LGBT Drug Treatment Blog

State medical board says Dr. Clifford Bernstein failed to treat woman’s symptoms after rapid detox.
BY BLYTHE BERNHARD and COURTNEY PERKES
The Orange County Register

State health regulators have accused a well-known Newport Beach anesthesiologist of medical negligence in his unorthodox “rapid detox” drug addiction treatment program.
Dr. Clifford Bernstein released a female patient who later developed pancreatitis and other health problems after undergoing opiate withdrawal under anesthesia at Garden Grove Hospital, according to the accusation by the Medical Board of California.

The board accuses Bernstein of filling out the patient’s discharge papers without reporting her ongoing flu-like symptoms. Bernstein said that he treated the patient properly and that she had no medical problems at the time of discharge. “I am really disturbed by these allegations,” said Bernstein, 46. “She never had a fever. She never had anything wrong with her. She was just unhappy after she completed detox.”

Bernstein, who specializes in pain management, uses the Waismann Method of rapid detox from heroin or prescription painkillers such as Vicodin and OxyContin. The $15,000 procedure involves putting patients under anesthesia and flushing the opiates from the body with drugs that block the euphoria receptors in the brain that are triggered by opiates.

The Waismann Method, developed 14 years ago by Israeli doctor Andre Waismann, is offered only in Israel and Orange County. Waismann personally trained Bernstein and another anesthesiologist but said he has no role in the Southern California business operations, which are run by his sister. Freeway billboards advertise the Waismann Method and Bernstein’s Web site, which promises a quick recovery from narcotics without the brutal symptoms of sweating, shaking and nausea associated with withdrawal. The procedures are performed exclusively at Garden Grove Hospital.

The patient involved in the accusation, who is identified only as “Gina Y.” of Phoenix, received the treatment at the hospital in August 2005. The following day, she had diarrhea, vomiting and a temperature above 100 degrees, according to the Medical Board’s accusation.  Bernstein released her to the Domus Retreat for recovery in Anaheim Hills, where she continued to have the symptoms until she left three days later, state officials said. The next day, the patient was admitted to a Phoenix hospital where she was diagnosed with pancreatitis, low potassium levels, an elevated white blood cell count and dehydration.

According to the accusation, Bernstein’s colleague performed the rapid detox procedure, but Bernstein failed to diagnose the patient’s illnesses, order any tests or refer her to another doctor at the time of her discharge. “I was not the primary physician taking care of her,” Bernstein said. “She was fine to discharge. There was absolutely nothing medically wrong with her.”

In addition to the detox practice, Bernstein is a board-certified anesthesiologist who also runs Coast Pain Management of Newport Beach. According to his Web site, Bernstein “stresses the judicious use of opiate medications.” But some patients say they became hooked on painkillers Bernstein prescribed and then were encouraged to undergo his rapid detox program.
“It’s strange he (prescribes painkillers) and then he has a business that gets people off pills,” said Elaine Domino of Newport Beach, who went to Bernstein for pain from a back injury. Of her rapid detox experience, she said: “It knocks you out physically for months. I would never recommend that to anybody.” Domino says that after her detox Bernstein prescribed Klonopin, an anti-anxiety medication that experts say can also be addictive.
In 2005, Domino promoted her experience with rapid detox to the media, including The Orange County Register. Now, she says she regrets acting as a spokeswoman for the program. “I was on ‘Good Morning America,’ and I had popped 10 Klonopin in my mouth,” she said. Bernstein said he doesn’t routinely prescribe Klonopin and offered another view of Domino’s treatment: “I saved her life,” he said.

Doctors who prescribe addictive drugs while also running a detox program could give the appearance of building their own patient base, ethicists said. “On the one hand you could see how the medical expertise could be valuable in treating pain and managing addiction to those medications,” said Judith Daar, a law professor who serves on UC Irvine’s medical ethics committee. “But if there’s an active program to create business opportunities, that’s clearly an obvious conflict of interest and it’s a significant breach” of trust.
Bernstein said his experience makes him uniquely qualified. “As a specialist in pain management, I have a very thorough understanding of treating complex chronic pain,” Bernstein said. “My experience with detoxification gives me significant insight into the nature of opiate dependency and the risks associated with taking higher doses of opiates. I see no conflict of interest when patients are prescribed a responsible amount of medication. To the contrary, I feel I am more qualified than most physicians to treat chronic pain patients with opiate medications.”

