How does Vivitrol help treat alcohol abuse & addiction?

Vivitrol is a rather new treatment for alcohol abuse and addiction. The trials that got the FDA approval showed significant improvement over placebo in reducing drinking and/or helping to maintain sobriety. Vivitrol (naltrexone) is administered as an intramuscular injection once each month, and it is slowly absorbed into the bloodstream during that period. Naltrexone, the active medication, appears to help by reducing cravings for alcohol and reducing euphoria if alcohol is ingested. Naltrexone can be given orally daily to achieve the same effects. However, a patient may forget to take the naltrexone or choose not to take it for a day or longer and resume drinking. If taking an injection one time a month, the patient only has to make a decision once a month to get the benefits of that positive decision all of the next month.

Vivitrol may be free with the manufacturers discount for patients who have insurance. For those who don’t have insurance, the medication and the injection process is usually in the $600 range each month.

The patient needs to be under the care of a physician, preferably a specialist in alcohol addiction, who can order and manage the treatment and provide additional expertise in administering or referring the patient to a specialist in cognitive behavioral therapy. Cognitive behavioral therapy includes many formats such as one to one substance abuse counseling, 12 step meetings, working with a sponsor, and advocating changing one’s social life from drinking associates to recovering friends.

An addiction specialist can provide options to Vivitrol injection treatment if the patient prefers some other form of medication treatment or has side effects to Vivitrol. Options include oral naltrexone daily tablets, Campral, Topamax, or Antabuse. An addiction specialist who is also a psychiatrist is well prepared to evaluate and prescribe medication for potential co-occurring psychiatric conditions that may be contributing to the development and perpetuation of the alcohol problem. Bipolar patients have an eightfold risk of alcohol problems. Depressed patients have at least 8 twofold increase risk of alcohol problems. Anxiety disorders, ADHD, and drug abuse problems all increase the risk of alcohol problems. Patients who are properly diagnosed, treated with the appropriate medication, and improve psychiatrically have a significantly improved chance of getting away from alcohol.

If you would like to be evaluated for Vivitrol or another medicine to help reduce or stop drinking, call Atlanta psychiatrist Dr. Hege’s office today.

Psychiatric Self Pay vs. Insurance Coverage Advantage

There are three main advantages to psychiatric self-pay over health insurance coverage to pay for psychiatric evaluation, treatment and follow up. While many feel managed care reduces out of pocket expenses, this decision comes with a price. With so much variation between insurance companies including the types of policies they offer, it is not feasible to discuss all the differences between individual plans or work supplied group coverage. Today use of “networks,” “managed care,” or “HMO’s” may help cut costs for the patient as well as the insurance company; however, these types of policies typically place restrictions on who you can see, what you may pay “out of network,” as well as provide incentives to mental health providers to provide less treatment overall to their patients.

Insurance Plans Interfere with Process of Therapy

There is a growing trend among mental health professionals to provide services on a self-pay basis. The U.S. mental health system has serious coverage gaps, where psychiatric service is generally slated for limited payments and encounters. Very often group insurance plans require the patient to start with telephone-based counseling through an employee assistance program, or require first starting with a limited number of mental health practitioners including social workers or a family counselors, before authorizing an evaluation and treatment by a network or plan psychiatrist. Even if the plan allows partial payment for an out of network practitioner, the paperwork,  appeals for denied treatment, wait time for additional authorizations or restrictions to time or number of days, directly impact and interfere with the process of therapy and developing a therapeutic working bond.

Psychiatric Self Pay vs. Insurance Coverage

The Therapist Directory  categorizes the three main differences as  1.  Payment,   2.  Choice of Therapist,  3.  Choice of Length / Type of Treatment

Here are some of the other differences:


  • Self Payment: Info strictly confidential; therapists unable to share information about treatment without prior patient written consent, except in cases of danger to self or others.
  • Insurance: Info required to justify treatment. Therapist must provide a diagnosis, treatment plan and progress notes. Info put in database where others may access it.


