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Substance Use Disorder

Atlantic Family Physicians – Sussex County

Personalized Treatment Plans

Delaware is a beautiful state known for its historical landmarks, distinction as “The First State,” and lack of sales tax. Sadly, this state is also home to many experiencing substance abuse problems — ranging from alcoholism to opioid use disorder to heroin and fentanyl addiction.

If you or a loved one is dealing with problems such as these, know that in Sussex County, Dr. Fabricio Alarcon one of the few internist in the state of DE also board certified in addiction medicine.

Our Georgetown-based practice offers patients an effective alternative to traditional drug and alcohol programs. You can count on our skilled team to help you through what is often an enormously challenging ordeal.

What’s more, our out-patient practice offers lifesaving Medication for Opiate Use Disorder (MOUD). Many find this to be a more desirable alternative to an in-patient rehab facility. We make every effort to make this treatment easy and comfortable. We will accommodate appointments within 24 hours and even same day. We use telehealth services to facilitate the visits

Our Team

Dr. Alarcon and his staff of experienced nurse practitioners are prepared to prescribe and treat patients in need of Medications for Opioid Use Disorder. We provide the resources and assistance that help our patients recover for a healthier life.

The professionals at Atlantic Family Physicians have a genuine passion for their work and take great pride in helping patients recover from the problems they face. With drug addiction problems on the rise across the state, we are dedicated to doing our part to help those who need excellent assistance.

In short, Atlantic Family Physicians is uniquely qualified to offer addiction-related services to patients in Georgetown, Rehoboth Beach, Lewes, and beyond.

Substance use disorders include the use of alcohol or illicit drugs ranging from occasional abuse to dependence to a deep level of distress or impairment.

Unfortunately, the number of people who experience this disorder is rising. Based on data from the National Center for Drug Abuse Statistics, nearly 32 million people (more than 11.5% of the country’s population) actively use drugs, with marijuana, prescription stimulants, and methamphetamines at the top of the list.

Just over 15% of United States adults reported an increased or new substance use due to Covid-related stress. Drug overdose deaths across the nation also increased from about 72,000 to 93,000.

This significant uptick in the use and subsequent deaths related to these substances has affected a disproportionate amount of people of color. However, the greater number of deaths remains associated with white individuals.

The most significant and medically challenging contributor to this high number of deaths results from an Opioid Use Disorder (OUD). Of all drug overdose deaths in Delaware, more than 90% were related to opioids. This accounted for more than 400 deaths during that year in Delaware alone.

Based on information from the DEA, the main drug threats in the state include:

  • Illicit opioids
  • Cocaine
  • Controlled prescription drugs
  • Methamphetamine

Of the opioids that present a problem in the state, heroin, fentanyl, and fentanyl-related substances are considered the most dangerous.

Anyone suffering from opioid addiction deserves the care of a physician with Dr. Alarcon’s experience   prescribing MOUD. In the Georgetown / Lewes / Rehoboth Beach area, Dr. Alarcon is among the few who understand the proper treatment methods and level of care required to prevent tragic deaths from these substances.

If you or a loved one is looking for a way out of addiction and dependence, don’t hesitate to contact our office right away.

What to Know About Alcohol Addiction and Dependence

Overcoming an addiction of any kind can take time and patience. This applies to alcohol addiction as much as it does addiction to drugs. Excessive drinking can cause a number of problems in your life, such as:

  • Behavior and mood changes
  • Heart problems
  • Liver damage
  • Pancreas issues
  • Elevated risk of some kinds of cancer

Stopping the consumption of alcohol can feel impossible and be exhausting when attempted without professional assistance. The team at Atlantic Family Physicians can help you create goals, prepare for the change, and assist you in finding solutions.

Rather than going into residential treatment or choosing a partial hospitalization option, you will appreciate the benefits of out-patient treatment. This lets you live your life while working to break an addiction to alcohol.

Atlantic Family Physicians focuses on you as a whole rather than simply treating the symptoms of alcohol addiction. We’ll ensure your body and mind are working at their best to make it easier to kick your addiction once and for all.

Reasons to Choose Medicated Treatment for Alcohol Addiction and Dependence

Among individuals who use alcohol frequently and/or in large amounts, stopping use without assistance can be extremely dangerous. When you stop drinking alcohol, your body feels deprived of something it is used to. This can lead to symptoms that range from mild to moderate to severe.

Both physical and psychological withdrawal symptoms may occur when you stop drinking.

  • Moist, clammy skin
  • Headache
  • Heart palpitations or rapid heart rate
  • Increased blood pressure
  • Insomnia
  • Pale skin
  • Sweating, frequently on the face or palms
  • Tremor in the hands
  • Vomiting and nausea
  • Anxiety
  • Depression
  • Nightmares
  • Feeling nervous or on edge
  • Irritability or becoming easily excited
  • Rapid mood swings
  • Shakiness
  • Trouble thinking clearly

If these symptoms are not treated, withdrawal can lead to alcohol withdrawal delirium. This may include seizures —  a life-threatening problem. Nearly one in 20 people who experience delirium tremens (DT) die due to the withdrawal symptoms.

