Welcome to the first episode of Waismann Method® Podcast. Clare Waismann is here to answer questions about the process of medical treatment for opiate dependence. Medical opioid treatment encompasses the process of detoxification, but as Clare describes today, it is about so much more. Individualization of the treatment protocol is of primary importance in identifying the best treatment option for a patient, whether it’s rapid detox under sedation or medically-assisted detox without anesthesia. Our next episode will be focused on what it means to “Recover From Dependence vs. Being In Recovery”
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Episode 1: Individualized Medical Treatment for Opioid Use Disorder (OUD)
Dwight Hurst: Hey there, everybody, welcome to the first episode of Waismann Method® podcast. This is from Waismann Method® Advanced Treatment for Opiate Dependence. You may or may not be familiar with our treatment strategy or treatment clinic, but we are excited to be able to come to you to talk about medical treatment and medical detoxification for opiate dependence. In fact, that’s going to be our topic today.
The format that we’re going to follow for this podcast is putting out information about recovery from dependence and recovery from symptoms of addiction through the medical treatment medical model. This show is going to be hosted by myself, Dwight Hurst, and Clare Waismann, the founder of the Waismann Method. She’s going to come on and answer questions that I’m going to bring to her, that many of which will be submitted by listeners, as well as just general questions that have come from working in the treatment community and being around recovery. Clare is a wealth of experience and is able to pioneer the use of medical detoxification, especially rapid detox, but that’s only a part of the approach that she brings to treatment. Today, we’re actually going be talking directly about how Clare approaches treatment and what she does at the Waismann Method Treatment Hospital to help people get through the medical process of detoxification and start on the road to sobriety.
Dwight Hurst: So really excited to be here with you. Clare, I’m actually excited personally to learn more about the rapid detox as well. That’s a big thing that sort of stands out in your method, right?
Clare Waismann: It is. It is mostly what we do, but not all we do, because patients are very different. And so are their clinical needs, their health or emotional needs should be tailored to the patient. That’s one of the major differences of the Waismann Method and addiction treatment. We don’t focus on addiction. We focus on the human being that is suffering from addiction.
Dwight Hurst: What are some ways that approach makes things different for you?
Clare Waismann: I think when people say treating addiction, they are talking about a set protocol that should fit everybody. They are talking about a condition. The root of their condition is a very different person to person treating the condition is just putting a Band-Aid, a temporary Band-Aid the root of the issue is still going to be there. So when people say, well, relapse is part of recovery, it has to be part of recovery because the root has never been treated, the consequence of the untreated condition will surface again. And that’s what addiction is, it is not the issue itself, but a consequence of an issue that has not been properly treated.
Dwight Hurst: I remember hearing a long time ago the idea that addiction is not a problem. It’s a solution. Right. And if we don’t look at it that way, you take someone’s solution away. Now they have a problem, the same problem that got them there.
Clare Waismann: But if these people receive treatment, how people receive care is also very different. The way we receive love, the way we understand and perceive, you know, others trying to help us is so different. So what we are able to absorb is treatment is also very different.
Dwight Hurst: It becomes difficult to accept help than when we’re in that perception or that place of addiction.
Clare Waismann: Correct. Few issues with that. Number one, is not being emotionally present when we are not completely off the drug that is numbing our feelings. It is very hard to make assessment of what the issue is, what the mental health issue is, what the emotions that they are trying to mask are, because the drug itself is causing you to mask those emotions. So how can you see something you’re trying to mask?
Dwight Hurst: You see people focusing on the behavior that comes from the addiction. I mean, I’m thinking like loved ones and family members who get burned out and then the patient over and over before they ever come into treatment has been told, “Oh, you’re a liar and you’re a criminal or you’re this bad person.” And they internalize that and that can become an obstacle.
Clare Waismann: Oh, of course, number one issue is with the stigma and the rules. The sayings of addiction “You’re always going to be an addict,” and “You’re always going to be an addict anyway,” and you’re always going to be considered one. Why should you try to be anything different? If that’s how you’re going to stay. So you’re making people hopeless by telling them that the same as a child that misbehaves. And if you tell them you’re always going to behave like this, it doesn’t matter if you behave really nice today, tomorrow you’re still going to behave like that. I can makes people hopeless. You’re always going to feel like a misfit in society. If I break your legs and if I tell you, you’re a disabled person, that will never be able to walk. How do I expect you to get anywhere?
Dwight Hurst: Yeah. You catch your child taking money from a purse or a drawer in the house. Do you tell them, “Hey, don’t take that money? Let’s talk about why we shouldn’t take money and what’s going on? Why did you need the money?” Or do you say, don’t be a thief? You’re a thief.
Clare Waismann: Exactly.