Other drug addiction treatment specialists agree that operating both a pain clinic and a detox program, while rare, is not necessarily a conflict of interest. “Many addiction medicine doctors are pain management experts, too,” said Dr. Michael Stone, medical director of Cornerstone drug addiction treatment programs of Tustin. “I wouldn’t see it as a conflict as long as they’re recognizing when somebody has chronic pain or when somebody is taking 30, 40, 50 Vicodin to get high.”

Still, Stone and others said that it is rare for a doctor to actually practice both fields. He said he’s more concerned about the safety of rapid detox. “Detox from opiates – done any way but rapid – is not dangerous. It’s miserable, but it’s not dangerous,” he said. “Coming off opiates with the Waismann Method is dangerous.”
But Dr. Waismann, who developed his method after witnessing young soldiers in the Israeli army become addicted to narcotics after injuries, said the practice is safe because it employs modern medicine in the safest of environments, an intensive care unit. Waismann said he does not know the details of the state’s accusation but said Bernstein is very competent and knowledgeable. “Maybe Dr. Bernstein made a bad medical decision, but this has nothing to do with the method,” Waismann said.

Bernstein and other doctors have performed rapid detox at Garden Grove Hospital for about four years. The hospital declined to comment on Bernstein’s methods or its financial agreement with him. A spokeswoman said the hospital treats about 25 rapid detox patients each month. Rapid detox, which includes Waismann and other anesthesia-assisted methods, has been in use for more than 10 years in the U.S. but remains controversial for its expense, the lack of scientific studies verifying its success and a link to patient deaths.

The Journal of the American Medical Association in 2005 issued a report that said rapid detox offers no benefit over other detox programs, is not less painful and can be life-threatening. The American Society of Addiction Medicine has said the procedure should not be used because of uncertain risks. The lure of a pain-free withdrawal plays into patients’ and families’ desperate hopes for an easy cure, some addiction specialists say.
“Rapid detox is, from a marketing point of view, a very attractive product,” said Rick Rawson, associate director of UCLA’s Integrated Substance Abuse Programs. “Addicts and their families want to believe there’s a quick fix. Yes, you can do an overnight detox. You still have to do all the work to learn how to be a sober person and live a life that will support sobriety.”

Rawson said that opiate addiction is traditionally treated with methadone and ongoing intensive therapy, and that there is not enough evidence to show rapid detoxification is a more effective or safe option.
Rapid detox under anesthesia has drawn the attention of medical regulators in the past. The number of doctors offering rapid detox has declined since New Jersey physician Lance Gooberman was suspended in 2003 following the deaths of seven patients. Last year, two Michigan doctors received suspensions after the deaths of three patients. “This isn’t a procedure that has acceptance in the professional community, and there really should be more research before this is sold on the open market,” Rawson said.
Bernstein said his method is successful, safe and its detractors just don’t understand it.
“Most opposition is from professionals that do not understand what I do, or even try to find out,” he said. “I am always open to explain our procedure with addiction specialists.”

Bernstein has been named in several lawsuits over his pain management and detox practices. In April, the adult children of 54-year-old Candy Street sued Bernstein for wrongful death, alleging she suffered irreversible brain injury after receiving an injection to treat neck pain and headaches. The complaint states that Street stopped breathing after receiving an injection in Bernstein’s office, which had “inadequate and insufficient resuscitation equipment.” She was transferred to Hoag Hospital and died 10 days later, the complaint says.
In another case now in binding arbitration, Bernstein is accused of having performed rapid detox on a woman who went off medications for her endocrine disorder and subsequently suffered permanent health damage.
In another suit, a woman who suffered back pain after a 2001 shuttle bus accident alleged that Bernstein and a colleague prescribed so many opiate pain medications that she became addicted and had to undergo the Waismann Method. Her attorney, Federico Sayre, said the case was dropped last year after the woman received a large settlement from the accident. Bernstein declined to comment on the two pending cases, but he said the latter had no merit.

