{"id":10360,"date":"2025-03-01T14:07:45","date_gmt":"2025-03-01T19:07:45","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan383\/"},"modified":"2025-03-02T00:53:55","modified_gmt":"2025-03-02T05:53:55","slug":"dhan383","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan383\/","title":{"rendered":"php\/alerts\/dhan383 ~  Division of Public Health  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan383.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->383 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->March 23, 2018 5:06 pm <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  \n\n<h2 class=\"center\">Health\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n\n\n\nAlert<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\n\n\n\nGUIDANCE AFTER KENT COUNTY PSYCHIATRIST\u2019S LICENSE SUSPENDED<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n\n\n\n\n\n\n\n\n<p>The Delaware Division of Public Health (DPH) is issuing this health advisory to advise health care \n\n\n\n\nproviders that Gregory Villabona\u2019s medical license was suspended by Secretary of State Jeffrey \n\n\n\n\nBullock and the Delaware Board of Medical Licensure and Discipline due to allegations of unprofessional \n\n\n\n\nconduct related to the prescribing and distribution of controlled substances. Secretary Bullock also \n\n\n\n\nsigned a separate order suspending Dr. Villabona\u2019s Delaware controlled substance registration. \n\n\n\n\nThere may be former patients of Dr. Villabona who wish to obtain benzodiazepines, stimulants, and in a \n\n\n\n\nvery few cases opioids, for continuing management of their symptoms. These individuals who may be misusing \n\n\n\n\nand abusing these prescription medications are at a higher risk of drug seeking behavior, illicit use of \n\n\n\n\nprescription medications and illegal substances and for dangerous withdrawal symptoms, including the \n\n\n\n\npotential for overdose or death.<\/p>\n\n\n\n\n\n\n\n\n\n<h2>Summary<\/h2>\n\n\n\n\n<p>Certain individuals with regular access to controlled substances \u2014 particularly if they are not \n\n\n\n\nwell monitored by a medical practice \u2014 may be at significantly higher risk for medication misuse, \n\n\n\n\nphysiological dependence, addiction or overdose. Medical providers prescribing controlled substances \n\n\n\n\nshould monitor patients closely, screen for addiction risk, consider non-opioid medications for treatment \n\n\n\n\nof chronic pain and non-benzodiazepine medications and therapies for the treatment of anxiety disorders.<\/p>\n\n\n\n\n\n\n\n\n\n<h3>Background<\/h3>\n\n\n\n\n<p>Dr. Villabona is a psychiatrist with a practice in Dover who was previously disciplined by state licensing \n\n\n\n\nauthorities in 2003 for unprofessional conduct arising from sex offenses in Maryland to which Dr. Villabona \n\n\n\n\nplead guilty. He was disciplined again in 2007 for violating the terms of a 2005 order, which, in part, \n\n\n\n\nprohibited Dr. Villabona from treating minor patients in unsupervised settings. In 2008, Dr. Villabona \n\n\n\n\nentered into a consent agreement with the state that placed certain permanent restrictions on his medical \n\n\n\n\nlicense, including limiting his practice to male patients over the age of 18.<\/p>\n\n\n\n\n\n\n\n\n\n<h3>Recommendations\/Reporting<\/h3>\n\n\n\n\n<p>To help Dr. Villabona\u2019s patients find appropriate continued psychiatric care and appropriate medication \n\n\n\n\nsupport, DPH is recommending that:<\/p>\n\n\n\n\n<ul>\n\n\n\n\n<li>Prescribers should evaluate which patients are at risk for benzodiazepine withdrawal. \n\n\n\n\nBenzodiazepine withdrawal can be serious and potentially life-threatening. Benzodiazepines include Xanax \n\n\n\n\n(alprazolam), Ativan (lorazepam), Klonopin (clonazepam) and Valium (diazepam). While most patients will \n\n\n\n\nnot experience withdrawal symptoms, those who do will need to seek immediate medical