Total Body Appraisal

Complete health assessment key to successful recovery.

Recovery from drug or alcohol abuse is a total-person experience. That’s how the staff at Riverside Recovery of Tampa approaches the process. They believe recovery requires mental, spiritual and physical health.

Dr. Michael Sore discusses the medical side of the recovery process at Riverside Recovery of Tampa.

Dr. Sore has more than 35 years of emergency medical experience.

The Riverside Recovery staff is comprised of qualified clinicians who help clients achieve mental and spiritual well-being and is led by Michael Sore, MD, who is uniquely qualified to evaluate the medical needs of people struggling with substance abuse.

Dr. Sore is an emergency medicine physician board eligible in addiction
medicine. He’s worked in emergency medicine for nearly 35 years, starting as a tech and working his way up to physician and medical director of the emergency department of several facilities.

“As an emergency department physician, I worked with a high
psychiatric patient population,” he relates. “Unfortunately, many psychiatric patients have co-occurring substance abuse disorders. That’s where I learned withdrawal management and detox protocols for patients suffering with addiction.

“When I came to Riverside Recovery, I was given freedom to develop the medical protocols for the recovery program. I created a comprehensive plan and one I’d want in place if a family member or friend needed recovery treatment. The medical program was also designed to align with the goals set by Riverside Recovery’s founders.”

In addition to Dr. Sore, the experienced team in the medical program includes two specially trained nurse practitioners who assist the doctor with intake and ongoing client care. There are also registered nurses on staff who manage clients’ medical needs on a daily basis. A psychiatrist is also available to consult with clients who have related psychiatric disorders. 

Preliminary Appraisal

When clients are initially admitted to Riverside Recovery, their overall health is assessed as part of the intake process. Clients’ medical histories are reviewed, and they’re given thorough physical examinations. The exams include bloodwork to screen for disease and evaluate organ function.

“What sets Riverside Recovery apart from other centers is we do a full medical screening on clients when they come in, including a complete history and
physical,” confirms Dr. Sore. “We do this to make sure we don’t miss any underlying medical issues that need to be treated.

“In the bloodwork, we look for conditions such as anemia and thrombocytopenia, a low blood platelet count. Thrombocytopenia often occurs with excessive alcohol consumption and makes people more prone to bleeding. In addition, we check certain values in the blood such as ammonia levels, which can be high in heavy drinkers and can lead to significant complications, including cirrhosis and liver disease.”

The bloodwork includes a comprehensive metabolic panel, which reveals indicators of kidney and liver function. It’s important to determine the health of these organs because the medical team often uses medications to support the recovery process.

“These medications will be cleared from the body though the kidneys and liver,” explains Dr. Sore. “If there’s pre-existing damage to these organs, the medications can potentially exacerbate that damage. We need to know the
condition of the kidneys and liver to ensure we’re using the medications safely.”

The intake exam looks for chronic health conditions as well. The team tests for high blood pressure and other cardiac risk factors. If the clients present with heart-related symptoms, they’re given EKGs to evaluate heart function.

“We also check a diabetes measurement called hemoglobin A1c in clients who have the disease,” notes Dr. Sore. “Many people abusing substances don’t take good care of their health on a daily basis, so many of those with diabetes have uncontrolled blood glucose levels, which need to be stabilized.”

Sometimes, clients are impaired by drugs or alcohol when they arrive at Riverside Recovery. In those cases, Dr. Sore and his team try to obtain as much health information as possible at intake and continue their evaluations the following day.

“It depends on their level of impairment,” he elaborates. “Some folks can give us everything we need and be accurate. Others may be in a state in which we can only check them over quickly and make sure they’re safe. Then, we see them the next day in the detox unit for the more in-depth examination.

“As part of the medical team at Riverside Recovery, our main goal is to make sure the clients are medically stable,” he adds. “Then, we address any medical issues the clients have and make sure those issues are well managed. By addressing their medical needs, we help our clients recover their physical health.”

Continuing Care

Dr. Sore or one of the nurse practitioners visits the clients daily while they’re in the detox phase. During these visits, they perform additional physical exams and evaluate the clients’ overall health status as they go through withdrawal.

“We check on how they’re feeling in general,” Dr. Sore reports. “Are they sleeping well or sleeping too much? Do they have a good appetite, or are they nauseated? We monitor their blood pressure and other vital signs, which include pulse, temperature and breathing rate. The nurses then check these vital signs several other times throughout the day.

“Our goal with withdrawal management is to make the clients as comfortable as possible. We’re trying to safely wean them off the substances they’ve been abusing. The more comfortable they are through detox, the more likely they are to be successful during the recovery phase, where the real work begins.”

Once the clients move into residential treatment, they receive weekly visits by Dr. Sore or a nurse practitioner. If clients develop a new condition or experience complications of an existing medical issue, Dr. Sore sees them as needed.

One tool Dr. Sore uses to assist in the recovery process is non-narcotic
medication. The medications used depend on the substances the clients are abusing. They support recovery by helping clients relax during withdrawal and control their urges. The drugs are given under close supervision by the medical team.

“If the clients abuse alcohol, we typically use a class of drugs called
benzodiazepines,” informs Dr. Sore. “These include drugs such as Valium®, Ativan® and Librium. For those addicted to opiates such as heroin or prescription pain pills, we generally give them a medication called buprenophine, or Subutux.

“Alcohol and opiates are two of the most common addictions we encounter. A third is abuse of drugs such as Xanax®, which is also a benzodiazepine. We treat this addiction with a medication called phenobarbital, which is actually an anti-seizure drug. We use this medication because there’s a risk for seizures with benzodiazepine addiction.”

A big component of the medical team’s protocol, describes Dr. Sore, is education. The team teaches clients about their medical conditions and how to manage them appropriately. They also concentrate on healthy ways to handle their issues that don’t include self-medicatingwith the substances they’ve abused.

“The recovery process at Riverside Recovery takes a holistic approach, and the medical team agrees with that reasoning,” states Dr. Sore. “For one thing, once we make sure the clients are medically stable, we teach them healthy ways to manage their stressors, such as through meditation and exercise.

“Secondly, we work to instill in them that if they do need to take a medication, such as a pain medication, they need to be sure it’s a non-narcotic
medication, something that doesn’t have abuse potential. It’s all part of the
education side of what we do.”

Dr. Sore used his own education and experience to develop the medical
protocols used at Riverside Recovery. He’s proud of the medical program he created and how it makes Riverside Recovery an elite center for substance abuse recovery.

“I think our model offers excellent clinical care from intake to detox to residential recovery to our outpatient program,” he says. “There are many recovery options for people in this area, but I believe Riverside Recovery is truly
something special.”

 

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