PRESCRIPTION NARCOTICS (Opiates)

Vicodin           Oxycontin      Percocet        Darvocet        Lortab             Lorcet

Abuse and dependence of prescription narcotics often begins quite benignly with the medication being prescribed for pain. Dependence can occur very rapidly and withdrawal from these medications can be very painful, although not life-threatening.

Detoxification or maintenance (induction) from the above medications is performed in an outpatient setting using Suboxone, a synthetic opiate.

 Buprenorphine / Suboxone / Subutex
Subutex (buprenorphine hydrochloride) and Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) are FDA-approved for the treatment of opiate dependence. Subutex and Suboxone treat opiate addiction by preventing symptoms of withdrawal from prescription opiates.

The first of these formulations, Subutex, contains only buprenorphine and is intended for use at the beginning of treatment for drug abuse. The other, Suboxone, contains both buprenorphine and the opiate antagonist naloxone, and is intended to be the formulation used in maintenance treatment of opiate addiction. Naloxone has been added to Suboxone to guard against intravenous abuse of buprenorphine by individuals physically dependent on opiates. Both drugs are supplied in 2 mg and 8 mg tablets which are placed under the tongue and must be allowed to dissolve.

Outpatient Prescription Opiate Detoxification
Detoxification is intended for patients whose craving levels are generally lower and/or who, in the past, have had longer periods of abstinence.

Our doctors will determine whether detoxification (and not Suboxone Maintenance) will be appropriate.

Detoxification is performed in an outpatient setting generally over the course of 4-5 consecutive days and usually requires two (2) in-office visits to start. These office visits are part of the induction process and include:

• Comprehensive History and Physical (H&P)
• Nursing Assessment
• Psychological Assessment
• Labs
• Urine Drug Screen
• All medications during induction
• Take-home medications for completion of the detoxification (generally 2-3 days)
• Aftercare planning

Patients can generally expect to spend 5-6 hours per day during the in-office visits and should be accompanied by a sober companion. We take the time to very carefully, and slowly perform the procedure to minimize the effects of withdrawal.

It is important that patients arrive in a mild-medium state of withdrawal. It is extremely important that methadone is not present in the system. Patients who are on methadone maintenance, at our physician’s discretion, should be using no more than 20-30 mg of methadone per day or reduce consumption to that level prior to undergoing detoxification with buprenorphine

Outpatient Suboxone Induction & Maintenance

Induction and Maintenance is intended for patients whose craving levels are generally higher and/or who, in the past, have had relatively shorter periods of abstinence.

Our doctors will determine whether the patient is better suited for maintenance.

The process starts with an induction period which is performed in an outpatient setting generally over the course of two (2) consecutive in-office visits to start. In some cases, a third day will be required to properly stabilize the patient. These office visits include:

• Comprehensive History and Physical (H&P)
• Nursing Assessment
• Psychological Assessment
• Labs
• Urine Drug Screen
• All medications during induction
• Take-home medications for the evening

Patients can generally expect to spend 5-6 hours per day during the in-office visits and should be accompanied by a sober companion. We take the time to very carefully, and slowly perform the procedure to minimize the effects of withdrawal.

It is important that patients arrive in a mild-medium state of withdrawal. It is extremely important that methadone is not present in the system. Patients who are on methadone maintenance, at our physician’s discretion, should be using no more than 20-30 mg of methadone per day or reduce consumption to that level prior to undergoing detoxification with buprenorphine

Upon discharge from the induction phase, the patient will receive:

• An Individualized Aftercare/Counseling Plan
• Prescription for Suboxone
• Appointments for weekly follow-up visits over the next three(3) weeks

How Long Will I Be on Suboxone?

The length of time that a patient is on Suboxone Maintenance will vary. It is important that a person engage in their continued counseling to address the issues that caused them to use in the first place.