  • Self Payment: Freedom to pick a therapist, get a second opinion, or change therapists.
  • Insurance: Some plans limit choice of therapist, require treatment through a psychiatrist in their network, or provide no reimbursement for out-of-pocket care

Duration & Type of Treatment

  • Self Payment: Patients active participants in their care. Treatment sessions continue as long as necessary without interference or restriction.
  • Insurance: Plan determines session length, type of treatment, maximum dollar payout, or visit frequency

Atlanta Psychiatric Self Pay Treatment

Dr. Darvin Hege, a leading area self pay psychiatrist for over 30 years does not subscribe to insurance company restrictions or third party privacy invasions, but rather works with you to provide a successful mental health treatment plan that is unique to your needs. Call us today.

Open Discussion with Psychiatrist Promotes Optimal Treatment Plan

For most people, making an appointment to see a psychiatrist about behaviors or symptoms that are impacting their personal, academic or work life is a hard first step to take. Psychiatrists are specialists who are not there to judge you, but to work with you to find the best medication and treatment regime for your specific needs – making that first appointment takes you in a positive direction toward turning your life around.

Psychiatric Help Needed by Thousands Who Never Seek Treatment

The website Every Day Health reports that almost 66% of adults with depression will never seek treatment. For those with addictive behaviors, a chronic history of substance abuse, or mental health issues that are causing havoc with one’s life, only approximately 35% seek help, usually when they are faced with a failed relationship, loss of their job, failing college grades, or a criminal record.

Comprehensive Psychiatric Evaluation Needs Full Disclosure by Patient

The initial evaluation appointment with your Atlanta psychiatrist follows an organized plan that includes finding out about your issues, concerns, behaviors, symptoms and areas where you are having difficulty, and the information you give will affect the treatment strategy and time frame of the recovery process.

An experienced and practiced psychiatrist like Dr. Hege understands patients may hold back or alter important information out of embarrassment, fear, anxiety or trust issues. Accurately answering questions, and describing symptoms and behaviors experienced will lead to building a sound foundation for a successful treatment plan.

Common Information to Discuss During Comprehensive Evaluation

Many points and issues are discussed during a comprehensive evaluation with your psychiatrist. Talking about one area of concern may lead to a whole new set of questions. Some common topics that may be discussed include:

  • Medications currently taking – include prescription medications and their dosage, as well as all over-the-counter (OTC) herbal remedies, vitamins, supplements or pain medicine you use. Discuss any products that may have caused a side effect or left you “feeling bad.”
  • Stress in your life – stress comes from many different directions such as work, home, friends, children, money, debt, weight, pain, loss, worry, etc.
  • Self Medication – use of drugs or alcohol to help you “cope” with life
  • Physical Symptoms –  includes trouble sleeping, poor appetite, voracious appetite, feeling run-down, loss of energy, loss of interest in sex, low frustration tolerance or any other symptoms that are interfering with your daily routine
  • Suicidal or Homicidal Thoughts – discuss any thoughts about hurting yourself or others with your psychiatrist; thinking may not mean follow through but this is a serious issue that needs to be addressed right away

Atlanta Mental Health Management Psychiatrist

Dr. Darvin Hege, a highly regarded Atlanta mental health management psychiatrist has a long history of successfully planning and implementing individually based treatment plans.

Schedule an evening or weekend appointment with Dr. Hege and start positively changing your life.

Receive Medication Support During Nicotine Withdrawal

The use of tobacco and nicotine can become an addiction that is as difficult to break as alcohol, cocaine and morphine abuse. The CDC, Center for Disease Control and Prevention estimates almost 44 million people in the U.S. smoke cigarettes with over 68% of those smokers making repeated attempts to quit. The desire to quit smoking continues throughout a person’s life, with almost 45% of smokers 65 years of age and older still fighting the battle against nicotine addiction. 

The Physical and Psychological Addiction of Nicotine

The National Institute of Health reports that tobacco use, the leading cause of preventable death in the U.S., accounts for one-fifth of deaths every year. Nicotine addiction comes with a variety of physical and psychological effects that are often tied together, making the attempt to quit even more difficult.

For example, smoking typically decreases appetite, and the fear of weight gain affects the ability to successfully quit. Nicotine also boosts mood and alertness, often masking underlying depression, which leaves those trying to quit with a loss of motivation and well-being.

