All programs begin with an initial physician visit , this can be done at home or the office of our Suboxone clinic, at that time, a thorough and comprehensive interview and exam is completed to determine the appropriate dosing protocol for your case. If appropriate, the first dose of SUBOXONE will be started. This is a mandatory face to face interview and is required for our 30 day program.
We believe that the first 24-72 hours are critical so we would like patients to be in close proximity to the clinic during that period especially for out of state residents. Also it would be beneficial for the patients to be away from their current environment during this period, this will help avoid triggers in the first stages of recovery and give the family a much deserved break, we call it the RESPITE period.
Over the next 30 days frequent communication with our team through unlimited email/phone correspondence will help adjust your medication doses and add medications if necessary to alleviate any discomfort then gradually taper you off Suboxone. You tell us how you feel and we adjust your medication to reach an optimal status of comfort during your detox. Some of our programs the costs for all medications that we use in our protocols are covered while in others they are not part of the package.
Psychosocial rehabilitation is a crucial part of the program and can be offered through face to face sessions or telecommunications.
Relapse prevention. It is recommended that all patients be enrolled in an ongoing relapse prevention program in addition to our detox program. The detoxification procedure is only the first step in the recovery process. Just as it is the case with any chronic relapsing disease, in opiate dependence future exacerbation of the disease can occur. Hence, it is very important that after we establish remission of the disease, patients should continue to undergo treatment whether in one of our programs or in a different program while they watch for any signs of relapse. If any of these occur, patients are instructed to contact us immediately so that we can work with them to prevent a relapse.
1700 Soscol Avenue Suite 21
Napa, CA 94559
Frequently Asked Questions: For Family Members — Suboxone® Treatment Information
What is an opioid?
Opioids are addictive narcotics in the same family as opium and heroin. This includes many prescription pain medications, such as Codeine, Vicodin, Demerol, Dilaudid, Morphine, Oxycontin, and Percodan. Suboxone® is also an opioid, and is used to treat dependence.
Why are opioids used to treat dependence?
Many people wonder why doctors use Suboxone® to treat opiate addiction, since it is in the same family as heroin. Some of them ask, "Isn’t this substituting one addiction for another?" Suboxone® is not "just substitution." Medical studies since 1965 show that treatment helps keep patients healthier, keeps them from getting into legal troubles, and prevents them from getting AIDS. Suboxone® is not a cure for dependence, just as insulin is not a cure for diabetes, but rather it is a tool to be used for treatment. Suboxone® does not eliminate physical dependence, and if it is stopped suddenly, the patient will experience withdrawal symptoms.
What is the right dose of Suboxone®?
Family and friends of patients who have been addicted to heroin or prescription pain medications have watched as their loved ones use a drug that makes them high, or out of touch with reality, or have watched the painful withdrawal which occurs when the drug is not available. Sometimes, family has not seen the ‘normal’ person for years. They may have seen the person misuse doctors’ prescriptions for narcotics to get high. They are rightly concerned that their loved one might misuse or take too much of the Suboxone® prescribed by the doctor. They may watch the patient and notice that the patient seems drowsy, or stimulated, or restless, and think that the Suboxone® will be just as bad as heroin or prescription pain medications.
Every opioid can have stimulating or sedating effects, especially in the first weeks of treatment. The ‘right’ dose of Suboxone® is the one that allows the patient to feel and act normally. It can sometimes take a few weeks to find the right dose. During the first few days, the dose may be too high, or too low, which can lead to withdrawal, daytime sleepiness, or trouble sleeping at night. These symptoms should be noted or even written down. The Napa Hope doctor can then use all these clues to adjust the amount and time of day for Suboxone® doses.
Once the right dose is found, it is important to take it on time in a regular way, so the patient’s body and brain can work well.
How can the family support good treatment?
Even though Suboxone® treatment for opioid dependence works very well, it is NOT a cure. It is a tool, if appropriately used, will help the individual to achieve a goal, whether that goal is maintenance or detoxification and freedom from opiates all together. This means that the individual must follow program protocols, especially for the use of Suboxone®. The best way to help and support the patient is to encourage regular contact with Napa Hope.
