Ultra Rapid Outpatient Detox with the RMOD
The Rodriguez Method of Opiate Detox
The Rodriguez Method of Opiate Detox, also known as the RMOD, is the most significant advancement in opiate detoxification science since Suboxone. Using intravenous sedation (but specifically NOT anesthesia), Dr Rodriguez is able to completely detox opiate dependent individuals in a matter of hours. These methods had been in development for over 5 years and were released in 2013. The RMOD procedure is based on the use of intravenous (IV) medications, fluids, and vitamins under direct observation in an outpatient setting. This allows for very powerful medical interventions in a tightly controlled and well-monitored setting. The results are profound neurophysiologic changes being achieved in a very short amount of time and with the least discomfort possible.
The RMOD was originally developed to detox patients off of Suboxone and Subutex, with the effectiveness with conventional opiates being realized later. Up until now, patients have been weaning down easily but then kept getting stuck at 1-2mg a day of buprenorphine. Going below 1-2mg a day seemed almost impossible, usually due to the intensity and duration of the withdrawal symptoms. There have been endless reports of lingering post-acute withdrawal symptoms lasting several months. Inpatient options are far too short and have failed miserably. Simply trying to wean off of Subutex or Suboxone does not work, as everyone quickly finds out. The UROD done under anesthesia adds the risk and expense of the anesthesia with only a partial reduction in the total withdrawal symptoms. Many patients who have undergone the UROD report waking up in moderate to full intensity withdrawal symptoms that takes days to reduce in severity and over a month to resolve completely. This adverse experience is most prominent when coming off of buprenorphine-based medications. This is due to the very high receptor binding affinity of buprenorphine on the opiate receptor. The RMOD specifically accounts for this trait, which is critical to achieving a successful detox off of buprenorphine with minimal withdrawal symptoms and no post acute withdrawal. The RMOD is the first true effective option at coming off of Subutex and Suboxone.
How the RMOD works
The RMOD is very proficient at detoxing people off of buprenorphine and is just as efficient in detoxing individuals off of conventional opiates, methadone and Kratom. The RMOD is a 3-phase process that achieves a complete, 100% opiate detoxification with minimal discomfort. There are 2 preparatory phases and then the active induction phase. The specific details of these phases are proprietary and part of a pending U.S. patent. The first phase is planned for 1 to 4 weeks, depending on a number variables including logistical convenience. The patient is fully comfortable and functional during this phase. This is followed by the brief pre-induction phase, which lasts 1 to 2 days.
The final stage is the actual IV induction. Patients are first thoroughly hydrated, and then receive the preparatory medications (The specific details of these medications are proprietary and part of a pending U.S. patent). The patient then undergoes the active phase, which is mild to moderately uncomfortable. The active phase can average 2 hours for the more difficult cases and as brief as 20 minutes for lighter cases. The total time spent under observation averages 4 hours. The active phase concludes with an IV infusion of vitamins to speed up physical recovery. Patients typically go home after to sleep off the remainder of the IV sedation medications. Almost all patients have been able to go back to work the very next day and describe feeling as if they had worked out intensely the day before. Every patient is seen for a follow-up the very next day to confirm that they are 100% detoxed with no lingering withdrawal symptoms. In rare cases, a brief second induction is done the following day to fully resolve any lingering symptoms. Second day inductions take only 20 minutes on average and are very mild reactions. Every single patient that has undergone the RMOD has completed it with full effectiveness and without complication. This is attributed to a tightly controlled treatment setting and careful patient selection.
Who is an appropriate candidate for the RMOD?
Patients that have been on Suboxone or Subutex for a long time and have succeeded in remaining abstinent from opiates are ideal candidates for the RMOD. Individuals who still need the craving suppression and protective properties of buprenorphine are encouraged to build up a longer period of opiate abstinence before undergoing the RMOD. Those on Suboxone that have a shorter opiate abstinence may still undergo the RMOD if they follow it with a long acting depot naltrexone, such as Vivitrol. Individuals who are taking buprenorphine for only pain management reasons, who have achieved pain relief by non-medical means, are also considered good candidates for the RMOD.
Individuals that are actively abusing oxycodone, heroin, Dilaudid, hydrocodone, methadone and other opiates can be fully detoxed using the RMOD. This method is just as effective with conventional opiates as it is with buprenorphine. A relapse prevention program and a long acting depot naltrexone, such as Vivitrol, is recommended following the RMOD to ensure a successful long term recovery.
Individuals that are actively taking oxycodone, Dilaudid, hydrocodone, methadone and other opiates for pain management reasons and wish to stop can also be fully detoxed using the RMOD. Chronic pain management situations frequently complicate with hyperalgesia, which is a syndrome of increased pain sensitivity due to long term opiate consumption. The RMOD is very effective at eliminating hyperalgesia, which will help lower an individual’s perception of pain. Many who had thought they were still in pain long after their injury have realized that they were really in a state of hyperalgesia that resolved following detox. Many of these individuals can then have their pain managed with non-narcotic or even non-medical options following the RMOD. In the cases that did have to resume opiate based medications to manage the pain, the hyperalgesia was still resolved and they then required much lower doses of pain medications to achieve pain relief.
