Why medication assisted treatment for opiate addiction?
The two aspects of addiction that keep you sick are cravings and withdrawal. Medications like Suboxone suppress the debilitating symptoms of cravings and withdrawal, allowing you to engage in supportive therapeutic interventions such as counseling and 12-step programs. Engaging in recovery implements positive long-term changes which develop into new healthy patterns of behavior.
What is Suboxone?
Although Suboxone is the most commonly used opiate replacement drug, there are others available. I only prescribe Suboxone, Zubsolv, or Bunavail, as these contain Naloxone, which deters IV misuse of the medication. I will use the term “Suboxone” to mean Buprenorphine/Naloxone drugs, for simplicity’s sake.
Suboxone is a combination of two medications, buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, which means it acts like an opioid and prevents withdrawal symptoms by partially blocking the opioid receptor. It is a controlled substance and can only be prescribed by providers who have obtained a special certificate from DEA.
Naloxone is present in small amounts to prevent injection of Suboxone. Naloxone is the same drug as Narcan, which reverses overdose. If Suboxone is injected, you will go into withdrawal as Naloxone knocks buprenorphine off the opioid receptor and then blocks it.
Therapy Requirement
The disease of addiction is not “cured” by medication.
I provide the medication part of medication assisted addiction therapy. That is only a portion of the fight against your disease. You need to address the reasons you abuse drugs in the first place. You need to develop healthy skills to deal with stress other than getting high.
I strongly recommend individual therapy, actively participating in a 12-step, SMART Recovery, or Celebrate Recovery program, or have attended or are attending an inpatient or intensive outpatient program with follow up therapy.
In order to receive ongoing prescriptions, I require you to attend a therapy session from a licensed counselor, at the very least, twice a month. I do not have therapists on site. There are many good therapists in the area who work different schedules so you can find one that fits with your schedule. I require documentation you are going to therapy.
After 6 months of treatment, the counseling requirement is optional.
Patients who have relapsed are required to go to counseling at least once before they return for follow-up. I require documentation you attended and you plan to continue seeing your therapist. Don’t turn a relapse into a failure; learn how to bolster your recovery.
Many patients do well in the first few weeks or even months without therapeutic support. The risk of relapse is very high if they do not learn to adjust to life without drugs. Don’t be one of them!
Urine Drug Screens
You will be required to take and pass a UA at each appointment in order to receive prescriptions. You may not use benzodiazepines (Ativan, Xanax, Klonopin, Valium, etc.) while taking Suboxone.
How long does medication assisted treatment last?
That depends on the patient. We will work together to determine the correct dose for you and how long you need to remain on medication. Generally, the longer and more you used, the longer you will need Suboxone. Most patients taper off the medication successfully over a few months but some need a low dose indefinitely. The goal is to prevent significant withdrawal and relapse so you can continue to work or go to school without uncomfortable symptoms or cravings.