1) Regular medical care
Most patients will be required to see the physician for ongoing Suboxone® treatment every four weeks. If they miss an appointment, they may not be able to refill the medication on time, and may even go into withdrawal, which could be dangerous.
Individuals who are recovering from dependence need counseling in order to learn how to adjust to life without the opiates. Napa Hope will assist in scheduling regular appointments with an individual counselor, or for group therapy. These appointments are key parts of treatment, and work together with the Suboxone® treatment to improve success in treatment for opiate dependence. Sometimes family members may be asked to join in family therapy sessions, which also are geared to improve addiction care.
3) Taking the medication
Suboxone® is unusual because it must be dissolved under the tongue, rather than swallowed. Please be aware that this takes a few minutes. While the medication is dissolving, the patient will not be able to answer the phone, or the doorbell, or speak very easily. This means that the family will get used to the patient being ‘out of commission’ for a few minutes whenever the regular dose is scheduled.
4) Storing the medication
If Suboxone® is lost or misplaced, the individual may skip doses or go into withdrawal, so it is very important to find a good place to keep the medication safely at home – away from children or pets, and always in the same location, so it can be easily found. The doctor may give the patient a few ‘backup’ pills, in a separate bottle, in case an appointment has to be rescheduled, or there is an emergency of some kind. It is best if the location of the Suboxone® is NOT next to the vitamins, or the aspirin, or other over-the-counter medications, to avoid confusion. If a family member or visitor takes Suboxone® by mistake, he or she should be checked by a physician immediately.
What does Suboxone® treatment mean to the family?
It is hard for any family when a member finds out he or she has a disease that is not curable. This is true for dependence as well. When chronic diseases go untreated, they have severe complications that may lead to disability and death. Fortunately, Suboxone® can be a successful treatment, especially when it is integrated with counseling and support for life changes that the individual has to make to remain ‘clean and sober.’
Chronic disease means the disease is there every day, and must be treated every day. This takes time and attention away from other things, and family members may resent the effort and time and money that it takes for Suboxone® treatment and counseling. (It might help to compare dependence to other chronic diseases, like diabetes or high blood pressure. For example, in the case of hypertension, it takes time to make appointments to go to the doctor for blood pressure checks, and it may annoy the family if the food has to be low in cholesterol, or unsalted. But most families can adjust to these changes, when they consider that it may prevent a heart attack or a stroke for their loved one. )
Genetics and dependence
Another very important issue for family members to know about is: dependence can be partly inherited. Research is showing that some persons have more risk for becoming dependent than others, and that some of this risk is genetic. So when one member develops opiate dependence, it means that other blood relatives should consider themselves ‘at risk’ of developing dependence or alcoholism. It is especially important for young people to know that alcohol or drugs at parties might be dangerous for them (that is, they may be more likely to ‘get hooked’), even more than for most of their friends.
It is common for people to think of dependence as a weakness in character, instead of a disease. Perhaps the first few times the person used drugs it was poor judgment. However, by the time the patient is dependent, and using every day, and needing medical treatment, it can be considered to be a ‘brain disease’ rather than a problem with willpower. In fact, research brain scans clearly show the difference between a "dependent" individual and a "normal" individual.
Sometimes when the patient improves and starts feeling normal, the family has to get used to the new "normal" person. The family interactions (sometimes called ‘family dynamics’, or ‘system’) might have been all about trying to help this person in trouble, and now he or she is no longer in so much trouble. Some families can use some help themselves during this change, and might ask for family therapy for a while.
Support of family and friends can be very helpful to patients on Suboxone® treatment. It helps if the family members understand how dependence is a chronic disease that requires ongoing care. It also helps if the family gets to know a little about how the medication works, and how it should be stored at home to keep it safe. Family life might have to change to allow time and effort for ‘recovery work’ in addiction treatment. Sometimes family members themselves can benefit from therapy.