Suboxone Treatment through Therapeutic Health Services
Therapeutic Health Services offers medically assisted treatment with Suboxone prescription. As part of our mission, we believe that those who are opioid dependent (prescription or illicit) may benefit from either a MAT-Methadone or MAT-Suboxone treatment program. We combine this with counseling and psychosocial support. We conduct treatment under the direction of a qualified physician (according to the Drug Addiction Treatment Act).
What’s the difference between Suboxone and Methadone?
Methadone is typically provided through our dispensary and is generally for those patients who are high risk for chronic severe opioid dependence where individuals inject more than a gram per day. Methadone is also a full agonist where it requires medically supervised withdrawal and maintenance that is in tandem with additional treatment and psychosocial support.
Suboxone has the combination of Naltrexone and Buprenorphine and is antagonist (Naltrexone) and partial agonist at the mu-Opioid Receptor. It is a prescribed medication where the treatment is focused on prevention of potential relapse due to opioid dependence that is either moderate to severe, and generally beneficial for those individuals who smoke or intermittently inject heroin that is less than a gram per day. Suboxone is also medically supervised through withdrawal management.
How do I know if Suboxone Treatment is appropriate for me?
We screen and assess each individual to determine appropriateness for the Suboxone program. This involves an initial alcohol/drug assessment where we screen an individual for appropriate level of care and whether they are medically appropriate for Suboxone.
The factors we look for to determine appropriateness for care is based off the TAP 40.
1. Determination of a diagnosis of an opioid substance use disorder that is moderate to severe
2. Presenting signs and/or symptoms of intoxication or withdrawal; and, whether there is a severe risk of withdrawal present
3. Individual interest in buprenorphine treatment
4. Educating and understanding the benefits and risks of buprenorphine treatment
5. Expectation to adhere to treatment plan and expectations for either intensive outpatient or weekly outpatient while on the buprenorphine treatment
6. Ability and willingness of the individual to follow all recommended safety procedures regarding buprenorphine treatment
7. Individual agreement to engage in and actively participate in treatment upon review of and clinical recommendations for opiate substitute treatment
8. Determination of individual’s psychiatric stability (low to no suicidal or homicidal risk factors; cognition and emotional function/stability).
9. Pregnancy or potential pregnancy – may be referred to Methadone or Subutex treatment
10. Diagnosis of Alcohol (moderate to severe) presence
11. Diagnosis of or current use of Benzodiazepines (prescribed or illicit)
12. Risk factors of potential continued use or continued problems where an individual has had multiple history of treatment interventions (inpatient and/or outpatient, methadone, and past Suboxone treatment). High risk factors of relapse proneness
13. Prior adverse reaction to previous Suboxone (allergic reactions) treatment/use
14. Any prescribed medications that may be contraindicative with a buprenorphine (always discuss all prescribed medications with all prescribing physicians).
15. Presenting medical issues/complications that may be contraindicative to buprenorphine treatment and intervention
16. Recovery environment conducive to treatment (stable housing, employment, supportive network of family and friends)
17. Individual’s level of motivation concerning treatment follow through and commitment
A complete biopsychosocial assessment that Therapeutic Health Services utilizes helps determine whether Suboxone may be an appropriate treatment intervention, in conjunction with appropriate level of care. We also consider additional criteria regarding current, or recent, methamphetamine use.
How do I get started with Suboxone?
As previously mentioned, an individual will contact one of our local branches to schedule an assessment for our Alcohol/Drug assessments. The request for Suboxone treatment is made at the time of the appointment.
Arrive 30 to 45 minutes prior to the scheduled assessment to fill out necessary paperwork. Provide a urine sample (if the assessment is also part of any legal requirements or conditions for probation, CPS, Employee Assistance Program participation; or, if this is an expanded evaluation and part of the family court/custody evaluation).
The assessment usually takes approximately 90 to 120 minutes. At the conclusion of the assessment, we inform the individual of the appropriate treatment recommendation and we schedule an appointment for an induction to meet with the prescribing physician.
Each participant admitted into the MAT-Suboxone program is then recommended to present in withdrawal at their induction where they will meet with the doctor for approximately 60 minutes. A urine sample will be requested and tested for illicit substance use. Any presence of Benzodiazepines may prevent from starting on the Suboxone treatment program and the individual will be requested to schedule a new appointment to follow up within the next week.
Once we complete the induction, we provide the individual with a prescription and recommend to engage in their appropriate treatment program (Intensive Outpatient or Weekly Outpatient).
What is the Suboxone Treatment Program?
Each person we admit into the Suboxone Program at Therapeutic Health Services meets with their assigned counselor and the prescribing physician each week for the first 30 days. We conduct UAs at the time of the appointment.
After 30 days, we schedule each patient to meet with their counselor and prescribing physician every 2-weeks for their follow up.
We allow those with private insurance to attend monthly individual appointments with their counselor and prescribing physician after 60 days of admittance. Those individuals who have apple health/state health insurance will remain with every 2-weeks of meeting with a counselor and prescribing doctor.
What happens if Suboxone is not appropriate for me?
First of all, you should meet with your assigned counselor to discuss whether or not Suboxone may be appropriate. This may require an update of the individual’s assessment into the MAT- Methadone program. Upon verification of medical appropriateness, the counselor will work with you to medically withdrawal down to 30 mgs of methadone.
If you have any additional questions, feel free to contact and speak with any THS Branch assigned Suboxone Coordinator.
Written by Timothy R. Berman, CDP
Chemical Dependency Professional