Are you ready to get clean, but unsure of how to choose a medical detox center? If so, you won’t want to miss this exclusive interview with Dr. Peter Coleman, detox expert and founder of The Coleman Institute.
The Coleman Institute is an accelerated outpatient detox program founded in 1998 by Dr. Peter Coleman. With multiple locations in major cities across the country, The Coleman Institute detoxes and stabilizes clients addicted to opiates and alcohol. The original location is in Richmond, Virginia, and is owned and operated by Dr. Coleman. Dr. Coleman has also set up nine additional locations across the United States.
Before people come to our residential rehab, they often need a medical detox program to safely remove residual alcohol or substances from their body. When people ask us for medical detox center recommendations, we often mention The Coleman Institute.
If you’re looking for a proven, safe, effective detox, The Coleman Institute is a good place to start your search. They serve individuals with addictions to heroin, prescription drugs, pain medications, Suboxone, Methadone, alcohol, Benzodiazepines, and more.
About Dr. Peter Coleman
Dr. Peter Coleman is the founder of The Coleman Institute, which provides high-quality outpatient detox programs. Born in New Zealand, Dr. Coleman emigrated to the United States in order to work in a Virginia clinic.
His parents dealt with addictions, and as a teen Dr. Coleman struggled with serious drug and alcohol abuse of his own.
Even after a near-fatal overdose, he tried to convince his doctors that he didn’t have a problem. Fortunately, he entered treatment in 1984 and has been sober ever since.
Once he’d recovered himself, Dr. Coleman was motivated to help others get clean and sober. He founded The Coleman Institute to provide a safe, secure process to wean people off alcohol and other substances.
Medical Detox Technique at The Coleman Institute
The Coleman Institute’s program is well-regarded, successful, and integrative. It utilizes the Accelerated Detox Technique (ADT), which is a medication-assisted protocol that alleviates withdrawal symptoms and mitigates the physical challenges associated with detox.
The final stage of ADT includes Naltrexone Therapy and may include the Naltrexone Implant, which empowers people to go forward with their lives and also receive support to stay clean.
The Coleman Institute’s success rates speak for themselves; they have a 96% satisfaction rating and 98% of their patients complete detox successfully.
Important Things to Consider in Medical Detox
We’re thrilled at the opportunity to interview Dr. Peter Coleman, and we hope that you enjoy our conversation!
In our interview, we discuss …
- What to look for in a detox center; how to discern the good from the bad
- How to decide between inpatient and outpatient detox programs
- Realistic cost ranges for both types of detox
- How an Accelerated Opiate Detox Program takes people through the detox process with minimal discomfort
- Common fears about going through detox, and how to help allay them
- What to expect at each stage of the Coleman Center detox process
We’ve also included an edited transcript of our interview below. Enjoy!
Caroline McGraw: Hello and welcome. My name is Caroline McGraw with The Clearing. The Clearing is a residential dual diagnosis addiction treatment center located in Friday Harbor, Washington, and we specialize in helping people to discover and heal the underlying core issues that drive addiction. And today we are so honored to be speaking with Dr. Peter Coleman. Welcome, Dr. Coleman.
Dr. Peter Coleman: Thank you. Thanks for having me.
Caroline: Well, Dr. Coleman you've written about how you struggled with addiction yourself from a young age. Can you talk about some of the underlying issues that really led you to start drinking and using?
Dr. Coleman: Yeah, it's a good question. I'm 61 now and I've been in recovery for 32 years ….
My mother was an alcoholic, and I didn't have any idea about that when I was growing up, until I started struggling with my own addiction ... She really did drink too much and it was a lot of fights with my dad and stuff.
So, that I was a bit of an overachiever when I was a kid and I really wanted to be a doctor and I went off to medical school, I partied like other people, like other kids. I just liked doing it more than most of my friends. So, I sort of escalated from drinking alcohol - I would get pretty drunk - and I started smoking pot, and eventually I got into cocaine because that became a big thing in the 1980s. Then I ended up getting into even morphine and using IV drugs and I had a drug overdose and went to treatment.
Fortunately, I was forced to go to treatment for four months because I was a doctor and they said, "Well if you don't go you'll never work as a doctor again," and it got my attention because I had no clue that I really had an addiction problem!
I really thought I was just having fun and being a scientist and trying this and trying that. In truth, I'd been suffering for a long time. And when I finally was able to get all the drugs out and really look at how my life was, I realized how much pain I'd been in.
