Studying homeopathy led Tracy Woodward Gagetta to explore an innovative titration system for drug detoxification, as she explains
After training and working in the fields of mental health and addictions, I developed a dilution titration system to reduce the withdrawal symptoms of and cravings for heroin, while studying for a degree in homeopathy. This was originally a research proposal for my graduating year, but soon developed into a titration for different drug detoxes, called the Tauto-Mod titration system.
The first pilot project was funded by the Homeopathy Action Trust and was a one-day-a-week project in a rehabilitation centre in Luton and a homeless day programme in Slough. After results proved positive for the programme, the detox was then taken on by South Westminster Drug and Alcohol Service (SWDAS) to be used in conjunction with a range of other interventions at the service. Detoxification from opioids and alcohol in this service is carried out under medical supervision, and employs a range of NICE approved drug (allopathic) therapies, with adjuvant evidence based psychosocial interventions. The homeopathic treatment outlined in this article was additional to this.
Since the pilot started at SWDAS in April 2013, 45 clients have taken part in the detox and study. Out of these clients, 60 per cent had self-referred after attending a guest speaker group and hearing about the detox from other clients. Seventy per cent were male and 30 per cent female, with a dropout rate (attending less than three appointments) of six clients in total. Alcohol clients had the highest overall attendance, at 55 per cent. Among all the clients, there was an overall retention rate of 80 per cent for weekly appointments and a successful completion rate of 61 per cent (including those detoxing from the programme, remaining abstinent and/or no longer using the primary drug.) Of those on the programme, nine clients were also on a drug replacement therapy prescription, including detoxing from methadone.
The drugs we detox, and which were included in the SWDAS study, are alcohol, cocaine/crack, heroin, cannabis, methadone, benzodiazepines, amphetamines, methamphetamine, GBL and ketamine.
The Tauto-Mod system adopts a tautopathic approach, which involves the drug or substance that has caused the illness and/or toxicity in the client being prescribed at a high dilution. This system is believed to work in accordance with the ‘hormesis concept’.
Hormesis in toxicity involves providing a low-dose stimulation (the drug in high dilution) to cells in order to trigger a restorative process – that is, the compensatory response to damage. It is proposed that these low doses of toxins or other stressors might activate the repair mechanisms of the body. In layman’s terms, the Tauto-Mod system works primarily at the cellular level to flush toxins from the body, thus reducing cravings, withdrawal symptoms and long-term toxicity.
The recording of results and the prescribing of the appropriate dilution occurs weekly and is based on whether the symptoms for each drug present as nil, mild, moderate or severe for each titration chart. For example, a client presenting with mostly moderate to severe withdrawal and toxicity symptoms will be prescribed the appropriate tautopathic medication at low dilution. The more amelioration of symptoms recorded in subsequent weeks, the more the dilution of the tautopathic medicine is increased. Clients are recommended in most cases to take a couple of doses daily. This is to ensure they are receiving the full effects of the medication, particularly as most are still using the drug on top of their tautopathic prescription and maybe taking conventional medications alongside this system.
Tauto-Mod involves weekly titration charts that record symptom levels for each drug misused per person. Depending on the level of severity of symptoms, the client is then prescribed the drug at a specified dilution level. The higher the level of symptoms and toxicity, the lower the dilution of the drug. The system titrates upwards only, which differs from conventional methods of prescribing methadone. The premise is that the higher the dilution, the more this method is believed to work on the mental/emotional level once most of the physical symptoms have been alleviated by the lower dilution preparations.
The expectation of the Tauto-Mod detox is that the patient attends weekly appointments to observe and record shifts in symptoms and prescription. This also allows the practitioner to liaise directly with the project workers and medical staff to ensure the best treatment is provided and to flag any risks and concerns, as well as positive progress. Substance misusers often live chaotic lifestyles, so it is not always possible to see the patient on a weekly basis for a minimum of 12 weeks; however, so far at SWDAS, the attendance rate has been high and surpassed expectations.
This programme also has a second system running parallel to the tautopathic prescriptions. Since the addictions sector is now acknowledging that we must focus on the client’s underlying reasons for becoming a substance misuser in the first place, the project also prescribes dilution medications for any associated mental and physical health symptoms, ensuring that the client receives holistic support in their recovery. Mental health issues, such as depression, anxiety, delusions and paranoia, are prescribed for with relevant homeopathic medications. The same follows for any physical health symptoms such as restless leg syndrome, chronic coughs, headaches and constipation. This holistic approach allows the client to develop a sense of overall wellness and attempts to pre-emptively address any reasons why the service user may relapse in the future, such as past trauma and life changing events.
With the aim of rolling this out to other services in south east England and eventually nationwide, I realised I needed help from someone else in the industry and partnered with Mark Dempster, practising psychotherapist, drugs counsellor and author of Nothing to Declare. He was very enthusiastic about an ‘innovative detoxification system that has limitless potential in the future’ and said that ‘a titration system fit for purpose which can accommodate the needs of developing drug trends and markets has to be a good thing.’
As the system is not only a clinical treatment programme but also a study, progressive services and boroughs throughout the country now have the opportunity to benefit from our results, helping to obtain more positive outcomes as well as being part of this exciting study. This service has worked well in an integrated health care system and can be accessed at most levels of treatment.
The aim is to ensure that the service user can access a holistic treatment system that is tailor-made to their needs, expectations and long-term health goals. The substance misuse field is finally addressing the issue of long-term methadone maintenance. However, there is still great scope for investigation into complementary and unconventional therapies, their worth to the sector, and the holistic side of treatment.
Tracy Woodward Gagetta is CEO and founder of Restorative Recovery Prescribing Ltd. For more information on the Tauto-Mod system, visit www.recoveryprescribing.com