the worst part of trying kick heroin, and the biggest barrier. Symptoms include unbearable sweating, shaking, extreme feelings of hot and cold, leg spasms, insomnia, vomiting, diarrhea and nausea.

"It makes it harder when you know all you have to do is go back into a bag of heroin and you'll be able to sleep, eat, and you'll even feel good for a little while," Joe said.

THE TREATMENT

The reason opiate addiction is so difficult to overcome is the drug creates thousands of nerve receptors or storage areas in the brain that crave the drug 24 hours a day, said Clare W. Kavin, who helps administer her brother's drug-treatment program.

She equates overcoming opiate addiction to trying to go back to eating normally after you've grown an additional 20 stomachs. Dr. Clifford Bernstein helps head up the treatment at Waismann's College Hospital institute. He is Joe's attending physician. The treatment begins with a complete physical exam and is followed by medication and anesthesia in the hospital's intensive care unit. While under sedation, Joe undergoes a drug-induced accelerated neuro-regulation, or rapid detoxification, procedure that blocks the brain's receptors from any opiate in the body.

"He'll be asleep before he starts his withdrawal, and he'll be awake after the worst of it is over," Bernstein said. "It's a humane way of detox." Other drugs are given to help deal with the physical reaction to the rapid withdrawal. After four to six hours, the process is completed, and Joe is moved to recovery for eight to 10 hours of sleep.

The next day, he feels tired and worn, but has no symptoms of withdrawal. For the next nine months, Joe will take a daily dose of Naltrexone, which blocks opiate receptors.

"It's like getting a second chance at life," Joe said.

AMERICA

Rapid detoxification has been used for the past 10 years, and Waismann criticizes less reputable and poorly administered versions of his treatment.  College Hospital is Waismann's only location in the United States, but he has worked extensively in other countries, including Hungary and Israel, where the first clinic is located.

He said he is willing to collaborate with any academic institution or government, providing free training in his procedure. His hope is to have the treatment available at low cost in public hospitals, such as one that just opened in Sydney, Australia.

The nine-month program -- which includes the initial neuro-regulation treatment, follow-up counseling and the medication -- costs under $10,000. Methadone treatments cost $70 a week and may continue for years.

Waismann said he estimates it will be 10 to 20 years before his treatment is recognized as mainstream, but hopes it eventually will become available in any hospital.

"That's the worst -- when medicine is out there, available, and people are dying unnecessarily," Waismann said.

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