And I stayed there long enough to be able to learn how to stay clean and sober, and I changed my life enough to be able to maintain that. So it's been really fun.
I believe that most people have a genetic vulnerability for addiction, that a lot of people try alcohol and drugs and some people just don't like them that much, and I did. And my brother's alcoholic and my uncle's alcoholic, and I just think that's a big part of it.
So, to a certain extent, it was just normal experience, a childhood experimentation, but, I'm also aware that most people - including me - have quite a lot of deep-seeded underlying sort of trauma and low self-esteem.
So those drugs and alcohol kind of fill the hole a little bit with not feeling good enough, maybe not having enough friends, wanting to be popular, having some depression. Those things need to be taken care of during your recovery so that you're not tempted to go back.
That's the way I look at it.
Caroline: Absolutely. Couldn't have said it better. So, in your own words, how did you go about founding the Coleman Institute? When did you decide to create the program?
Dr. Coleman: Sure. Well, part of my recovery, part of my treatment program was four months, and the last three months of that I had to do volunteer work. And the program was set up to do volunteer work in a kind of a field that would be helpful to you and so they put me in a detox center. So I worked with a Dr. Mark Holt and I started detoxing people under his care and I loved it. It was just fun seeing people get off drugs and start getting back on track.
I looked up to Dr. Holt as just one of the most wonderful men I've ever met. The patients loved him, the nurses loved him, and I loved him, and he loved me. I mean, he sort of took me under his wing.
And part of their program is to sort of figure out-
"What's your path in life? What is it that you want to be doing? What flips your switch and is almost a mission?"
And for me, helping people get clean and sober was what clearly came to mind. So I left that program, went and did a fellowship in addiction medicine, and have been working in the field ever since. Then in 1998 this big heroin and opiate crisis happened, so I learned how to detox people and I've been doing that really well and successfully since then. I’ve seen a lot of people get clean and sober.
Caroline: Wow. That's so amazing how your process of getting clean led you to the path of, "Wait a second. I want to help other people do this, and this is what really flips my switch,” like you said. So, also, I guess I want to ask, how does your experience with having been through detox and been through addiction yourself, how does that influence what you do in the program?
Dr. Coleman: Yeah. I mean, a hundred percent. It's what I do. It's what I love doing, it's what I'm good at doing, it's what I feel led to be doing. Patients enjoy the fact that I can relate the them on that sort of level, of course. I don't think it's absolutely necessary, but it does help.
It's a joy. I mean, to see people get clean and sober, I mean, we see enough people ... though not everybody, unfortunately, maintains long-term sobriety. Addiction is a difficult thing to stay in recovery forever. And yet I believe that everybody can if they work hard enough at it.
You know, in the 12 Step philosophy they say you've got to be willing to go to any lengths. You've got to be willing to put a hundred percent into it. And, you know, that means doing what you're told. It means sitting through some discomfort.
It means paying attention, learning new things, learning new tools, learning how to deal with stress and emotions and all of that stuff because life is stressful and guess what? Those things are going to come up and temptations are going to come up.
Caroline: That reminds me of one of the things we'll often say in our program, "You have everything you need to heal inside of you. You have the tools and if you're willing to make that choice, that it's possible for you to do.
Dr. Coleman: Absolutely. And you've got to do it. I mean, you can't just talk about it, you've got to actually do it. You can't say, "Oh I'll do anything," you know.
I had a patient this morning, an alcoholic guy, that's probably going to be dead in ... I gave him six months, but my nurse practitioner said, "I don't think he'll last that long because his liver is already shot."
He said, "I'm willing to do anything." I said, "Okay then, do these things." He said, "I'm not doing that." So I said, "I guess you're not willing to do anything."
You know, it's sad, because it's like he's got a terminal illness, like cancer. If he had cancer and I said, "Okay there's this one drug that's going to save your life. It's the only thing." He would take it. But when that one thing is going to a treatment program, he won't go.
Caroline: Wow, that is fascinating. So, I also wanted to ask, what are some of the myths that you encounter most often in your work? For example, you did a video recording about addiction myths on your website, talking about how a lot of times people think that addiction is just about a lack of willpower, and how that's not the case.