Dwight Hurst: In that way, now you’ve taught…
Clare Waismann: So the question to the child should be, should be not just “Why you’re taking the money?”, but “Why do you think you could not have come to me and ask for what you need? You know what’s missing there? And even what is the issue with our relationship.
Dwight Hurst: Yeah, well, exactly. And accepting that there is a responsibility and a context to the relationship that isn’t just the kid’s fault to say, “Have I communicated that you can’t come to me? or, you know, “Is there a reason why you’ve internalized that?” I think it’s a really powerful approach and it becomes a sort of a controversy in addiction treatment. I’ve seen people who really embrace the title of an addict and some who don’t. Some, in fact, I know some treatment programs don’t even like the use of the word addict.
Clare Waismann: Correct. But this is the last few years things have changed slowly. Now, with that said, you know we treat a lot of people that have been in the 12-Step program for 20 or 30 years and they’ve been sober for 20 years or 30 years, you know, and then something happened. But because that’s what they believed for the times, they stay sober. I don’t know how productive it is to break that belief, because that’s all they have to hold on to.
Dwight Hurst: I always when I worked with patients, I like to try to learn a little bit about how do they define that term. And is it a healthy, productive definition in their own head or is it shame-based? And I think to their to your point, I think that’s a big difference. As far as how is it served now?
Clare Waismann: Yeah, I think it’s almost a missed space. I don’t belong anywhere else but in that room. Do you know what I’m saying? Nobody else in the world. I feel lesser than everywhere else, other than in that room.
Dwight Hurst: Well, and if I feel less then, though, why would I be sober?
Clare Waismann: Correct. We’re talking a lot about behavior. But the the other issue with, you know, addiction to drugs or alcohol is it changes the chemistry in your brain, it actually changes your whole metabolism. So obviously it changes how you make decisions. You know, replacement drugs are keeping people in that space where they’re almost robotic.
Clare Waismann: Again, you know, we don’t recommend or not recommend – every patient is different. If the patient is in an environment where they are using a tremendous amount of heroin, Fentanyl – it’s not a patient that is in a safe environment to be completely detoxed yet. Then if they have to be in something like this for a short period of time until a safe environment is found.
Dwight Hurst: So it’s really a case of individual treatment planning is what you’re talking about. Isn’t it funny that should be a radical approach? You’d think?
Clare Waismann: Exactly. It’s sad. It’s not even funny, it’s sad, but it’s a pharmaceutical world. You know, big profits are made on long term treatment and not solutions. So I think anybody, period, can be medically detoxed without suffering or going through all the misery of withdrawal, managed through detoxification, and then have strong mental health assistance, psychotherapy or a psychiatrist, whatever that is, and live a productive life. I think they will do much better.
Dwight Hurst: Tell me a little bit about what happens to me. Let’s say I walk into Waismann Method. I’m going to assume that I have an appointment. So I walk into the clinic. What are some of the first things I’m going to run into as a new patient? How much? How does that work?
Clare Waismann: So before you even come in, there is a preliminary intake that is done, assessment to know if you are a candidate because we’re not a dual diagnosis facility. You know, we don’t want to extend the treatment for people that we believe we can’t help. And B, this is not the best option for them. So once the patient is here for treatment, they arrive at a full service accredited hospital. There is a comprehensive health evaluation. In other words, we’re going to check their heart, their liver, their kidneys, make sure none of the major organs have been compromised.
Clare Waismann: And you would be amazed at the amount of times we find medical issues that they were not aware of. You know, when you’re taking numbing devices, your physical response to medical issues are not the same. So that the whole point of opioid is so you don’t feel pain. Our body issues provide us discomfort. You can’t feel the discomfort. You don’t know there’s an issue.
Dwight Hurst: Yeah. That makes sense. And then there’s also the lack of self-care that goes along with that, too. I imagine that.
Clare Waismann: Correct!
Dwight Hurst: I image that not just the direct damage of the drugs you’re talking about. Yeah, the secondary effects of bad health management as well.
Clare Waismann: And these drugs are dehydrating your whole system. Most of our systems function with fluids. So that first day we do an evaluation. We start hydrating the system. We start giving the patient what they need. So after detoxification, the transition will be a lot easier on them.
Dwight Hurst: So a lot of this is pre-detox as well. It sounds like there’s quite a bit of prep.
Clare Waismann: This is all pre-detox, especially if it’s anesthesia detox. We need to make sure that the patient is where they need to be before detox starts.
Dwight Hurst: I imagine that’s a pretty harsh blow to the system anyway, to go through the rapid detox?
Clare Waismann: You know, that’s that’s the funny thing. Yes and no. I think any detox is harsh on the system. Now, let me ask you a question, “Do you think it’s harder for the system to be under sedation? Same sedation you would have if you went through a colonoscopy or oral surgery, for an hour to an hour and a half in an ICU of a full service accredited hospital?” Or “To spend five, six, seven days vomiting, having diarrhea, high blood pressure, rapid heart rate with no medical assistance?”