attention. Signs and \n\n\n\n\nsymptoms of benzodiazepine withdrawal may include:\n\n\n\n\n<ul>\n\n\n\n\n<li>\u00a0Sweating<\/li>\n\n\n\n\n<li>\u00a0Tremor<\/li>\n\n\n\n\n<li>\u00a0Increased heart rate<\/li>\n\n\n\n\n<li>\u00a0Increased blood pressure<\/li>\n\n\n\n\n<li>\u00a0Nausea and vomiting<\/li>\n\n\n\n\n<li>\u00a0Hallucinations<\/li>\n\n\n\n\n<li>\u00a0Seizures<\/li>\n\n\n\n\n<\/ul>\n\n\n\n\n<\/li><li>Patients can be safely prescribed benzodiazepines in an outpatient setting with a plan to continue the current \n\n\n\n\ndose or safely taper down to an appropriate dose or off completely. However, patients experiencing any of the above \n\n\n\n\nsymptoms should be directed to the nearest emergency room for evaluation and treatment.<\/li><li>Stimulant medications are prescribed for the treatment of ADHD and include medications such as \n\n\n\n\nRitalin (methylphenidate), Adderall (amphetamine sulfate), Concerta and Vyvanse. While stopping these medication \n\n\n\n\nabruptly may lead to a return of ADHD symptoms and possible fatigue, irritability and depression, there are no \n\n\n\n\nimmediate life threatening complications associated with their discontinuation.<\/li><li>Prescribers should evaluate patients for substance use disorder risk as part of any regular clinical \n\n\n\n\nvisit but especially if they will be prescribing any controlled substances in general and opioids in particular. \n\n\n\n\nA sample opioid risk assessment tool can be found at Help Is Here <a href=\"http:\/\/www.helpisherede.com\/Content\/Documents\/Opioid-Therapy.pdf\">http:\/\/www.helpisherede.com\/Content\/Documents\/Opioid-Therapy.pdf<\/a> or <a href=\"https:\/\/www.drugabuse.gov\/sites\/default\/files\/files\/OpioidRiskTool.pdf\">https:\/\/www.drugabuse.gov\/sites\/default\/files\/files\/OpioidRiskTool.pdf<\/a>.<\/li><li>If a patient appears to be at risk for substance abuse disorder, consider alternatives to controlled \n\n\n\n\nsubstances and in the event the use of these medications is unavoidable, monitor their use very closely. To the extent \n\n\n\n\npossible, use alternative therapies such as:\n\n\n\n\n<ul>\n\n\n\n\n<li>\u00a0Rehabilitative services, physical therapy, exercise and strength training for chronic pain<\/li>\n\n\n\n\n<li>\u00a0Cognitive behavior therapy and relaxation techniques for chronic pain and anxiety<\/li>\n\n\n\n\n<li>\u00a0Clinically appropriate non-controlled medications including but not limited to:\n\n\n\n\n<ul>\n\n\n\n\n<li>\u00a0acetaminophen and\/or non-steroidal anti-inflammatory drugs (NSAIDs) for chronic pain<\/li>\n\n\n\n\n<li>\u00a0selective serotonin and serotonin and norepinephrine reuptake inhibitors (SSRI and SNRIs) or tricyclic \n\n\n\n\nantidepressants (TCAs) for anxiety and chronic pain<\/li>\n\n\n\n\n<li>\u00a0atomoxetine (Strattera) and\/or guanfacine (Intuniv) for ADHD<\/li>\n\n\n\n\n<\/ul>\n\n\n\n\n<\/li>\n\n\n\n\n<\/ul>\n\n\n\n\n<\/li><li><strong>If you have questions about appropriate dosages, or tapering down dosages of prescribed \n\n\n\n\nmedications contact the Division of Substance Abuse and Mental Health (DSAMH) Director of Addiction Services \n\n\n\n\nDr. Sherry Nykiel at 302-255-9430 (office) 617-947-7434 (cell) or via email at <a href=\"mailto:sherry.nykiel@delaware.state.us\">sherry.nykiel@delaware.state.us<\/a><\/strong>.\n\n\n\n\n<\/li><li>Patients can also be directed to contact DSAMH\u2019s Mobile Crisis Line for Kent and Sussex \n\n\n\n\nCounties at <strong>800-345-6785<\/strong>.<\/li><li>For further information on substance abuse disorder for community members and medical providers, \n\n\n\n\nvisit \u201cHelp is Here\u201d at:\u00a0 <a href=\"http:\/\/www.helpisherede.com\/\">www.helpisherede.com<\/a>. \n\n\n\n\nFor a list of current locations that offer outpatient, inpatient, detoxification, recovery support, and recovery \n\n\n\n\nliving, visit <a href=\"http:\/\/www.helpisherede.com\/Resource-Guide\/Here-for-me\">www.helpisherede.com\/Resource-Guide\/Here-for-me<\/a>.