OVERVIEW OF ADDICTION TREATMENT

“But the worst enemy you can meet will always be yourself; you lie in wait for yourself in caverns and forests…

…You must be ready to burn yourself in your own flame: how could you become new, if you had not first become ashes?”
― Friedrich Nietzsche

This is an optimistic message. It’s optimistic for the realist who knows that we have self-sabotaging drives, i.e. dark drives. Recovering from addiction and fear is about conquering one’s own demons. It’s an unconscious battle one has with themselves. It takes a while to even be able to see those unconscious patterns. You must have a good addiction psychiatrist/therapist who can help you master your demons so you emerge a better version of yourself.

Supportive psychotherapy is great, but this is more than that. This is more intensive than just psychiatric medication management and supportive psychotherapy. Sometimes the patient is hooked on a substance. That substance can be a medical medication, psychiatric medication or an illicit street drug. Dr. Datta is a tough coach who will only work with you if you work with him. If you need an empathic person who understands your plight, but a tough coach who will help you beat your addiction, then Dr. Datta is for you. Dr. Datta will not continue to prescribe your controlled substance medications reflexively without thought. Dr. Datta does not fill controlled substance medication before their due date, ever. This is one of the reasons the phone screen is required before being accepted into this practice. We need to have a basic understanding of each other before getting started with this type of recovery.

Dr. Datta is the medical director of Addiction Services at St. Joseph’s Medical Center in Yonkers, where he started a suboxone and vivitrol program to treat substance abuse as well as general psychiatric conditions. This website, however, is the Midtown Manhattan private practice which is independent of at St. Josephs.

– Suboxone (sublingual) and its variations is prescribed to treat opiate use disorder and for relapse prevention.

– Sublocade (subdermal), the monthly subcutaneous suboxone injection, is provided in-office.

– Vivitrol (intramuscular), a monthly anti-craving injection which helps in addiction recovery, is provided in-office.

– Outpatient detox regimens are tailor made to a patient’s exact specification. Patients here have been detoxed from alcohol, Xanax, opiates, cannabis, cocaine and crystal methamphetamine.

– Dr. Datta can provide a second opinion. Dr. Datta can refine existing controlled substance medication regimens or taper a regimen down so that you can be on a healthier non-addictive regimen.

– Students as well as adults are evaluated and treated for ADHD and adult ADHD.  Affordable Psychological testing is $50 for a 45 min computerized test that covers 16 cognitive categories of thinking in comprehensive evaluation of ADHD. However, this test is not sufficient for certain settings which require a full psychological evaluation.

– Genetic testing is done to find the right regimen with precision. This is helpful for patients who have been on multiple medications in the past. Find out which medications work specifically for you.

– Behavioral addictions are treated. Behavioral addictions can be just as profound as drug addiction. It follows the same pathway in the brain. Dr. Datta is knowledgable about this due to his behavioral research fellowship at Albert Einstein College of Medicine in Bronx, NY. Treatments include, but are not limited to: gambling addiction, video game addiction, pornography addiction and sex addiction.

Dr. Datta follows a harm-reduction approach, not a zero tolerance one. Dr. Datta believes in 12-step programs and Smart Recovery as well.

OUTPATIENT DETOXIFICATION

Many patients are working and do not want to take time off for inpatient rehab. Dr. Datta is not an emergency provider. The duration of each detox regimen is specific to your needs, ranging from one month to one year. All patients are screened, not all patients are accepted. Dr. Datta does provide a custom tailored outpatient detox regimen for the following substances.

  • Alcohol (most classical form of outpatient detox)
  • Heroin (detox using Suboxone)
  • Synthetic Opiates (oxycodone, oxymorphone, hydrocodone, hydromorphone, morphine derivatives and kratom).
  • Dr. Datta does not prescribe Percocet or Vicodin
  • Barbiturates (phenobarbital, pentobarbital)
  • Benzodiazepines (Xanax, Klonopin and Valium)
  • Cannabis and cannabis derivatives
  • Stimulants (Adderall, cocaine, crystal methamphetamines)

Detox is followed by a maintenance period. This means that outpatient detox can take time depending on the person, the drug and the regimen. Patients often continue on naltrexone, an anti-craving medication, after they have tapered down off their drug.  “Comfort medications” are given to make the detox process more soothing. Patients can be referred to short term or long-term rehabs.

Combination detox regimens are also provided. This means Dr. Datta can taper you down off multiple controlled substance medications. Dr. Datta does not prescribe methadone, Percocet or Vicodin. These are prescribed by a pain management provider. Dr. Datta can refer you to one.

Outpatient detox regimens are not easy. Sometimes certain people have a tough time with the outpatient detox regimen and take too much medication too soon. They may have check into an inpatient detox hospital floor or clinic. Not every person is a candidate for Dr. Datta and may have to check into detox first. A limited quantity of controlled substance medications are given because some patients can’t help themselves and take more than what is prescribed. The customized outpatient detox regimen appointments are usually more frequent, such as weekly or twice weekly.

