|
|
The
three phases of maintenance treatment with buprenorphine for opioid addiction are
(1) induction, (2) stabilization, and
(3) maintenance.
Suboxone induction (approximately 1 week), the first phase of treatment, involves helping
a patient begin
the process of switching from the opioids of abuse to buprenorphine. The
goal of the induction phase is to find the minimum
dose of suboxone at which the patient
discontinues or markedly diminishes use of other opioids and experiences no withdrawal
symptoms,
minimal or no side effects, and no uncontrollable cravings for drugs of abuse.
The induction phase is completed and the stabilization phase is begun when the patient is
experiencing no
withdrawal symptoms, is experiencing minimal or no side effects, and no
longer has uncontrollable cravings for opioid agonists.
Dosage adjustments may be necessary during early stabilization, and frequent contact
with patients increases the likelihood
of compliance. Until full stabilization is achieved,
weekly assessments of patients may be indicated to make necessary dosage adjustments.
This period varies per patient, but significant considerations must be addressed. Attention
must be given
to the psychosocial and family issues that have been identified during the
course of treatment.
Other issues that will need continual monitoring are related to cravings for opioids and to
preventing relapse. Some other issues
related to opioid abouse that need to be addressed
during maintenance treatment include, but are not limited to, the following:
• Psychiatric comorbidity
• Somatic consequences of drug use
• Family and support issues
• Structuring of time in prosocial activities
• Employment and financial issues
• Legal consequences of drug use
• Other drug and alcohol abuse
The frequent presence of some or all of these problems underscores the importance of
providing counseling services to address the needs of patients and to maximize the
chances of the best possible outcomes.
The design of long-term treatment depends in part on the patient’s personal treatment goals
and in part on objective signs
of treatment success. Maintenance can be relatively short term
(e.g., <12 months) or a lifetime process. Treatment success
depends on the achievement of
specific goals that are agreed on by the patient, counselor and the physician.
Following successful stabilization, decisions to decrease or discontinue buprenorphine should
be based on a patient’s
desires and commitment to becoming medication-free, and on the
physician’s confidence the tapering would be successful.
When the decision is made to discontinue suboxone combination treatment, the daily does
will
be decreased gradually over a predetermined period or at a rate negotiated by the patient,
counselor and the physician together.
AND OTHER REQUIREMENTS
Fees are $250.00 for assessment, toxicology screen, laboratory
work and a prescription for one week
of medication. Patients
must obtain their medication at their pharmacy of their choice. This
is due at
the time of intake. Money orders and credit
cards are acceptable.
Following INTAKE, fees are $100.00 due upon admission and at
every scheduled appointment thereafter, plus the cost of medication (some insurance may
provide coverage). Money orders and credit cards are acceptable. For this service, patients
will not be allowed to carry a balance, Administrative Detoxification occurs when fees are not paid. The patient loses
all pick-up privileges, no prescriptions will be given
and the dose is rapidly reduced. Money orders and credit cards are acceptable.
With established service, personal checks may be acceptable. Some private insurance companies
are accepted.
According to Federal Regulations, patients are not entitled to evaluation for "pick-up" privileges
until they have beenstabilized.
In the
first week of treatment, patients may be required to come to the facility daily for observation and evaluation
and assessment. Your primary counselor will provide you with the conditions and procedures required to
qualify for "pickup” privileges.
Patients are assigned “codes”
based
upon several factors such as length of time in treatment, toxicology
screens and adherence to therapy sessions. The codes are as follows:
1 1 week prescription
T 2 week prescription
M 4 week prescription
All patients MUST come to the facility for counseling and payment of fees. All appointments must be scheduled. There will
be NO call-in orders to a pharmacy.
Patients who make referrals will have one (1) week’s service waived. The new
patient must name the patient who made the referral at the time
of intake.
You will be required to submit a blood sample for basic screening within your first thirty (30) days
of treatment. Trained lab technicians are employed for this process. PATIENTS may not refuse to give
blood. However, blood
work can remain incomplete when technicians are unable to successfully draw
a sample. Additional attempts will be made
to secure a blood sample from you while in treatment.
If you are under medical care and can provide current documentation
of blood work that includes;
a Chemistry and Hematology profile, a Urinalysis, RPR, and a Hepatitis test performed within
14 days
of admission, a sample will not need to be drawn.
Once admitted into treatment, you are required to submit to a T.B.
Mantoux test. If testing has been
done by a private physician, within 90 days of admission, documentation
must be provided within your
first seven (7) days of treatment.
All new patients and reinstatements are required to submit a urine
sample upon admission and samples upon request for the duration
of treatment. Requests may be made by the medical staff, your counselor
and administration.
Monday through
Saturday - 7:00 am - 11:00 am
The clinic is closed on Sunday and holidays.
Therapeutic sessions are conveniently scheduled at the individuals's convenience.
Go Top
|