Symptoms of Nicotine Withdrawal

Research indicates about 50% of smokers suffer from at least four symptoms associated with nicotine withdrawal. Common symptoms reported are:

  • Anxiety
  • Depression
  • Irritability and anger
  • Increased hunger, appetite, and weight gain
  • Insomnia and drowsiness
  • Headache
  • Intense craving for nicotine

Nicotine withdrawal symptoms can begin within a couple hours of quitting, with symptoms peaking in about 3 days. Partnering with a nicotine addiction psychiatrist will ease symptoms experienced using prescription medication to reduce cravings in combination with cognitive behavioral therapy. A successful addiction withdrawal program will address both the physical and psychological obstacles to quitting.

Quitting Smoking with Mental Health Issues

A psychiatrist with a successful history of treating nicotine addiction and other mental health issues develops a treatment plan addressing both the addiction and any underlying psychiatric issues. A diagnosis of depression, anxiety disorder, ADD, or bipolar disorder significantly reduces the success rate in overcoming nicotine addiction. Treatment tailored to an individual’s overall needs plus their mental health concerns has proven most successful in prevention of relapse during and after nicotine withdrawal.

Medication Support during Withdrawal and Beyond

Several medications are available from a certified nicotine addiction psychiatrist. Chantix, a medication recently approved for nicotine addiction, has higher success rates for both 3 month and 1 year nicotine abstinence. Other medications with a history of success for tobacco and cigarette addiction withdrawal are Zyban, Wellbutrin, and buproprion. Diagnosis of mental health disorders may require a combination of medications to effectively treat the whole person and their needs.

Atlanta Tobacco and Nicotine Addiction Psychiatrist

Tobacco and nicotine withdrawal is difficult and repeated episodes of relapse are common. Dr. Hege, Atlanta’s tobacco and nicotine addiction psychiatrist has a long history of experience and documented success.

Call to set up an appointment, and let Dr. Hege work to help relieve your withdrawal symptoms, manage any mental health issues, and strengthen your resolve and ability to quit for good.

Cognitive Behavioral Therapy and Medication Successful in Cocaine Addiction Treatment

Cocaine is an extremely powerful central nervous system stimulant. Up to 75% of the people who try cocaine become addicted to it. The Stop Cocaine Addiction website reports well over 2 million cocaine addicts in the U.S., and only 25% of those who try to quit will succeed without outside help. Cocaine addiction is a chronic relapsing disease that is the result of changes in the brain and the uncontrollable need to obtain the drug.

Cocaine Addiction Tied to the Brain’s Pleasure Center

Cocaine has a direct and immediate affect on the pleasure center of the brain which produces euphoria and feelings of being hyper-energized. The “high” quickly fades, and within 30 minutes the desire or craving to use the drug again returns. Repeat use of cocaine results in increased tolerance and the need to use more of the drug in order to achieve the same feelings.

Cocaine Addiction Relapse Easily Triggered

The National Institute of Drug Abuse states that repeated use of cocaine causes disruptions in the brain chemistry responsible for the regulation of mood and pleasure. Strong cravings for cocaine can be triggered by a memory associated with past use, even when it may be months to a year since it was last used. With memories at every corner, the need to use cocaine becomes too strong to resist. Help is available from cocaine addiction medical professionals.

Depression Common Psychological Withdrawal Symptom

Very often the attempt to stop using cocaine fails because of the psychological withdrawal experienced. There is no true medical detox for cocaine addiction as the drug is water soluble and leaves the body fairly quickly. Developing depression is a common, often overwhelming occurrence during cocaine withdrawal which often pushes an addict to use cocaine to relieve their depression.

Dual Treatment Highly Successful for Cocaine Withdrawal

The psychological withdrawal, depression, and the memories that trigger relapse can be successfully treated by a trained expert in cocaine addiction withdrawal. Very often a dual method such as a medication regime in conjunction with Cognitive Behavioral Therapy, CBT, closely monitored by your addiction psychiatrist has the best success. Dr. Hege does not provide CBT, but can recommend someone who does.

Medications Prescribed for Cocaine Withdrawal Symptoms

Prescribed medications for cocaine withdrawal symptoms may include Disulfuram to help reduce the degree of cocaine cravings, and N-acetyl-cysteine as a nutritional supplement. Dependending on your evaluation, other medications may be used to help reduce fatigue, help relax muscular tension, help stabilize your moods or work to reduce cocaine’s euphoric effects (i.e., modinifil, baclofen, naltrexone, Topomax).

