DETOX DRUG COMBO HELPS PALM BEACHER GET SOBER

Palm Beach Daily News
DATE: Sunday, January 9, 2005

DETOX DRUG COMBO HELPS PALM BEACHER GET SOBER
By DAVID ROGERS
State Licensed Healthcare Clinic
Copyright 2005 Palm Beach Daily News

At 12 years old, Palm Beach resident Turner Benoit began smoking pot and drinking alcohol. It was just something the Palm Beach Day School student did with some of his friends.

A year later, in 1995, the death of his father, Constant "Pete" Benoit, deeply disturbed him and provided another reason to drink. Benoit, now 23, started frequenting Palm Beach bars. The nightspots did not always enforce drinking age laws, he said.

"Palm Beach is different," he explained. "You go to a bar and there are going to be kids there. You grow up in this era when you think you are supposed to drink. I thought I was supposed to do it."

As time passed, Benoit progressed from pot to painkillers Percocet and Vicodin. Then he tried OxyContin. And methadone. For about four months, before seeking inpatient treatment earlier this year at Columbia Hospital, Benoit got his fix from heroin. His family's affluence made it easy for Benoit to fund his addiction.

"They say three things keep you high - money, youth and beauty. I think I had all three," he muses.

Benoit said his referral from Columbia to Meditox of Palm Beach saved his life.

The outpatient Drug Detox Program is run by Dr. Mark Agresti, a psychiatrist with a private practice in West Palm Beach and the medical director of psychiatric services for Columbia Hospital in West Palm Beach. He began Meditox of Palm Beach about four months ago.

Meditox features a six-week at-home detoxification program that provides clients with maximum privacy and less disruption of their normal routine. The program does not accept insurance.

Agresti said he is having success helping clients such as Benoit beat addictions to prescription painkillers - such as narcotics OxyContin, morphine, codeine and semi-synthetic opioids such as Demerol and Percodan - using a relatively new drug combination.

Until recently, treatment for painkiller dependency was only available through an inpatient center across the course of several weeks or months. But the FDA approval in October 2002 of buprenorphine, which blocks withdrawal symptoms, made possible the outpatient treatment of opioid addiction. Buprenorphine - by itself and in combination with a drug that mutes withdrawal symptoms - was put on the U.S. market in pill form a year ago.

"This medication doesn't get you high. If you take too much of it, it shuts itself off. It's tough to abuse," Agresti said. "People don't nod off or get drowsy with it. They don't appear drugged whatsoever. They can go back to their normal function the next day."

Agresti, however, warns that the drug, when combined with benzodiazepines such as Ativan, Xanax and Valium, can cause potentially fatal respiratory depression. Still, the psychiatrist calls the new treatment "nothing short of a miracle."

"You feel great and you get the monkey off your back with no disruption to your work or life," Agresti said.

A nationally recognized expert on drug dependency, Dr. Herb Kleber, acknowledges the usefulness of medications containing buprenorphine to fight opioid addiction. Kleber is a professor of psychiatry at Columbia University and served from 1989 to 1991 as deputy drug czar in the administration of George H.W. Bush. Columbia University was one of the first institutions to employ buprenorphine to battle drug dependency. Kleber calls the drug an important advance in treating addiction to narcotics.

Individuals, though, can get addicted to buprenorphine, a narcotic, Kleber said, contradicting Agresti. When people die of drug overdoses, it is often because the drug depresses respiration, he said. He also cited the danger of mixing buprenorphine with benzodiazepines.

"It is safer, but it is a relative safety," Kleber said.

Deception, stealing

Benoit said he believes his drug use did not greatly affect others until he started using heroin in 2004.

Before then, he thought others did not know when he was high. "I lived in a fantasy world."

"Towards the end, I had no money," he said. He sold his stereo. Lying and stealing became a way of life.

"I stole pills from people and did a lot of lying and stuff," he laughs. "I would lie to get my way, to get myself out of a situation."

Benoit used his mother's credit card and his own to buy gift certificates that he traded for drugs.

His lowest point was risking his life to buy heroin on Tamarind Avenue in West Palm Beach. When he pulled onto the street, the drug dealers greeted him by name. He feared getting attacked.

"You are so psyched up to get high that that overcomes your fear," Benoit said.

But that life appears to be behind Benoit. He said his participation in the Meditox of Palm Beach program has given him a better chance of leading a drug-free life.

"Right now, my future is wide open. Four months ago I didn't have a future," he said.

Benoit is closing in on his senior year at Florida Atlantic University, where he is majoring in history, and has a positive outlook.

The thought of dying from an overdose motivates him to stay clean.

"As long as I don't pick up, I will survive. If I do, I'll die," Benoit said.

Benoit's initial treatment with Meditox ended a few months ago, but he continues to take Suboxone. Suboxone is a good choice for people with heroin addiction, said Stuart Birnbaum, a longtime "sober coach" who is working with Benoit. The program is gradually decreasing Benoit's dosage.

Birnbaum, vice president of Meditox of Palm Beach and a former Los Angeles screenwriter and producer, communicates by phone or meets with clients every day throughout the treatment process and coordinates their counseling. The detoxification program incorporates 12-step recovery principles derived from the Alcoholics Anonymous program.

Birnbaum said the program respects client confidentiality. Benoit's decision to talk about the program was his own, Birnbaum said.

"He does what everybody in the 12-step program is encouraged to do - to reach out and help people who are suffering. He is very generous in this regard and he's a model patient," Birnbaum said.

The sober coach said painkiller addiction is not uncommon. Rush Limbaugh's nationally publicized addiction to painkillers is just one of many, Birnbaum said.

"It's springing up like wildfire in Palm Beach and everywhere," he said.

His business partner, Agresti, said he has used buprenorphine to treat as many as 2,000 people. In the few months since he created Meditox of Palm Beach, more than 70 people have enrolled in their outpatient drug detox program, Agresti said.

That number is likely to rise, with the county demand for mental health services hitting a three-year high.

Mary Andrews, executive director of the Mental Health Association of Palm Beach County, said area professionals are seeing a spike in calls for counseling in the months since hurricanes hit here. Emotional issues surrounding the holidays spur more people to abuse alcohol and drugs, and to seek help this time of the year, Andrews said.

"Incidences for the 211 crisis line, the mental health calls and calls for substance abuse, have been the highest over the past two to three months than they have been in the past three years," Andrews said.

Drug Detox as a starting point

The cause of painkiller addiction is not over-medication, but the lack of a plan to end their use, Birnbaum said.

"Many doctors don't have exit strategies," he said. "So people are caught between a rock and a hard place. It's a very difficult thing to stop once you've started."

The trend of managed health organizations reducing the number of inpatient treatment days they will fund propelled the development of buprenorphine in pill form for outpatient treatment, Kleber said.

The nationally recognized psychiatrist urges the public to view detoxification programs as a starting point for recovery.

"The issue with narcotics is it's not hard to get off them, it's hard to stay off them," Kleber said. "Our experience is most people are not able to detox and stay off the drug. Despite therapy, there is a high relapse rate."

Columbia Universityrecommends a maintenance period with counseling and monitoring for a minimum of six months once a drug-dependent individual goes through drug detox.

The psychiatrist calls buprenorphine an advance in drug detoxification but said it is probably better suited for maintenance. Many patients relapse following this or other detoxification methods, Kleber said.

"They need to understand detox is not the end of treatment, it is the beginning of treatment," Kleber said.

"It's what you do to get your head on straight."

For press and media inquiries, please contact:

Bridgette King
954.937.9616
bridgette@getthescoop.com

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