Bernstein said he’s successfully treated more than 2,000 patients in seven years. He said his patients, who typically became hooked on OxyContin or Vicodin after injuries, felt uncomfortable in traditional rehab settings.
“I’d send them to a drug detox center for rehab, and they’d be very upset, saying, ‘We’re not drug addicts, we don’t identify with those people.’ ”

He said treating addiction as a medical condition is a humane way to remove the body’s cravings for drugs, when compared to methadone clinics or 28-day rehab stays.

“The Waismann Method is good, common-sense medicine that gets patients off drugs,” Bernstein said. “I cannot understand what would be the objection to such treatment when done appropriately by an experienced physician.”

As a gay man it was not so easy to locate a drug rehab that I felt comfortable with. All the drug rehabs said they could provide me with good care and told me that sexuality didn’t matter. Rehab was rehab and people were people. I would have liked to see them say that without smiling.

I have been in rehab before and know that what they said is true, but until you have had a therapist that is homophobic you haven’t lived. Here was this guy saying he would help me, when he was scared to death of who I was. He was telling me to be honest, develop trust and not to be judgemental. Child please!

Take it from me and do your homework. Not all drug rehabs are the same. They all have their own way of doing things and you have to find one that works for you. Make sure the rehab has a staff that knows how to deal with our issues and doesn’t have issues with us. don’t worry, I finially found a rehab with a program that understood my needs and really treated me as an equal. I hope you do too.

Drug Rehabilitation
Drug rehabilitation is a term used to describe the process by which an individual gains the understanding and tools to rebuild their lives and learn to live a normal, drug and alcohol free life. Often drug rehabilitation is not only the process of going through a drug rehab, but also a life-long process to abstain from drug use. Drug rehabilitation consists of many different phases. First and usually most physically demanding, is the drug detox phase. It is in this phase of the rehab process that the toxins resulting from the drug abuse are removed from the body. Depending on the seriousness of the drug addiction and the drugs used, this process can take anywhere from a few days to several weeks. Complete drug rehabilitation cannot begin until the body has become independent of the drug’s harmful and addictive toxins. Secondly, drug rehabilitation moves on to the educational and skills-building phase. In this phase, the addict meets with counselors and undergoes group and individual therapy to understand the powerful illness of addiction and the most effective ways for that individual to overcome his or her disease. The length of this process depends on the individual and severity of the drug addiction. Often, for more serious addictions, long term drug rehab is recommended, lasting a period of 2 to 3 months. The third and longest phase of drug rehabilitation is after rehab has been completed. It is in this phase that an addict must take the skills learned at the drug rehab and apply them to the real world in order to maintain sobriety. This process will not end for the rest of the addict’s life and it is here that many addicts experience relapse, forcing them back into the drug rehab process, starting at the beginning with the often painful and dangerous drug detox phase.
With the continuing rise in numbers of people addicted to illegal, prescription, and over the counter drugs and alcohol, drug rehabilitation centers have played a central role in helping millions recover from the often life threatening disease of addiction. Since so many different kinds of people suffer from drug addiction, including more and more teens these days, a blanket approach to drug rehabilitation is no longer efficient in this battle. Today, drug rehabilitation comes in a variety of forms, some of which include residential, outpatient, sober living homes, support groups, and long term rehab. In the fight to regain control over their lives, addicts and alcoholics must determine what kind of addiction treatment is best for their rehabilitation to be successful. Some mild cases of drug addiction are adequately addressed by outpatient drug rehab programs. Here, the addict can attend therapy and counseling sessions on a group and individual basis several times a week for a few hours after work, then return home at the end of the day. Many of these programs are coupled with group meetings like Alcoholics Anonymous as well. For more serious addictions, many drug rehabilitation centers offer residential treatment programs. Here, an addict will undergo more intense therapy in a residential setting where they will live amongst certified counselors and therapists for whatever length of time is necessary. Generally, the minimum length of time spent at a residential drug rehabilitation center is 28 days, however depending on the severity of the drug addiction, some addicts may require longer stays up to and beyond 3 months. These residential treatment programs are usually coupled with support groups. For many addicts, it is recommended that they continue aftercare once the drug rehab program has been completed. In this part of the drug rehabilitation process, an addict will live at a place called a sober living home. This is more like a transitional living environment where recovering addicts will live amongst one another in a substance-free environment while attending work, school, and other outside activities. This serves as a way for addicts to apply the skills they’ve learned in drug rehabilitation to the real world, while still remaining under the umbrella of support they had in drug rehab. Sober living can serve as a gradual, more seamless transition back into society.

