In House Alcohol and Drug Rehab in Manhattan

Drug and alcohol detox and medication-assisted therapy can help you or a loved one stop self-sabotaging behaviors of addiction.

Drug & Alcohol Treatment

It’s not unusual for people to turn to sex, food, drugs or alcohol when life becomes overwhelming.It may seem like an easy way to cope with stress and many of life’s problems. However, these substances can quickly become problems of their own and cause your life to spin out of control. Medically supervised, in-home alcohol and drug rehab can help. It offers a compassionate, confidential alternative to high-end addiction rehab facilities.

psychiatrist  talking to man about drug and alcohol addiction

Types of Substance Abuse, Behaviors We Treat

Dr. Raymond Zakhari, NP, at Metro Medical Direct uses medication-assisted addiction therapy to help you or a loved one get off alcohol or drugs, including addictions to opioids and benzodiazepines (anti-anxiety medications).

Other unwanted behaviors can also be addressed, such as compulsive or unhealthy gambling, sex, and other habits that may have gotten out of control.

FAQs: Our In-Home Addiction Treatment & Detox Care

The first step is to seek help and schedule an appointment for detox. Detox is the process where the body naturally flushes the chemical toxins out of your system and you start to experience a physical and psychological awakening. The symptoms of withdrawal are reduced with supportive medications. Medications reduce the intensity of withdrawal symptoms. Most substances wash out of the system in 4-7 days. At that point detox is complete.

Addiction and recovery treatment begins after detox in which you engage in psychotherapy and group therapy to continue on your journey of healing. Sometimes, patients benefit from supportive psychopharmacology in the short term to help build good habits. Sometimes medications are longer-term in nature. I try to use the least amount of most effective medications.

Some medications include Naltrexone and Suboxone. Other medications include antianxiety and antidepressant medications. Drug and alcohol abuse takes a physical toll on the body. Blood pressure pills, gastric medications, and nutritional supplements are some other kinds of supportive medications.

Addiction can take many forms, such as drug addiction, alcoholism, or the abuse of pain medications. People will commonly self-medicate with chemically addictive substances. They may also engage in behaviors such as gaming, gambling, and sex addiction (more accurately called compulsive sexual behaviors) to help themselves feel better, if only for a short time.

Many patients with addiction also have an underlying mental illness such as depression, anxiety, or PTSD. It is best to treat both conditions at the same time to help achieve and maintain sobriety.

Because addiction takes a toll on the whole family, many clients benefit from a family system approach to addiction therapy. This comprehensive approach requires a team of experts to collaborate to get you the best possible care.

Dr. Zakhari works with Family Addiction Specialists in Brooklyn, New York, to provide a one-stop-shop solution – including everything from crisis intervention to recovery maintenance – for high net worth individuals and families dealing with addiction.

There are a variety of medications we may use that can help prevent alcohol or drug abuse, including:

  • Naltrexone (Vivitrol®), which comes in tablet and long-acting injection form. These pharmaceuticals can help reduce a person’s dependence on alcohol or drugs by preventing the pain relief and euphoria that come with certain substances like opioids.
  • Suboxone®, which consists of buprenorphine and naloxone, can ease withdrawal symptoms while preventing abuse.

Recovery maintenance therapy offers the highest success rates when treating drug or alcohol addictions or other types of unwanted behaviors. This includes therapeutic intervention that can help prevent relapse after detox. It includes how to make healthier choices and strengthening a patient’s coping mechanisms.

When needed, in-home detox care can be a good alternative to inpatient detox.

Dr. Zakhari works with Alliance Home Care, a concierge nursing agency that provides the required registered-nurse level of care for alcohol or benzodiazepine detox in the home over the course of 7-10 days.

During an alcohol or benzo detox, the registered nurse will monitor a patient’s vital signs and clinical indications of withdrawal (CIWA or COW scores) to assess their stability to be able to complete the detox at home. A patient’s withdrawal scores are based on the following:

  • Clinical Indications of Withdrawal Alcohol (CIWA) Scale: This helps quantify how likely a patient is to have severe adverse effects from alcohol or benzo withdrawal that, if not timely and sufficiently treated, may be fatal. This is why direct supervision by an RN is essential to a safe and effective at-home detox.
  • Clinical Opioid Withdrawal Scale (COW) Scale: This scale is used to quantify a patient’s symptoms of opioid withdrawal to better time the suboxone dose or bridge device for the most comfortable results. If suboxone is taken too soon, it can lead to more intensely experienced withdrawal symptoms.

The RNs from Alliance Home Care work with Dr. Zakhari to ensure your medications are adjusted appropriately throughout all phases of the detox.

Most people stop having symptoms between 4-7 days from last use. Sober maintenance therapy can start between days 7-10 if using Vivitrol. Supportive medications can be continued long-term as needed.

The CIWA scale is used by the registered nurse or trained sober companion to monitor your withdrawal from alcohol so that it can be safely done in the home.

The COWS scale is used by the registered nurse or trained sober companion to monitor your withdrawal from opioids including Oxycontin, Fentanyl or Heroin, to make your detox more comfortable.