ELEVATE ADULT PSYCHIATRY IN LUBBOCK, TX
It is important to understand that OPIOID DETOX using Suboxone /Buprenorphine
may take different duration of time since it depends on multiple factors: type of the
opioid being used, the dosage, duration, prior history of opioid detoxifications,
personal tolerance of withdrawal symptoms, concurrent use or abuse other of
addictive substances, patient’s personal commitment and motivation to complete
the detoxification treatment. Patients should keep in mind that Suboxone itself is an
addictive substance and it is not easy to quit taking it especially when their
withdrawal symptoms and craving for opioids have already been stabilized on a
higher dose of Suboxone. Using long-acting Buprenorphine called SUBLOCADE has
been very promising in making it easier to stop the Suboxone and live opioid free.
Using SUBOXONE FOR MAINTENANCE treatment will require a follow up visit in one
week after the initial evaluation to adjust the dosage of Suboxone. Then, monthly
visits during the first year of treatment (11 visits) with random saliva test. The
patient will then have an opportunity to schedule visits every 2 months if no
incidents of positive saliva tests and no potentially dangerous behaviors for relapse
happen during the first year of the treatment. Upon completion of the second year
without an incident of positive saliva test or potentially dangerous behaviors for
relapse, patient will be able to have follow up appointments every 3 months for the
rest of the maintenance treatment, only 4 visits per year.
In case of POSITIVE SALIVA TEST, a relapse, patient will be given weekly medication
twice with 2 saliva tests at the patient's expense. Only after 2 negative saliva tests
will patients receive a monthly supply of Suboxone. Patients will continue a monthly
visit until it is agreed between the patient and the Doctor when to move to a less
frequent follow up schedule. Patients will be recommended to go for substance
abuse rehabilitation treatment before they get any suboxone after their 3rd relapse.
Patients who would like to stop taking Suboxone and wean themselves off it, should
consider staying on a smaller dose of Suboxone, and discuss what would be the
best way to get off the Suboxone; clonidine and SABLOCADE may be considered.
POTENTIALLY DANGEROUS BEHAVIORS FOR RELAPSE are:
1. Missing appointments.
2. Running out of medications too soon
3. Taking medications off schedule
4. Not Responding to phone calls
5. Refusing drug screen
6. Arguing about the results of drug screen (saliva test)
7. Neglecting to mention new medications and outside treatment
8. Neglecting to mention change of address, job, or home situation
9. Appearing intoxicated or disheveled in person or on the phone
10.Inappropriate outburst of anger
11.Non- payment of office visits
12. Lost or stolen medications
13.Frequent physical injuries or auto accidents
These behaviors will be brought to the patient’s attention and he or she will be
supported in making appropriate responses to them.