An alcohol rehab consists of three general alcoholism treatment option steps. These three steps are intervention, alcohol detox and rehab. Many persons with a drinking problem do not see or acknowledge that they have a problem with alcohol abuse. Intervention used in an alcohol rehab program used to be more confrontational since problem drinkers would be confronted about their excessive drinking and threatened with consequences if they did not begin rehab.

Today, the more effective alcohol treatment option consists of caring and understanding counseling and intervention. Studies have found that more people begin an alcohol rehab program when family members or employers are honest with them and try to help the drinker see that alcohol abuse is adversely affecting their health and lives in many ways. Family or friends may need to help start the process of drinking problem recognition by reading relevant books on the subject to become better informed, by contacting their healthcare professional or by locating the nearest Alcoholics Anonymous or similar group.

An alcohol treatment program intervention is a structured process where a group of family members, friends or co-workers get together in a caring way to communicate their concerns about a problem drinker’s behavior. Done correctly, intervention has the objective of moving the person (and those who are part of the problem drinker’s life) out of crisis mode and into addressing the addiction. Without the problem drinker recognizing and acknowledging that he or she has a drinking problem, there can be no effective and lasting alcoholism treatment option.

Here are the three main alcohol treatment program steps:

1. Intervention - this is the initial alcoholism treatment option whereby the drinking problem is recognized and acknowledged by the drinker and perhaps family members or employer as well. Once the alcohol problem is recognized, alcohol consumption is stopped for those persons that are alcohol dependent.

If the person is a problem drinker and not alcohol dependent, moderate drinking may be successful. Many alcoholics at first will not acknowledge that their drinking is out of control, and moderation can often be a successful way to deal with the drinking problem. If moderation works, the drinking problem is solved. If it doesn’t work, then the person is usually ready to try abstinence. Because alcoholism affects the people closely related to the problem drinker, education and treatment for family members through counseling is often necessary.

2. Alcohol Detox - this phase of an alcohol treatment program usually takes from 4 to 7 days. The more alcohol a person has been drinking each day, the higher the likelihood the person will develop alcohol withdrawal symptoms when they stop drinking and require alcohol detox.

Alcohol withdrawal symptoms can range from annoying and uncomfortable to serious and even life-threatening. Withdrawal symptoms generally begin within 12 hours of the last alcohol consumption and will be the maximum in two or three days.

The person may need to stay at the detox for medical observation. In a medically supervised environment, withdrawal from alcohol can be done safely, and medications can be used as needed to relieve withdrawal symptoms. Other medical problems that may exist increase the likelihood of developing severe withdrawal symptoms. For example, blood clotting and liver problems are often found in heavy drinkers, and serious symptoms such as convulsions, fever or delirium tremors can develop.

3. Alcohol Rehab - recovery from alcoholism should include support for the problem drinker once the alcohol detox phase is completed to help maintain alcohol abstinence. This important recovery support will likely include counseling, nursing and medical care within these kinds of programs. Alcoholism disease education and alcohol effects on the body should be part of this alcoholism treatment option and rehab.

An alcohol rehab can be an inpatient or outpatient program. Medications are sometimes prescribed in alcoholism treatment to help prevent relapses. Naltrexone will reduce the desire for alcohol. Antabuse is another drug that is used in alcoholism treatment. It functions by producing unpleasant side effects if any alcohol is consumed within fourteen days after the drug is taken. Counseling or support groups are often needed on a long-term basis to help maintain sobriety. Alcoholism and alcohol abuse can become life-threatening if not treated. It is never too late to begin the process of intervention, detoxification and rehabilitation to help a problem drinker regain control of their health and their lives.

If you’d like to see what alcohol rehabs exist, call the national helpline at 1-800-99-DETOX.

I am in addictions therapist at a top tier residential drug and alcohol rehab. While sitting around the lunch table this afternoon someone mentioned that they heard that the patient census in residential drug rehabs across the country is at an all-time low.

