FM Talk 1065 Podcasts
Time for a Check Up Dr Luke Engeriser from AltaPoint 7-15-24
[MUSIC PLAYING] This is Midday Mobile with Sean Sullivan on FMTalk1065. Welcome back. Midday Mobile on FMTalk1065 and time for a checkup. And good to see this man back in studio. Always good to see Dr. Luke Ankerizer from UltaPoint. Welcome back. Thanks for having me again, Sean. This is a new part of what y'all are doing. With UltaPoint this expansion, it's a six-- Come first step. Yeah, so we talked before about the behavioral health crisis center here in Mobile, right? And open for about three years. And one of the unmet needs that we've really helped with at the crisis center has been people that are trying to get away from alcohol and other drugs. And due to the really intense community need, we have built a standalone six-bed medically managed withdrawal unit specifically for people with these issues. You've talked with me before about this, and there are those two parts. There's like ongoing outpatient working with people, but there is-- especially you talk about opioids and then alcohol there. Sometimes you have to have a-- What was the old term was detox, right? Yeah, yeah, so the old term is detox. We call it medically managed withdrawal. OK. Yeah. [LAUGHS] But that thing that we all know, and that is-- is that in all cases or do you work with some-- does everybody go through that? Who has one of these problems or has it? Not everyone necessarily needs medically managed withdrawal, but most people that have a very serious history with regular alcohol and opioid use will need help with that first death. Now, listen to this. Dr. Inger Eishron, I talked about this before. It was surprising. Alcohol, people thought, eh, you know, it's-- I don't want to use the word benign, it's not. But it's one of the things that just cold turkey, another non-medical term coming from me, could kill you. Absolutely, and-- Alcohol, alcohol. Alcohol, yeah. And one of the problems, somebody that really wants to stop using alcohol and opioids, the first step is stopping and then going through the withdrawal. That can be incredibly painful and uncomfortable. With alcohol, as you said, it is medically dangerous as well. I mean, just surprise me, because I thought, you know, because it's the way it's ubiquitous in the society. And here's this thing that could be deadly if you just cold turkey. Yeah, so when somebody-- if someone's been using alcohol regularly when they stop using, they can go with withdrawal. And kind of on the mild side, maybe an elevation of blood pressure, heart rate, some shaking in their hands. But that, as that progresses, it can lead to very serious medical outcomes, like seizures or confusion and disorientation that we call delirium tremens. It can even lead to death, if not treated. On the opioid or the fentanyl side, too, you've talked about ways to lessen that as people get clean or get off this. There's ways to ease that, right? Yeah, absolutely. And with opioids, typically not by threatening, but so incredibly painful, you know, somebody that is trying to-- I hear people say you get sick. Oh, so sick. So, you know, intense joint aches, nausea, vomiting, diarrhea, sweating, increase in anxiety, not able to sleep. And this can go on for days and days. And, you know, somebody that's really motivated to stop, they just can't go through that. It becomes just so excruciatingly painful. It becomes the impediment, becomes the wall, even though they're sold or their brain, whichever, maybe part of both, wants to get to the other side of this. Right, right, yeah, I know. But it's just so painful that they're not able to do it on their own. So, okay, so you got the facility here, first step. But what are they-- I mean, they're medicines, right, that you can use to-- Yeah, yeah, so we treat alcohol withdrawal and opioid, which are all very differently with different kinds of medications, but medications are very effective. So on the alcohol side, we-- well, for both opioids and alcohol, we typically will use a medicine called gabapentin, which can decrease the anxiety significantly. For alcohol specifically, we use a class of medications called benzodiazepines, specifically a medicine called adavant, which can help somebody safely and comfortably get through alcohol withdrawal. And then on the opioid side, we use a medicine called buprenorphine or commonly known as suboxone to help people with opioid withdrawal symptoms. Okay, so they go through that process here with the medicine and the facility. But then eventually, it's over, right? Or how do you make sure you mitigate the amount of people going right back to it? Yeah, so we are focused at first step is to get people through that acute withdrawal period, but then that's not all we do. So we have peer specialists that connect people with community resources, 12-step programs. We have discharge planners and therapists that can really help people with kind of getting the social supports that they need. On the medical side, there are medications that will help people stay in recovery. So we have medications that can help significantly with alcohol cravings and opioid cravings. And we will typically start those when somebody's getting towards the end of that withdrawal period. But I mean, that's the mental side, right? 'Cause we go through the withdrawal, the physical side of it. But let's say it's out of their system, we've gotten through using these techniques, but there's still something. There's still something. There's when, if somebody's using substances regularly, there are changes in the brain that are not permanent, but they can be lasting for months after somebody stops using that substance. And kind of because of those brain changes, there could be very intense thoughts of going back to using substances that we call cravings. But we have really effective medications that can really reduce those cravings and help somebody stay in recovery. - Okay, so it is, you deal with it acutely, but then you deal with it afterwards with the maintenance. - Exactly, and we connect everybody with either outpatient or inpatient programs, depending on what they need to help foster that continued recovery. - Okay, so unmet need being met by what y'all are doing. Somebody listening to us themselves or want to give this information to somebody else. I mean, is this something, do you have to have a recommendation? How do they get to it? - Best first step, they can just call all two points access to Caroline. That's two, five, one, four, five, zero, 22, 11, four, five, zero, 22, 11, just call that number, say what kind of help they're looking for. And they will help walk them through that process. - Dr. And Guru Rancher has always appreciated having you on the show and come back soon. - All right, thanks so much, Sean. (upbeat music) (upbeat music)