Benzodiazepine Addiction and the Complications of Withdrawals

Benzodiazepines and alcohol have the most severe withdrawal symptoms, including death. Benzodiazepines (sometimes shortened to benzos) include medications commonly used to treat panic, anxiety, seizures, and insomnia.

Benzos include many different drugs that differ in how quickly they work, how long they work, and what they are prescribed for.

  • Xanax, Librium, Tranxene, Valium, and Ativan are used to treat anxiety disorders.
  • Klonopin, Tranxene, Ativan, Onfi, and Valium for prescribed for seizure disorders
  • Prosom, Dalmane, Doral, Restoril, and Halcion are used for trouble sleeping and insomnia.
  • Versed, Ativan, and Valium may be used in anesthesia.
  • Valium is sometimes prescribed for muscle relaxation
  • Librium is also used for alcohol withdrawal symptoms.

Whether prescribed or taken illicitly, all benzos have severe withdrawal symptoms. Stopping use of them without professional help can lead to various symptoms. During the early stages, a patient may feel symptoms of the original condition the drug was prescribed for coming back or worsening.

Withdrawal symptoms can last from five to 28 days on average but may last for months in some patients. In individuals who have used benzodiazepines for at least six months, withdrawal symptoms can be extreme. Some of them include:

  • Aches and pains
  • Anorexia
  • Anxiety and panic attacks
  • Concentration issue
  • Delusions or hallucinations
  • Depression
  • Detachment from reality
  • Grand mal seizure
  • Hypersensitivity
  • Hyperventilation
  • Insomnia
  • Muscle spasms
  • Nausea and vomiting
  • Strange bodily sensations
  • Sweating
  • Weight loss

In the worst case, withdrawal from benzodiazepines can lead to death. Dr. Alarcon is experienced in designing treatments that stave off many of these symptoms and ensure the recovery process is a smooth one.

Out-Patient Opioid Addiction Treatment

At Atlantic Family Physicians, medications for opioid use disorder are provided in a primary-care environment where patients feel more comfortable and cared for.

Patients opposed to entering an in-patient drug or alcohol rehab center can receive the necessary care to fight their addiction in a safe, private environment.

One of the primary goals of our MOUD doctor, Dr. Alarcon, is to help alleviate some of the stigmas around seeking treatment for opioid addiction. In addition, the entire staff builds relationships with all our patients and celebrates your victories beside you.

Our staff is honored to participate in our patients’ recovery.  Our office is a place free of judgment — where you can be assured you will be treated only with respect.

What to Expect from Your First Visit

Your particular substance of choice and its frequency of usage will guide us in devising your most appropriate treatment protocol. However, there are several essential things to keep in mind:

  • Someone dependent on short-acting opiates, such as fentanyl, may not need the same tapering period as someone who uses a long-acting drug.
  • The providers at Altantic Family Physicians can help to customize your treatment to reflect your particular issues.
  • Buprenorphine-based medications are a common care choice, especially at the onset of treatment. Treatment with Suboxone, which contains both buprenorphine and naloxone, or similar medications can help ease the symptoms of withdrawal and free you from your dependency.
  • If you are prescribed one or more medications appropriate for your condition, understand that adjusting to their effects may take some time.

Typically, you will start on a low dose and be monitored to ensure your response is as expected. Your dosage may be increased or decreased as time goes on based on your body’s response.

Dr. Alarcon will continually reassess how you are progressing and make recommendations for modifications to your treatment plan. You also may be advised to seek outside counseling for help living without the need for dangerous substances and possibly even MOUD treatment.

Follow-Up Office Visits

Patients will visit our Georgetown office at varying intervals, depending on the medication used for the particular substance or alcohol disorder. The process is individualized to ensure patients receive the proper care they need without spending unnecessary time in a clinical environment.

In most cases, patients will come into the office on a weekly basis at first. As patients engage in treatment and their situation improves, office visits can be made less frequently.

Over time, many patients with a disorder will visit our office approximately once a month.

We offer different treatments options for patients that struggle with use of opioid, alcohol and other substances. These include but are not limited to Buprenorphine (also known as Subutex, Suboxone, Zubsolv, Sublocade, etc)and Naltrexone (like Vivitrol but also oral tablets) for opioid use.

The length of medication-assisted treatment can range from as little as a few months to as long as a decade or more. It all depends on what works best for each patient.

“You have to let your brain retrain itself to produce your own natural opiates called endorphins. As that occurs, we can start tapering off treatment and start looking at full recovery.

Dr. Alarcon

When substance misuse becomes a problem that affects your work, family, hobbies, or other activities, our addiction specialists can help you start on a journey toward being clean and sober.

We have the knowledge and experience to battle these severe problems. Moreover, it’s an option that works for many people who prefer a private method of handling the disorder rather than spending considerable time at an in-patient facility.

Dr. Alarcon and his team at Atlantic Family Physicians are dedicated to helping you find the proper treatment for your needs. As our mission statement indicates, we seek to provide exceptional, consistent medical care for all of our patients.

The dedicated staff at our practice works together to offer comprehensive care and integrative medicine while paying attention to the needs of every individual patient.

If you or a loved one need help with addiction, don’t hesitate to call our office today.