We spent a good deal of lunch speculating on why this may be true. Certainly more people than ever need drug and alcohol rehab; but what has caused the sudden down turn in attendance? A plausible speculation was suggested that drug rehabs have been getting a very bad rap lately.

With celebrities and political figures treating them like weekends at the Marriott, perhaps there is a public backlash that is starting to believe that drug addiction treatment is ineffective. If true, that public perception would be detrimental to those who are sincere in their efforts to become sober. Entering drug and alcohol rehab has become the butt of jokes by late night comics. There seems to be an even bigger yo-yo effect than being on a starvation diet.

There is no question the drug addiction treatment works. It works best for those who are actively seeking actual drug treatment. Perhaps some people are using drug rehabs as contract negotiation ploys, to mitigate or reduce legal sentencing, or just to hide out and escape responsibilities.

If these are the reasons that people entered drug rehab, it is no wonder that they are soon drinking or drugging again. I believe that every single person has the ability to never drink or drug again, but it takes time and absolute prioritizing of commitment to abstinence to do so. For additional information relating to locating a quality drug rehab, you can call the national addiction helpline at 1-800-99-DETOX.

Drug Addiction Treatment and Addiction RecoveryAdmission is necessary as the first step in the management of drug addiction. After admission to rehab, the addict needs a complete evaluation. This is done by interviewing the patient as well his family members and close friends. The evaluation is done for two purposes:
1. To determine the causes resulting in drug addiction.
2. To determine the degree of their motivation to participate in drug addiction treatment.

Immediate and complete withdrawal of drug addiction results in extremely distressing and even dangerous withdrawal symptoms. The drug should be, therefore, gradually withdrawn over a period of time in a drug detox program. Sometimes, the drug is substituted with another drug having similar effects but which is less harmful. In any case, drug detox needs to be medically monitored while the patient is in rehab.

Management of Dual Diagnosis

In case of an associated mental disorder, dual diagnosis treatment is started along with the withdrawal of drugs. Dual diagnosis treatment is the treatment of drug addiction and mental health issue.

Drug Addiction Treatment

The patient should be encouraged to participate in group psychotherapy. He should receive emotional support from the rehab staff and the family members. Some insight into his problems is necessary so that he may be encouraged to seek and continue further psychotherapy following discharge from the rehab program. This rehabilitation is very essential to keep him away from drug after discharge. Relapse rate is very high in addicts, especially among those who do not follow the aftercare plan developed while they were in their addiction treatment center.Addiction is resorting to self abuse and the help of unnecessary medication or intoxicating sources, to overcome certain self-determined ‘impossible situations’. A person could be an addict of habit, medication or drugs and alcohol. The relief experienced is temporary and only indulged in as a ‘get away’ from the realities of life. While some indulge in such self-abuse in times when their financial or social standing is affected, some resort to the demeaning behavior to handle broken love affairs and yet some others, especially adolescents, to experiment.

Management of drug addiction is a strategy adopted by immediate society to help a person deal with the so called ‘impossible situation’ and provide all the external support for internal healing. The entire process is extremely painful to the person and family. Many addicts go through ‘withdrawals’, where the person’s craving for the drug becomes acute and violent. Nevertheless, management of drug addiction can be successful. It takes immense patience and perseverance by both, the addict and his immediate social circle.

Management of drug addiction could be handled either by professionals at the different addiction treatment centers or by private counselors, depending on the extent of the indulgence and the mind-set of the individual. There are various tried and tested methods, tools and resources that are adopted, to deal with the self-abuse. For additional information relating to drug addiction treatment or drug addiction in general, call the national addiction helpline at 1-800-99-DETOX. 

I don’t know, why you asking? If you are asking if you need drug addiction treatment because your

drug use is starting to cause more problems in your life,

then maybe you’ve answered your question.

If it were only that easy. One thing about people who have become chemically dependent is we want to continue to use as much as possible, as long as possible. We will make up fantasies, stories, and what really amounts to insane rationalizations to convince ourselves that is OK to keep on with our addictive use, despite the growing wreckage around us.