Dr. Coleman: Sure. If it was just a matter of willpower, everybody would stop as soon as they had that one thought like, "I don't want to do this any more. I want to stop smoking," or whatever it is. No, compulsion is deep-seeded in the brain, and those are all tied in with your memory circuits, so you get triggered with any little thing that reminds you of how good that felt when you did use drugs or how much relief you felt from anxiety or stress.
The opiates that we use are really powerful emotional pain killers, and so they're not just physical pain killers. And it's emotional pain that most of us have, more often than not, and we've got to learn how to deal with that.
But I think the biggest myth is that it's just the drug, that I'm just addicted to this drug and if I could just get off this drug my life would be fine.
Patients come to us and they think, "Oh, I'm hooked on this heroin, or on oxycodone, or Percoset, and if I just didn't have to go get that I know I could do it." And it's so much deeper than that.
You've got to get those drugs out, but then you've got to learn how to deal with stress, how to deal with anxiety, with loneliness, with boredom, with all these emotions that we don't like.
You've got to learn and you've got to be willing to change enough things about your environment that you're not triggered, that you're not reminded of it. It's like trying to be on a diet but work in a cookie factory. You know, I mean, that's not going to work. There's no way that's going to work.
You might make it for a month or two, but you're not that powerful. No one is. So you can't work in a cookie factory. Find another job. That's the thing, there are lots of other jobs out there but people don't get that. They think it's going to be easy and it's not.
Caroline: That's so profound, because even if a person hasn't struggled with a substance addiction, I can certainly relate to the idea of, "My life will be fine as soon as 'this' is taken care of."
Dr. Coleman: Absolutely. It's easy to believe that. It's very easy to believe that, yeah. But it's just much deeper than that.
Caroline: Yeah. I'm curious too, you mentioned all the various drugs that people come in addicted to - heroin, oxycodone, all those. Is there one particular addiction that you see the most often in your center?
Dr. Coleman: We mainly do opiates. We also do some alcohol. Of course, you don't really need to detox off cocaine or methamphetamines so we don't tend to see those people for detox but we do see some of them who are struggling with long-term recovery.
But mostly we do opiates, and of those about 20-25% are maybe chronic pain patients who were put on their drugs because of their physician and it was a legitimate. But they kept taking it too long and the doctor didn't supervise them stopping them taking it. So that's a big issue. About half of the others are ... well, maybe 30% are on oxycodone or pain pills that they're just buying from friends. Another 30-odd percent are heroin or they may have switched to heroin because it's cheaper and more effective.
Then we see a lot of people who have been taking methadone or suboxone and they are on this long-acting drug to help keep their brain stable while they learn how to stay clean and sober, and now it's time to get off of that. And so we can detox them off that over eight days.
If they've done a good job building up their recovery program and getting over some of that early trauma or other lifestyles that need to be changed they can do really well ... but they still need to switch to the naltrexone so that they don't relapse back to drugs because that post-acute withdrawal. It's going to take about a year for the brain to fully heal.
Caroline: That makes total sense. Well, when we've had participants come to us we've definitely heard some horror stories of detox centers where folks have really not been well looked after. So often when people come to us, they want to learn more, they want to prepare themselves because we don't offer detox as part of our program. We have people detox before they come to us.
So, if people are looking for a program, investigating detox centers, what should they really look for in a detox program?
Dr. Coleman: There are a number of ways to detox, you know. If you want to do an outpatient the most common way is to just switch to suboxone and then wean off that as you tolerate, but unfortunately that's still pretty painful. And lot of people just get hooked on the suboxone or the methadone if you're trying to do that.
I used to run a methadone clinic and we would do it, we had a 21-day program where we would put people on methadone and then wean them down slowly. But we only had about five percent of people complete it because during that 21 days almost everybody relapsed.
So now we do this outpatient detox where we get people of it in three days. We sedate them fairly heavily, give them a lot of comfort meds, and then we actually push the drugs out with the naltrexone. That actually seems to trick the brain to heal a little bit faster than it would and it gets them over and done with. People psychologically do better when they know it's going to be done in three days.
They're willing to put up with it. And they've got a support person with them so that they can't just change their mind and go out and use some drugs.
Other people detox inpatient and it can be helpful if the nurses and the doctors are giving you enough medicines to keep you comfortable and you're in a safe environment. It's a little bit more expensive, but it can be also very effective. But some people will run away from that as well because they just don't feel good.
How Much Does Medical Detox Cost?