Individuals who have already attempted a detox off of opiates using other techniques and are still experiencing post acute withdrawal symptoms, also known as “PAWS”, can be effectively helped with the RMOD. PAWS is a very common problem with most forms of detox, whether it be by the UROD, Suboxone, methadone or any other method. PAWS are common triggers for relapse, as well as being generally uncomfortable and difficult to live with. Many have reported PAWS for weeks to even months following their detox. The RMOD is the fastest and most efficient way to definitively resolve PAWS, even if it resulted from another form of detox. The RMOD for PAWS is actually usually a milder process that has an active phase takes 30-45 minutes on average.
How does a patient get scheduled to undergo the RMOD?
Every patient must first be evaluated to make an accurate diagnosis, assess appropriateness for the RMOD, and develop a treatment plan. The RMOD is available to individuals who live locally in South Florida as well as those who are willing to fly in from more remote areas. Dr Rodriguez routinely performs chemical detoxification on individuals from all over the world. All patients MUST be thoroughly evaluated in person prior to being considered a candidate for the RMOD. Patients that do not live locally require at least 2 trips: one for the evaluation and then a second one for the actual RMOD. Most patients from remote areas will require just 3 weekdays off from work in total. Most local patients require only 1 or 2 days off from work. The evaluation can be scheduled by simply calling 888-699-5679 or 561-779-0014 if it is after hours or on weekends.
What if I am not a candidate for the RMOD?
Not every patient is a good candidate for the RMOD and Dr Rodriguez will not conduct the procedure unless the patient is a good candidate. The RMOD is only one of many techniques that Dr Rodriguez has to conduct opiate detoxification though, and other viable options will be presented. Dr Rodriguez is always able to provide at least 2 or 3 different options for detox, even if the RMOD is not appropriate for a given individual.
What is the cost of the RMOD?
Please call our center to discuss pricing of the RMOD.
What if I cannot afford the RMOD?
Many patients cannot afford the RMOD, yet still need help with detox. All of the other conventional forms of outpatient opiate detox, including using Suboxone and Subutex, are still available to all patients and are relatively inexpensive. Higher complexity opiate detoxes may require up to 2 visits in the first week and then less frequent visits thereafter. Dr Rodriguez does his best to accommodate as many motivated clients as he possibly can.
How is the RMOD different from conventional UROD?
Conceptually, the stated goals of the RMOD and conventional UROD are similar. The actual process has a number of critical differences though, which are as follows:
1) The RMOD is done using IV sedation with a proprietary medication combination. This allows for a significant reduction in discomfort, but without adding the risk of death that is seen with general anesthesia. The IV sedation does not disrupt the accelerated detox mechanism of the RMOD and facilitates a very quick physical recovery. UROD uses general anesthesia, which is costly, poses certain risks including potential death, disrupts the accelerated detox process, and requires a longer physical recovery.
2) The RMOD active phase averages 2 hours, with a total procedure time averaging 5 hours when you factor in sedation time and setup. The active phase of the UROD is 4 to 8 hours with a total procedure time often exceeding 12 hours. Some UROD facilities take as long as 3 days to complete the process.
3) The RMOD provides a very thorough detoxification with no post-acute withdrawal symptoms (PAWS) following the procedure. Rare cases require a brief follow-up induction the following to definitively remove any final lingering post-acute symptoms. Almost all patients are completely free of any PAWS beyond 5 hours of starting the RMOD. Not a single patient has ever experienced PAWS beyond 18 hours of the start of the RMOD. The detox provided by the UROD is often incomplete with strong withdrawal symptoms lasting a number of days and PAWS lasting up to 6 weeks. The RMOD has sometimes been used to resolve lingering PAWS that have remained following a UROD procedure.
4) The RMOD requires a brief stay for patients that are from outside of the South Florida area. They typically need 1 day for the evaluation, 1 day for the actual RMOD, and then 1 last precautionary day for follow-up prior to discharge. Patients are usually nearly 100% recovered by the time they leave. The UROD takes at least 3 days typically and can easily extend to 4 or 5 days. Many UROD patients are still rather ill with opiate withdrawal symptoms or strong PAWS at the time of discharge.
5) The RMOD is substantially less expensive than the UROD. Prices for the UROD range from $7,800 to over $20,000. The RMOD procedure costs $9,800 with insurance, or $12,800 without insurance.
The Rodriguez Method or Opiate Detoxification (RMOD) is frequently performed for patients coming off of oxycodone (Oxycontin, Roxicodone), oxymorphone (Dilaudid), heroin, morphine, hydrocodone (Lorcet, Lortab, Norco), and codeine. This technique is also well suited for Kratom Leaf, methadone, fentanyl (Duragesic, Actiq), meperidine (Demerol), nalbuphine (Nubain) and buprenorphine (Buprenex, Subutex, Suboxone). This technique was originally developed to detox patients off of buprenorphine specifically and was later found to be just as effective with every other form of opiate. This technique is not suitable for all patients. Individuals must be carefully screened by the physician to determine appropriateness for this type of treatment.
Appointments are available at convenient times both before and after common working hours, so you can undergo outpatient opiate detox without missing work. The downtown Delray Beach location is convenient and very easily accessed by patients living in Delray Beach, Boca Raton, Boynton Beach, Lake Worth, Deerfield Beach, Fort Lauderdale, Coral Springs, Coconut Creek, and West Palm Beach.