SUBOXONE

Dr. Datta is a Suboxone specialist. If you desire discreet, confidential suboxone treatment for opiate-use disorder, then this is the practice for you. However, you still need to take the medication as prescribed. Dr. Datta does not over-prescribe and does not prescribe before the refill date, ever. Dr. Datta can find the right version of buprenorphine medication-assisted treatment for your opiate-use using Suboxone, Subutex, Zubsolv and Bunavail.

Sublocade, a subdermal suboxone injection, is beneficial for relapse prevention. Dr. Datta provides these subcutaneous injections in-office. Sublocade is appropriate for people who can seem to commit to sublingual suboxone. With Sublocade, you have buprenorphine in your system for a whole month. You can have that protection from cravings without taking any medication my mouth or sublingually. Individual cases may vary.

· Dr. Datta has a Drug Addiction Treatment Act waiver (DATA 2000) which is a license allowing a provider to prescribe buprenorphine or suboxone.
· Dr. Datta is a registered opioid treatment provider through the Substance Abuse and Mental Health Services Administration (SAMHSA).

VIVITROL AND NALTREXONE

Vivitrol injections are given in-office. Vivitrol is a once a month anti-craving medication for alcohol and opiate addiction. Naltrexone is the tablet version of Vivitrol which is has an anti-craving effect.

  •  Vivitrol and Naltrexone are prescribed for alcohol and opiate use disorder.
  •  Acamprosate and Antabuse are provided for alcohol use disorder.

BEHAVIORAL ADDICTIONS

  • Addiction is not just alcohol and drugs. Behavioral addictions follow the same addictive pathway in the brain and can be disruptive to one’s lifestyle and functionality as well. It can impair one’s ability to hold a job or meet family responsibilities, no matter how well they function. Behavioral addiction is often more abstract and nebulous than an illicit drug addiction. It lies in the unconscious mind and it will draw you in until you find yourself depleted, leaving you without energy and with the negative side of yourself. Some people lose faith that they can ever improve. Here you can regain that confidence. Dr. Datta is a tough coach who yields results, but only if you are dedicated and committed to the treatment.
  • Gambling Addiction – The temptation that one can win. It’s call intermittent reinforcement. Just one more time … double or nothing … I can get it back. The prestige of winning. The devastation of losing one’s life time earnings. Digging into the retirement fund or college fund to pay your debts. Functionality of life can be lost when succumbing to gambling addiction. One may be regressed, in a less mature age of functioning. One may be impulsive and risk taking, but has gone over the edge. The stories change, but similar patterns of addiction remain. In this practice we take a deep dive into the dark side of your personality in order to find light, balance and reason.
  • Video Game Addiction – This is a version of internet addiction. It is overindulgence in a virtual world, so much so that one sacrifices their family, friends and responsibilities. There may be pressure, reputation and prominence when one gains prominence in role-playing games, as it is a virtual society. However, one may not be meeting the responsibilities of life due to their affinity for the virtual world. One may not be conscious of its detrimental effects.

  • Pornography Addiction – This is a silent opponent these days. Our diet is more than what we eat. Our psychological diet is composed of the images and ideas we cultivate in our mind. Nowadays, men and women find it difficult to have a relationship because they have images of fantasy in their mind. We do not accept real partner because we have brainwashed ourselves with these ideal images or scenarios we’ve seen in the media. It is easy to get lost in these fantasies. The self-gratification feels good at first, but can ruin the feeling of real intimacy and relating to a real partner.

  • Love and Sex Addiction –  Do you fall for the narcissistic bad boy who does not have the capacity to love another person? Does he only love you when it serves him? Do you make impulsive decisions and put yourself in risky situations with people you don’t know? Does their touch make you feel loved or cared for, or is it a thrill or rush? We will explore your attachment style with psychotherapy based on John Bowlby’s Attachment Theory. One’s attachment style is difficult to change, but not impossible. Learning what this impulsive risk taking means for you, where you learned it and learn/practice/condition yourself to undo it. Develop more healthy habits and learn to love yourself which leads to a deeper, longer lasting love. Learn the difference between impulsive risk-taking and the physical and emotional intimacy you truly desire.

    Dr. Datta does psychotherapy as well as prescribe Naltrexone to improve your will power to overcome these addictions. Naltrexone allows you to resist these habits.  Naltrexone and psychotherapy has been shown to be effective against these behavioral addictions. Motivational Interviewing is based on the philosophy of clinical psychologists William R. Miller and Stephen Rollnick.

SMOKING CESSATION

Medication-based, behavioral therapies and tapering down using vaporizers (vape) are all implemented together to help you with smoking cessation. Chantix, Wellbutrin and Nicotine patch, gum and lozenges can be used in combination with vape taper down regimens. Psychotherapy and Motivational Interviewing Therapy (the therapy for addictive behaviors) are also effectively used in this process.

COLLATERAL TREATMENTS

In order to make progress in substance or behavioral addiction recovery, four or five modalities need to be done simultaneously. Psychotherapy and medication may not be enough.

  • 12 step programs and Smart Recovery with a group + sponsor.
  • Therapeutic communities as well as detox & rehab facilities
  • Family Therapy – support from friends and family has proven to be effective.
  • My style is harm-reduction as opposed to zero tolerance.
  • Sober companion who can accompany you at home. Ask for details.