Caroline: That's a great point and I had that further down the list to ask about inpatient vs. outpatient and you illustrated it perfectly. There are benefits and drawbacks to each approach, and some people might feel claustrophobic at the idea of an inpatient approach whereas others might really want that extra support.
What is a realistic cost range to detox from drugs or alcohol? I know it obviously varies depending on insurance and everything, but what’s realistic for that three-day intensive medical detox?
Dr. Coleman: The cost is somewhere between $6000 - $7500. So it is a little expensive, but it's over and done with quickly. And like you said earlier, we have 99% of people complete the detox and get onto naltrexone.
So, compared to going to an inpatient rehab for 28 days it's pretty inexpensive, although we're not doing the rehab piece of it. But that's about what it is for us.
"It's an investment for sure, but to the fact that it gets it over and done with and it's successful, then I think it's a good investment. And honestly a lot of our patients are using that much money in a month or two of heroin anyway."
Caroline: That's a very good point. They're spending that much anyway. So, also, just to clarify, that three-day period is the accelerated opiate detox program, correct?
Dr. Coleman: Correct.
Caroline: So, if people were searching on The Coleman Institute's website, that's what they should look for?
Dr. Coleman: Yes, and that price includes the naltrexone implant or the vivitrol so that they're then protected from any relapse for the first month or two and their cravings usually go away. Most people say their cravings go away completely, so that's pretty nice. They can then concentrate on their therapy, come to you or some other place, or do an outpatient rehab.
Caroline: Awesome. Do you find that people are often very apprehensive or afraid of going through detox? If so, where is that fear coming from?
Dr. Coleman: Well, only 100% of the time. Because everybody's tried stopping.
You know, I mean it's like cigarette smoking. Almost everybody's tried quitting at some point. And with heroin, they don't want to be on the stuff, they hate the stuff.
They know it makes them feel good, and they'll go eight hours and they start feeling some withdrawal. And if they go 12 hours it's more.
And it just gets worse and worse and worse.
So they've all tried that and they know exactly.
And a lot of them have been in five different detoxes and never completed one of them.
So, everybody who comes to us is terrified. We spend a lot of our time reassuring people that it's going to be okay, that you're going to be okay.
We talk to patients on the phone before they come with both our screening people, but also the doctor gets on the phone. That helps to reassure people that they're going to get through it.
And we can confidently say, "Look, we get 99% of people through this and it's going to be okay."
We've been doing this since 1998, so really 19 years. So we know what we're doing. That reassures people and it gives them confidence. And very quickly after they come to us we give them some comfort meds and they feel better.
They typically sleep a lot the first day, so they come back on day two and they're like, "Well I just slept all day yesterday, so that wasn't bad." And then they've only got one more day to go. So it's pretty nice.
Caroline: Well that's perfect. I was just about to ask to walk us through the three-day detox. So day one is sleeping a lot?
Dr. Coleman: Yes. We get people on the phone and talk to them and then they stop their drug use the day before, like at 6:00pm. Then we'll see them early the next morning. So they've gone maybe 12, 14 hours but they do that almost every day anyway, so they know they can do that.
And then we do a history and physical and get some labs and an EKG, and we give them some meds in the office.
It's not unusual that in 45 minutes they're already asleep and feeling much more comfortable. We give them a little naltrexone, a little shot in the arm to just push some of the drugs out, but just such a small amount that most of the time they don't even notice that. And we go back to the hotel or to their house with their support person.
They come in on day two and we adjust their meds a little and give them a bit more naltrexone and let them go home.
Then on the last day they come in early in the morning with NPO - they haven't had anything to eat or drink like they're going to have a medical procedure and then we put an IV in and we give them increasing doses of medicine to push the drugs out.
Usually they don't feel too bad, and by 1:00 or 2:00 in the afternoon they're up and about and they're done. All the drugs are gone and so then we can put them on naltrexone. It's really pretty amazing.
Caroline: Wow. That is such a stark contrast to ... I recently wrote a blog post about aversion therapy and the lengths that people will go to often to try and get clean, and this sounds much less painful on so many levels.
Dr. Coleman: Right. We've had a number of patients who've been really happy and then their family is like, "Are you sure this isn't going to make it too painless that they might relapse?"
And I understand their fear, but I don't think anybody relapses [for that reason]. They're about to use heroin again they say, "Oh, I'm not going to do this because I'll have to go through withdrawal again"... ? That's not what they're thinking at all.
What Really Causes Relapse
Caroline: I don't think so, either.