When it gets to the point where considering drug addiction treatment the stories and fantasies we have surround ourselves with have begun to crack. Reality sets in. We become aware that we need more and more drugs to get high, or worse yet they have stopped working. The time between drug use episodes has gotten shorter and shorter and when we’re not using we are sicker and sicker. These are indications of classic drug addiction symptoms of tolerance and withdrawal.

We can no longer convince ourselves that we’re not hurting people around us and ourselves, but the urge to continue the use is there as strong as ever. That’s the really scary part. We know we’re destroying ourselves and everyone around us yet the pull from inside, the gut wrenching stomach level, is to go use the drug, at any cost. What’s that all about? I don’t get the urge to repeatedly bash myself in the face with a hammer. But I think about one more high.

Well the answer to that question is about another characteristic of drug addiction called compulsion an obsession. The intellectual decision to stop using by itself is not enough, if it were, we would have stopped hundreds of times already, every time we said this was the last. To my mind, the only way to put an addiction in a state of remission, is with some outside help.

The best suggestion I can offer in getting started to seek drug addiction treatment is to get an assessment by a competent professional. There are different levels and types of addiction treatment available and not all are appropriate for all people. a competent assessment by an addiction professional will increase your chances on being matched to an appropriate drug addiction treatment program.

To locate an effective addiction treatment center you can call the national helpline at 1-800-99-DETOX. 

At one point, when you mentioned rehab for the gay and lesbian people thought it meant changing them into heterosexuals. May be it is hard to believe, but it is true. Today we understand that rehab for the LGBT is no different as for the heterosexual, it means treatment for drug addiction, treatment for alcoholism or treatment for dual diagnosis.  It has gotten to the point that there are even rehabs which specialize in providing addiction treatment for the LGBT. Now that is a change.

Gay rehabs are not necessarily  different than any other with the exception of being population specific. research has shown that it is actually better for the patient to be treated in a rehab with everyone else with specific groups designed to help address LGBT specific issues. This design can happen in any rehab as long as the clinical staff is trained on how to best address particular issues. The worst thing an untrained therapist can do is re - traumatize a patient.

To locate a gay friendly rehab, please call 1-800-99-DETOX.

One of the questions that we often receive is to explain the difference between drug detox and drug rehab. Detox is the process of helping people safely stop taking drugs or drinking alcohol. Rehab is the process of helping people address and handle the reasons that they were addicted to a drug or alcohol.

Detox is the first step of rehab because the person has to be withdrawn from the drugs or alcohol before the rehab process can commence. In many cases it is proper to do the detox in the drug rehab because there is no real medical risk. In other cases, there is a serious medical risk if a person stops taking the drug or drinking alcohol so a medical detox is required. In either case, a structured environment is best for the person to compelte drug detox.

When asking for a detox program, please keep in mind that detox without rehab generally ends in relapse. One of the main responsibilities of the staff in detox is to evaluate each person for the level of care they require. In almost every case, any person who requires detox, requires rehab.

For additional information on detox, go to www.99detox.com or call 1-800-99-DETOX. 

Lasting addiction recovery requires subscribing to an equally lasting approach—one which makes it clear what’s at stake and how best to address it. Addiction recovery is, at its heart, an emotional phenomenon, driven by the experiences, convictions and memories that drive so much of human psychology. That means the surest way to find lasting relief is in the hands of a trained professional.

A number of drug treatment programs fail to initiate such one-on-one contact, and this may be one of the main reasons why they tend to fail. The truth about emotional discovery is that it is often best achieved in more private settings, even when group therapy is abundantly available. If you can find a addiction treatment center that makes time for individual care such as this, you may rightly consider yourself most of the way there in your efforts to defeat that addiction.

The good news is that drug addiction can indeed be treated, and these days more addiction treatment centers than ever have begun availing themselves of modern techniques. From massage and meditation through substantive detox and hypnotherapy, you want to look for programs that cover all the bases throughout your stay. If you can find licensed physicians who may be able to offer concurrent diagnoses, all the better.

Getting real help for addiction recovery is easier than it has ever been. To locate a quality drug rehab whose effects are long-lasting and restorative, simply look around the Web for well-established drug treatment programs that provide lots of individual attention.
If you require help in locating a reputable addiction recovery program, you can call the national addiction helpline at 1-800-99-DETOX. This addiction helpline is toll free and does not charge for evaluations or referrals.