<\/li><li>To reduce \u201cdoctor-shopping\u201d and to check the patient\u2019s history for controlled \n\n\n\n\nsubstances, query the Prescription Drug Monitoring program at <a href=\"http:\/\/dpr.delaware.gov\/boards\/controlledsubstances\/pmp\/default.shtml\">http:\/\/dpr.delaware.gov\/boards\/controlledsubstances\/pmp\/default.shtml<\/a>.<\/li><li>Patients should be reminded to avoid taking opioids with alcohol and sedatives or tranquilizers, \n\n\n\n\nincluding benzodiazepines (i.e. Xanax and Valium); muscle relaxants (i.e. Soma or Flexeril); sleeping pills or \n\n\n\n\nhypnotics (i.e. Ambien or Lunesta); and other prescription opioid pain relievers unless prescribed by a health care provider.<\/li><li>Medical providers and law enforcement should be especially vigilant about potential patient \n\n\n\n\noverdoses or those with drug-seeking behavior, particularly in and around Dover where Dr. Villabona\u2019s \n\n\n\n\npractice was located.<\/li><li>For those serving pregnant or reproductive-age women, consider also screening for alcohol abuse \n\n\n\n\nby using screening tools such as the T-ACE questionnaire, which can be found on <a href=\"http:\/\/www.helpisherede.com\/\">www.helpisherede.com<\/a> \n\n\n\n\nand via Google.<\/li><li>Patients should be reminded to lock all medications up or put them out of the way of anyone, \n\n\n\n\nincluding children or pets, who might try to consume them, whether by accident or on purpose. Patients can \n\n\n\n\nsafely dispose of any unused medications at Delaware prescription medication drop boxes. There are 21 permanent \n\n\n\n\ndrop boxes at this time. For a complete list of locations, visit <a href=\"http:\/\/www.helpisherede.com\/\">www.helpisherede.com<\/a>.<\/li><\/ul>\n\n\n\n\n<h3>Additional Information<\/h3>\n\n\n\n\n<ul>\n\n\n\n\n<li>\u00a0 U.S. Surgeon General resources on opioids for physicians and patients:<br>\n\n\n\n\n<a href=\"http:\/\/turnthetiderx.org\/\">http:\/\/turnthetiderx.org\/#<\/a><\/li>\n\n\n\n\n<li>\u00a0 CDC Guidelines for Prescribing Opioids:<br>\n\n\n\n\n<a href=\"https:\/\/www.cdc.gov\/drugoverdose\/prescribing\/guideline.html\">https:\/\/www.cdc.gov\/drugoverdose\/prescribing\/guideline.html<\/a><\/li>\n\n\n\n\n<li>\u00a0 Department of State Press release on license suspension:<br>\n\n\n\n\n<a href=\"https:\/\/news.delaware.gov\/2018\/03\/19\/secretary-state-announces-medical-license-controlled-substance-registration-suspensions\/\">https:\/\/news.delaware.gov\/2018\/03\/19\/secretary-state-announces-medical-license-controlled-substance-registration-suspensions\/<\/a><\/li>\n\n\n\n\n<li>\u00a0 Opioid risk assessment tool:<br>\n\n\n\n\n<a href=\"https:\/\/www.drugabuse.gov\/sites\/default\/files\/files\/OpioidRiskTool.pdf\">https:\/\/www.drugabuse.gov\/sites\/default\/files\/files\/OpioidRiskTool.pdf<\/a><\/li>\n\n\n\n\n<li>\u00a0Help Is Here<br>\n\n\n\n\n<a href=\"http:\/\/www.helpisherede.com\/\">www.helpisherede.com<\/a><\/li>\n\n\n\n\n<\/ul>\n\n\n\n\n<p>************************************<\/p>\n\n\n\n\n\n\n\n\n\n<p>You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n\n\nIf you are not a member and would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a><\/p>\n\n\n\n\n\n\n\n\n\n<br>\n\n\n\n\n<hr>\n\n\n\n\n<br>\n\n\n\n\n<p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\n<!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #383 March 23, 2018 5:06 pm Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10360","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10360","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10360"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10360\/revisions"}],"predecessor-version":[{"id":11536,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10360\/revisions\/11536"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10360"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}