Atlanta Cocaine Addiction Withdrawal Psychiatrist

Dr. Darvin Hege, M.D. is a well recognized authority on successfully treating cocaine addiction and the associated withdrawal symptoms such as depression, violence, insatiable hunger, irritability and aggression, overwhelming fatigue and disturbed sleep patterns. Contact us today for an evaluation.

Psychiatric Medication Side Effects Respond to Management Strategies

With the world’s seemingly unending stressful events, such as money issues, family problems, random violence in the news, many people can develop a mental health issue. Whether or not the problem is short-lived or becomes chronic, both respond to psychiatric medications that when properly managed lead to the successful treatment of life-disrupting mental illness.

Psychiatric Medications Critical Part of Treatment Plan

Psychiatric medications are often a critical element in the development of a successful mental health treatment plan. The National Institute of Mental Health separates psychiatric medications into six main groups which include medications used to treat ADHD, anxiety disorders, clinical depression, bi-polar disorder, mood disorders, or medications used as a sedative. A qualified psychiatrist carefully diagnoses and prescribes after a thorough evaluation and history taking.

Top Five Psychiatric Medications Prescribed

Psych Central reports that the top ranking medication from 2005 forward to today is Xanax / alprazolam used for anxiety, with almost 48 million U.S. prescriptions written on an annual basis. The other four psychiatric medications range from almost 24 million U.S. prescriptions a year to well over 37 million.

The 2nd ranked medication includes Zoloft/sertraline for anxiety, PTSD, OCD, and depression; 3rd, the drug Ativan for panic disorder and anxiety; 4th, Prozac/fluoxetine for anxiety and depression; and 5th, Celexa/citalopram for anxiety and depression. The variety of psychiatric medications used for ADHD rank all the way from 15th to 25th with yearly U.S. prescriptions totaling up to more than 35 million a year.

Common Psychiatric Medication Side-Effects

Psychiatric medication side effects vary from one person to the next. There are numerous factors that change how your body will react to any one or a combination of medications. The four main psychiatric medication side effects are:

  • Weight gain
  • Sexual issues or dysfunction
  • Restlessness, hyperactivity, irritability or agitation
  • Tiredness, drowsiness, memory deficits or clouded thinking

Other significant side effects which may require more immediate psychiatrist medication adjustment and management include:

  • Diarrhea or GI upset such as nausea and vomiting
  • Impaired coordination and control of body’s extremities
  • Insomnia
  • Blurred vision
  • Cardio-pulmonary issues
  • Drop in blood pressure with feelings of dizziness or syncope
  • Black outs or feeling like you are in a trance or stupor
  • Becoming despondent or having feelings of great sadness and despair
  • Any change in your emotional or physical state that may be due to psychiatric medication side effect which is causing you emotional stress.

Atlanta Psychiatrist, Expert in Managing Medication Side Effects

If you are currently taking psychiatric medications and are experiencing side effects that have negatively impacted family, social relationships or work related interactions, it is time for a change – call Atlanta’s expert in managing and adjusting psychiatric medications.

Dr. Darvin Hege, M.D. Atlanta’s psychiatric medication side-effects doctor is ready to help you make the change for the better – call to set up an appointment today.

Opioid Dependence a Chronic Illness That Can be Successfully Managed

Columbia University research studies have documented that opioid addiction in the U.S. tripled during the ’90s. Statistics from 2009 indicate nearly 2 million Americans were either dependent on or abusing opioid prescription pain medication such as OxyContin/oxycodone, Vicodin/hydrocodone or Demerol/meperidine.

Atlanta Opioid Addiction Needs Long-Term Treatment

Opioid addiction is more common than the abuse or dependence on any other type of prescription medication and two-times greater than those addicted to cocaine. The World Health Organization presents opioid dependence as a complex health condition that typically requires long-term treatment.

Opioid addiction is viewed as a life-long chronic illness or disease, such as diabetes, asthma, or heart disease, which can be successfully managed but not “cured.” The development of a pharmacological treatment regime under the direct care of an opioid addiction psychiatrist has proven to be the most successful in overall management of opioid dependence.

Common Indicators of Georgia Opioid Dependence

While a thorough evaluation by an Atlanta opioid addiction psychiatrist provides the foundation for developing a comprehensive medical and medication treatment plan, the following list of behaviors may be the impetus that drives you to make an appointment with Darvin Hege, M.D.,  expert in opioid dependence with over two decades of experience in the field.

