Opioid Abuse Treatment
Our goal is to provide an easy, discrete and stress free transition from opioids to Suboxone while attempting to minimize withdrawal symptoms. Below is an outline of our clinic’s guidelines for treating opioid addiction.
Things to consider:
The day before starting Suboxone, we recommend an infusion with the classic Meyers’ Cocktail. The high dose vitamins and antioxidants help in minimizing withdrawal symptoms and make the transition easier. For short acting opioids like oxycontin, hydrocodone, morphine and heroin, you will need to abstain from using for 12-24 hours. For longer acting opioids like fentanyl and methadone, you will need to abstain from using for 48 hours.
Day 1 (Induction):
It is important when starting Suboxone that opioids be minimized in your system to prevent inducing withdrawal symptoms. For short acting opioids like oxycontin, hydrocodone, morphine and heroin, you will need to abstain from using for 12-24 hours. For longer acting opioids like fentanyl and methadone, you will need to abstain from using for 48 hours. You will feel like you are in early withdrawal at this appointment but this is important to prevent worse withdrawal symptoms. We also ask that you have someone provide transportation for you to this appointment as you will likely not feel well enough to drive.
You will be provided a prescription for 2 strips of Suboxone 8mg/2mg. We will have your driver go to the pharmacy and fill your prescription and bring it back to the office. You will take one strip and wait 30 minutes as we monitor you for withdrawal symptoms. If you are still feeling withdraw symptoms at this time, we will give you the second strip. Once you are feeling better you will be provided with one weeks’ worth of Suboxone. This appointment is usually 60 minutes in length.
Day 2-7 (Stabilization)
After your fist week of Suboxone you will return to clinic for a 30 minute re-evaluation. The goal of stabilization is to optimize your Suboxone to a dose where you no longer have cravings and experience few, if any, side effects. Typical doses range from 8mg/2mg to 24mg/6mg. Once the optimal dose is obtained, you will be provided a month prescription for Suboxone.
Beyond first week (Maintenance)
You will need to return to clinic on a monthly basis for refills and 30 minute evaluations. Urine drug screens will be performed on a random basis. The point of the drug screens is not to “catch” you using other drugs. We want to make sure all drug problems are addressed and avoid deadly consequences. The maintenance treatment with Suboxone can be indefinite, helping to prevent future relapses. Depression is often present in patients and Ketamine infusions can help with the symptoms of depression without adding more medications to your regimen. Patients also often suffer anxiety and insomnia and medical cannabis recommendation can be discussed as well.