Dr. Coleman: That's not what causes relapses.
Caroline: That's a really good point because that's another myth, maybe that if you have this really painful withdrawal then maybe then you won't use again.
Dr. Coleman: If that was true, women would never have a second baby.
Caroline: Very good point. Very good point.
Dr. Coleman: The brain is just set up to downplay pain and that's not what causes relapses. If that was true then no one would ever go off their diet. They would remember how bad they felt when they were 30 pounds heavier.
At the point that someone makes the decision to do that again - have one more cookie or something like that - then they're not thinking, "Oh, boy, this [pain] is definitely going to happen then." The brain just doesn't think that way.
Caroline: Right, right. Is it more like, "I just want to alleviate the discomfort I'm in right now. I just don't want to feel this"?
Dr. Coleman: Either that or, "I want to get the pleasure and the thrill that I want right now. I want to feel good."
I think most people can relate when you put it into a food [context]. Most people have thought, "I really shouldn't eat that extra piece of cheesecake," and then they've thought, "Well, I'll just have a half of one." And they downplay the negative consequences. They say, "Oh, well I'll work out again tomorrow or ... you know, it won't really make any difference.”
And with food, you can do that.
When it comes to heroin you can't, because once you do that one time, you're going to be back doing it again. Like cigarette smokers who almost never go back to just having one here and there.
Caroline: That's such a good point, that the rationalizations that work in one area of life don't carry over into others.
Dr. Coleman: Exactly. Exactly.
Caroline: Wow. Well this has been so helpful and I want to honor your time, but any final words of advice or encouragement - people who are thinking they might be ready for detox but they're scared?
Dr. Coleman: Well, it's not just ready for detox, it's ready for recovery. I see people clean and sober all the time who've had horrible diseases. I'm a member of International Doctors in AA and we have conferences with 500 physicians and to be there around that many people who've had serious problems, I mean horrible diseases - hurting people, their families - and they're all happy.
They're all doing well. They're all helping others. They're all living a happy life. That's available to all of us if we work at it, that's the key.
People need to be ready to work at it. You can't get something for nothing.
You've got to be willing to surrender to it. You've got to be willing to accept that this is your problem, it's not anybody else's. It's your job to do something about it, you know?
And then you've got to work at it. Working at it times is easy because it's like riding a bike. After you've learned how to do it, it's not that hard. You just ride your bike. Then you can see more things in the world and experience more things because you can ride a bike than before. But if you're too afraid to learn how to ride a bike because, "It's too wobbly and I might fall off," then you're not going to learn it.
So you've got to have the courage to do that. And then the world opens up and you realize, "Wow. I wish I had done this a bit sooner."
You know, my mother ended up getting sober for the last 10 years of her life. And she said to me, "Boy, I meet these people who are sober at age 25 and I'm 70. I wish it had happened a bit sooner."
Not that I can go back and regret the past, but she had a lovely ten years of her life. I see it all the time.
If anybody's thinking it's too hard, don't buy that. That's not to say you don't have to put work in - you do. But it’s incredibly worth it.
So, that's my last word of advice and wisdom.
Caroline: That's perfect. It's hard work, but on the other side, you can have an amazing life and recovery is worth it.
Dr. Coleman: It is. It's the life I think we were meant to lead. It's where happiness really is.
People that I know, we thought we wanted to be happy and we found drugs and alcohol and it looked like it was happy.
But it wasn't. It was just a dopamine rush in the brain. It was a pleasure that was there, and then it's gone. And you're actually a little emptier than you were before.
Because happiness wasn't there, ever. So if you're looking for that to bring happiness, it's not there. But it is in here if you just lead the right life. Putting drugs and alcohol in your brain - how are you going to get it with that? It's impossible.
Caroline: Well, it has been a delight to talk to you, and thank you for all that you do.
Dr. Coleman Yeah, thank you. Thanks for putting this together …. You guys do a nice job at The Clearing. I've heard some good things and I think a lot of people can really benefit from the kind of work that you do, so thank you.
What Happens After Medical Detox?
As Dr. Coleman mentioned, detox is just the first step to recovery. Physical substances and compounds have been safely removed from your system, but the underlying causes that drove you to use need to be addressed, and treatment is the way to do that.
If you're considering an residential rehab addiction recovery program, download our free guide to understand the questions to ask in order to find the best rehab to fit your specific needs.