Generally, a person who exhibits three or more of the following behaviors may be considered opioid dependent:

  • Reports withdrawal symptoms when opioid medications are stopped or significantly reduced, often using other drugs to help diminish withdrawal symptoms
  • Increasing amounts of opiates taken, or taking them for longer periods of time
  • Needing to take more of the opioid medication in order to get the same effect that you once experienced
  • Wanting to quit, however are unsuccessful time and time again
  • Increased time is spent trying to obtain more of the medication
  • Finding the recovery period from taking opiates take longer and longer
  • Employment issues arise, such as missing work, being late for work, not being able to perform work properly, or being unable to find work if unemployed
  • Spending less time with friends and family who do not use opioids
  • Continuing to use opiates even when faced with negative consequences

Georgia Opioid Dependence Takes Control of Your Life

Opioid dependence slowly takes over and controls your life. Opiates are highly addictive and by their nature activate the brain’s pleasure and reward centers while making changes in the brain’s structure and function. The belief often forms that opioids are necessary for survival and attempts are made by any means to obtain opioid medications, either legally or illegally.

Atlanta Opioid Addiction Psychiatrist

By the time a person develops a dependence on opioids their brain no longer functions normally without these drugs in their system. Brain centers that involve judgment, perception and caution become impaired.

The Atlanta opioid addiction psychiatrist Dr. Darvin Hege has successfully helped patients regain the life they once had through an individually constructed, medically managed pharmacological treatment plan. Call the office and begin to live your life once again.

Reduce Narcotic Cravings and Withdrawal Symptoms with SUBOXONE Film

Prescription opioid pain reliever use has more than doubled in the past 5 years. The National Institute for Drug Abuse and the World Health Organization have defined that dependence on opioids, such as prescription pain medication and heroin, are now recognized as a long-term brain disease — a medical condition and narcotic addiction that can be successfully treated by experienced psychiatrists and other medical specialists.

Statistics on Opiate Addiction and Abuse

With over 7-million people in the U.S. addicted or dependent on an opiate drug or prescription pain medications, the cost is almost $500 billion dollars a year. Emergency room visits related to prescription drug abuse well exceeds 1 million visits a year; in almost 400,000 of these visits the patient received a prescription for opioid pain relievers. The Institute of Addiction Medicine states that opioid painkillers are chemically similar to heroin and can be just as addictive.

Break the Chains of Physiological Addiction with SUBOXONE Film

Developing an addiction to opioids can happen to anyone. Management of pain, chronic or acute, can include a prescription for opioids which include for example: Vicodin, OxyContin, codeine, Kadian, or Percocet. Once a dependence on these medications develops, the willpower loses out again and again in the fight against the chemical, psychological, and behavioral stronghold of opioid addiction. Opioid addiction takes more than willpower to overcome the fight — it takes a medically managed and proven medication treatment plan.

Your Atlanta narcotic addiction psychiatrist Darvin Hege, M.D. may prescribe SUBOXONE Film while carefully monitoring your opioid withdrawal day by day until you are able to manage monthly medication reassessments. SUBOXONE Film assists with reduction of narcotic cravings as well as easing your body through the withdrawal symptoms. SUBOXONE Film, whose active ingredient is buprenorphine, a partial opioid agonist, produces less of a euphoric effect than a full opioid would, thus helps to suppress withdrawal symptoms and reduce narcotic cravings.

SUBOXONE Film Prescriptions Can be Called in to a Pharmacy

SUBOXONE Film contains both buprenorphine and naloxone which provides a medically monitored way to withdrawal over time as well as mixing in an ingredient that discourages misuse of the medication. Buprenorphine attaches to opioid receptors suppressing both the uncomfortable cravings and the symptoms of withdrawal. Naloxone has no physiological effect if SUBOXONE Film is taken as prescribed.

Atlanta Opioid Addiction Psychiatrist Has High Success Rate

If opioid pain medications have taken control of your life, there is a way back. The highly regarded Atlanta narcotic addiction psychiatrist Darvin Hege, M.D. is available to help bring you out of the clutches of pain medication addiction so you can make your life and family first priority again.

Call the office to schedule a confidential initial meeting and evaluation.