Hope amid withdrawal


    The Bridge is attached to the ear with electrodes that target certain pathways in the brain to help ease withdrawal symptoms and pain. Mail Tribune / Denise Baratta

    In the midst of heroin withdrawal, Brandi sat with her head in her hands as she suffered through nausea, aching muscles and bones, sweating, body tremors, anxiety and the almost overwhelming urge to bolt from Rogue Valley Fresh Start Detox and find a fix.


    Dr. Shawn Sills, medical director for the detox center in downtown Medford, cleaned her ear with alcohol, then used a light to find concentrations of nerves in her ear. He stuck a tiny device behind her ear and implanted three wires into her skin to deliver electrical pulses.


    Three minutes after being fitted with the Bridge device, Brandi — who asked that her last name not be used — was noticeably more relaxed, with occasional smiles crossing her face. Although she still felt nauseated, her body aches, sweating and shaking subsided.


    "I'm not crawling out of my skin like I was before," said Brandi, who became addicted to opiate painkillers after a back injury, then moved on to heroin. "It was a feeling like, 'I want to use. I want to get out of here and go take some heroin.' "


    Brandi is the second patient in Oregon to be treated for withdrawal with the new high-tech Bridge device, according to its distributor.


    The first, a man suffering even worse withdrawal symptoms, was treated earlier this month by Sills at the detox center. He also experienced relief within minutes.


    "The patient was in severe withdrawal," Sills said. "He was tearful, shaking and nauseated and crawling out of his skin. And within 15 minutes of placement, his withdrawals were almost entirely absent. He was laughing and feeling completely normal."


    Sills said seeing the transformation felt like witnessing a miracle.


    "The response couldn't have been quicker even if we gave him a dose of heroin," he said.


    The Bridge device is part of an emerging class of treatments called electroceuticals that use electricity instead of medication to target a variety of medical problems. The Bridge device has been cleared by the Food and Drug Administration for the treatment of acute and chronic pain, according to its maker, Indiana-based Innovative Health Solutions.


    With the device so new, Sills is working to get insurance companies to cover costs and fees, which he estimated at about $1,000. He plans to use the device at Touchstone Interventional Pain Center in Medford as well as at Rogue Valley Fresh Start Detox.


    Sills is hopeful the Bridge device can help people addicted to opiates, including prescription painkillers and heroin. He has special empathy for addicts after developing an addiction himself, then having to seek treatment and rebuild his medical career and reputation.


    When people try to stop using, withdrawal symptoms that include diarrhea, nausea, vomiting, sweating, restless legs, anxiety and insomnia often drive them to take drugs again.


    "It's like having the flu, but also having a shot of adrenaline. With the flu, you feel sleepy and tired. With withdrawal, you feel as sick as the flu, but your mind is racing," Sills said.


    He said the emotional changes in people fitted with a Bridge device are the most striking.


    "Early in the detox process, people get squirrelly and they want to bail. If we can retain them and get them into treatment, they have a one-in-two chance of success, versus a one-in-10 chance," Sills said. "The craziest part to me is the emotional change. They go from feeling the world is caving in on them to feeling hope in minutes."


    Opiates suppress activity in key areas of the brain and brain stem responsible for homeostasis, or equilibrium. When opiates are removed from a person's system, the suppressed areas respond by becoming hyperactive — triggering withdrawal symptoms. The Bridge device reduces those symptoms by stimulating areas of the brain through nerves concentrated in the outer ear, according to Innovative Health Solutions.


    Although different medications are available to treat various withdrawal symptoms, they aren't perfect.


    "Some detox medications have side effects, and some of the medications are also addictive. This is a way of detoxing someone without using other addictive substances," Sills said.


    The Bridge device works for approximately five days, allowing patients to go through the withdrawal process with less suffering. Patients wear it day and night, but must keep it dry while bathing.


    Withdrawing with detox medications takes twice as long, because the medications must clear a patient's system before he or she can move on to the next stage of treatment, Sills said.


    Once heroin, opiate painkillers or detox medications have cleared, a patient can begin a treatment program with Naltrexone, known by the brand names Revia and Vivitrol. Naltrexone helps prevent drug and alcohol relapses by blocking a patient's ability to experience a high from drugs.


    Patients have a 10 percent chance of breaking their addiction without help, but success rates improve to 50 percent with Naltrexone treatment, Sills said.


    At Rogue Valley Fresh Start Detox, patients are required to have an outpatient or residential treatment plan in place before they start the withdrawal process. The clinic can provide medically monitored detoxification and stabilization services to eight patients at a time. Their average stay is five days, said Anne Daugherty, medical services manager for Addictions Recovery Center, which runs the detox clinic.


    She noted withdrawal is not only painful and uncomfortable, stopping the use of alcohol and some types of drugs cold turkey can be deadly. Addicts can suffer seizures and die.


    But continuing to abuse drugs and alcohol can also kill.


    With the nation suffering an epidemic of overdose deaths from opiates, Sills said the Bridge device could be a game-changer in helping patients push through the painful withdrawal process and succeed in drug treatment.


    "Failure can be death for heroin addicts," he said. "Anything we can use to allow outcomes to improve is huge."


    For more information, contact Rogue Valley Fresh Start Detox at 541-779-1282 or Touchstone Interventional Pain Center at 541-773-1435.


    — Reach staff reporter Vickie Aldous at 541-776-4486 or valdous@mailtribune.com. Follow her at www.twitter.com/VickieAldous.

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