Dwight Hurst: Yeah, I’d go for option one, personally, having known a lot of people having gone through number two.
Clare Waismann: When people say, “Oh, rapid detox is a dangerous procedure!”, it’s almost humorous to me. Is it not dangerous to have no medical recourse? In California you are not even allowed in most rehab centers to check blood pressure.
Dwight Hurst: Really? That’s interesting.
Clare Waismann: You get you get these patients vomiting, having diarrhea, dehydrating with high blood pressure, rapid heart rate and no medical recourse. How how is that not dangerous?
Dwight Hurst: I know of a campground in one area that was basically just sponsored by volunteers who just said, “Yeah, you can come here and detox!” And they had little huts that you could use. It was essentially like camping with a bucket and a blanket. And yeah, that was that was terrifying when I heard about that. Also because of the medical danger that people can get into, too. So I can definitely see the advantage of being medically monitored. And tell me again about the timetable there, as far as how long does it take to be actually medically detoxed in this process?
Clare Waismann: There’s there’s a difference…
Clare Waismann: So the first day they go through that whole evaluation preparation and the second day they’re transferred to the ICU, where the rapid detoxification happens in usually less than an hour and a half, sometimes even less than an hour. Because what we’re doing is using antagonist medication to push all the opioids off the receptors while their blood pressure, heart rate and everything else is managed.
Dwight Hurst: I have heard people say that they feel like going through the non-medically supervised “bucket and blanket” type of multiple days long. People think that it is a necessary step, that they will be less likely to relapse if they go through it because it’s so uncomfortable. Now, personally, I haven’t observed that. I’ve seen a lot of people who have seemed to be just as prone to relapse who’ve been through that process. I think addiction will drive into that. But what do you what do you say about that mentality that the traditional…?
Clare Waismann: I think that mentality keeps a lot of people from seeking to rethink, that mentality allows, you know, people that just cannot make it through the withdrawal, allows it to snowball on them and they keep relapsing using more and more, and their tolerance gets higher and then they overdose even that the people that we see that went through detoxification, medical detox. And again, I keep repeating “medically assisted detox“, because “rapid detox” is just a protocol for some people, some people that are healthy, some people that have tremendous amounts of anxiety and cannot get through withdrawal some people that are taking drugs like Methadone and Suboxone that has a very, very lengthy withdrawal. So for those people, rapid detoxification is wonderful. Medically-assisted detox is when we also have those patients in the hospital. The end result is the same. We’ll get them completely off opioid. The difference is how fast we did it.
Dwight Hurst: And don’t you think the resistance people have to the medical? I fear that goes back to reinforcing the idea that addiction is not medical. How it was treated is just a behavior problem back in the day.
Clare Waismann: One hundred percent! We have evolved immensely in science. Fifteen years ago, we did not understand chemistry of the brain like we do nowadays. So was a lot easier to blame personality, DNA.
Dwight Hurst: A lot of the problems than are relegated to law enforcement rather than the medical community.
Clare Waismann: Correct. So if they’re fully detoxed, all you’re left with is yourself, your emotions to deal with whatever it is that led you to substance abuse in the first place.
Clare Waismann: Really, really important for people to know. Rapid detox will get you from A to Z through the withdrawal while you’re sleeping. With that said, to keep a healthy life – and that’s for any of us – it takes work. Some of us more than others.
Dwight Hurst: Part of a strategy to recover, not recovery all by itself. Important to say, I think that not one element of treatment is not treatment by itself. It’s just an element of support.
Clare Waismann: You know, you can have the proper diet, but you also need to exercise. It’s just being a complex human being. The difference between recovering and being in a recovery, that that’s another for another time, because that’s a long conversation.
Dwight Hurst: And we’re going leave it there for today.
Dwight Hurst: Thanks so much for listening to the podcast. As Clare mentioned, our next episode is going to focus on definitions of being in recovery for addiction. What is the difference between “being in recovery” and “recovering” and what does that all really mean?
Dwight Hurst: We’re going to talk about that next time. If you have questions that you’d like us to answer about that topic or topics on a future episode, please hit us up with those questions. You can tweet the questions @opiates on Twitter or you can e-mail your questions to [email protected].
Dwight Hurst: Keep them coming. Because remember, after all, where there’s questions, there’s eventually answers. And where there’s answers, there’s hope. The Waismann Method podcast is brought to you by the Waismann Method Advanced Treatment for Opiate Dependence. To learn more about the treatment, please go to opiates.com to learn more.
Dwight Hurst: The music that we have is the song Medical by Clean Mind Sounds. This show is edited and produced by Popped Collar Productions, where we bring podcasting solutions for business, entertainment, and non-profit podcasts. Check us out at poppedcollar.net.
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