What is buprenorphine?
Buprenorphine is an opioid substitute medication. It is taken under the tongue (sublingually), it has a long duration of action (approximately 33 hour half-life), and it blocks the effects, including euphoria, of other opioids. Most importantly, Buprenorphine itself does not produce euphoria. The absence of euphoria is crucial to the recovery of the opioid dependent patient. Over time, the patient’s brain will begin to recover normal functioning.
How often do you administer drug screens? How often are they given?
We test on-site, regularly on a monthly basis using urine drug screens. Each regular monthly drug screen is included in the cost of the visit. Any additional drug screens are $20.00
Do you accept insurance? What are your fees?
We accept cash and credit cards and do not accept any insurance. Our fees for intake and for monthly follow up appointments are all inclusive for clinic services cover everything except for the price of the medication, which you obtain at your pharmacy. You can provide your insurance company a superbill (invoice) which we can provide for you to possibly get reimbursed for your doctors visits.
Is attending group counseling required?
Medication Assisted Treatment only works with counseling and thats why we require all patients attend group counseling before every doctors visit. Your group counseling sessions are included in the monthly fee and all our patients are welcome to attend as many groups as they like, at no extra charge.
What is drug addiction?
Drug addiction is defined as a chronic, relapsing, disorder of the brain, manifested as compulsive drug seeking and use even while the person experiences severely negative consequences for this use. The areas of the brain affected by drugs of abuse, including opioids, make it virtually impossible for the person to stop their drug use for any length of time. Relapse to drug use is normal for those suffering from this brain disorder.
What are opioids?
Opioids are a family of drugs that have morphine-like effects; their primary medical use is pain relief. Continued use of the opioid to suppress pain may, depending on the circumstances, lead to opioid addiction. Buprenorphine is an approved medication for the treatment of this disorder. It has been shown to treat, successfully, addiction produced by prescription opioids as well as that produced by illicit opioids such as heroin.
What is the best treatment for opioid addiction?
Medication Assisted Treatment is recommended for the stabilization of opioid addiction by the National Institute on Drug Abuse, the Substance Abuse and Mental Health Services Administration, and the American Society of Addiction Medicine, among others. Medication Assisted Treatment consists of a comprehensive two-tier approach. The first tier consists of stabilizing the brain disorder of addiction with a medication such as Buprenorphine. Once stabilized on their medication, the addicted person will no longer engage in compulsive drug seeking and use of opioids. The second tier of treatment; that of counseling and behavioral therapy is then used to correct the dysfunctional behavior the patient acquired while in his or her addiction.
Do you prescribe any other medications besides buprenorphine?
We only prescribe buprenorphine based medications. This includes Subutex, Suboxone, Zubsolv, & Bunavail.
Does buprenorphine treatment cure opioid addiction?
t should be understood that there is no cure for opioid, or any other, addiction. This is a chronic disorder, such as Multiple Sclerosis or chronic depression, which the patient will deal with for the rest of their life. This does not mean they will remain on medication forever. It does mean that to remain opioid free in the absence of medication, that they must learn the skills and relapse prevention techniques that are necessary for the maintenance of their sobriety. This is one of the functions of the counseling component of treatment.
How does buprenorphine produce its effects?
Buprenorphine is a partial opioid agonist. When Buprenorphine binds with the opioid receptor, it activates the receptor only partially. This partial activation produces a diminished opioid effect. This is in contrast to the full opioid effect produced by full agonists such as hydrocodone, oxycodone, methadone, and heroin. Another characteristic of Buprenorphine is that its effects are limited by a dosage “ceiling.” This ceiling is reached at a dose of 16 to 24 mgs of Buprenorphine. When this ceiling is reached, no matter how much more Buprenorphine is taken, the magnitude of its effects will not increase. Buprenorphine is, thus, an extremely safe medication. This is again in contrast to the full opiate agonists. With a full agonist, as the dose increases, so does the magnitude of its effects. At very high doses, therefore, a full agonist may produce complete respiratory depression and death.
Which medication type is the best?
Patients have individual medical and financial needs that are taken into consideration by our physicians. All questions about the various brands of medication are throughly discussed during consultation and throughout treatment. We have medication guides in our group rooms, physician offices and links to the medication tyypes can be found in the resources page of this website.
Why give an opioid medication to an opioid addict?
Addiction is caused by the euphoria the person experiences when taking opioids. This euphoria, over time, causes changes in the structure, and thus the function, of specific regions of the user’s brain. These structural and functional alterations produce the phenomenon of addiction. The goal in Medication Assisted Treatment is to eliminate the euphoria, keep the patient from undergoing the devastating trauma of opioid withdrawal, and eliminate the need for opioids that drives compulsive drug seeking and use. Buprenorphine therapy accomplishes this goal.
Isn't this trading one addiction for another?
The answer to this question: Not at all. Addiction is manifested as compulsive drug seeking and use. The need, the craving, for the euphoria produced by the opioid drives the compulsive behavior of addiction. When taken consistently, as prescribed, Buprenorphine does not produce euphoria. Patients report that it makes them normal; that they feel like they did before they ever took opioids. They also report that, on occasion, they forget to take their Buprenorphine. (If a drug is producing euphoria, the person is not going to forget to take it.) Buprenorphine therapy is, thus, comparable to a person taking Baclofen to control the muscle spasms of Multiple Sclerosis or a person taking Prozac to control the symptoms of depression.
What are the different types of medication I will be prescribed?
Suboxone and Zubsolv are a combination of Buprenorphine and Naloxone. Suboxone is a strip that is placed under the tongue (sublingual administration). Zubsolv is a small pill that is also administered under the tongue. Both include the opioid antagonist, Naloxone. As an antagonist, Naloxone binds with the opioid receptor but produces no effect. Naloxone will, though, block any other opioid from binding with the opioid receptor. It is included in the formulation with Buprenorphine to discourage intravenous use of the medication. If taken as directed, under the tongue, Naloxone cannot be absorbed into the blood stream. It is, thus, ineffective. Naloxone is effective only if injected.
Subutex is also a sublingual strip. It contains Buprenorphine alone. Because of the greater possibility of intravenous use of this formulation, and the greater risk of diversion to illicit use, there are more restrictions on its use as a medication.