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Program Overview


 

 

 

 

 

 

 

Who is a candidate for Suboxone treatment?

  • People who abuse opiates and have not been able to quit on their own
  • People who are otherwise healthy and are able to participate in an office-based program
  • People who have the financial resources to afford treatment and medication
  • People who are appropriate for outpatient treatment and do not require detox from other addictive drugs (i.e. alcohol, Xanax, Valium, Klonopin)
  • People who have received previous treatment for their addiction, but continue to have cravings
  • People who are honest about their addiction, serious about their recovery, and understand that this program is their best chance of success

 

Assessment

This appointment takes about 1 hour during which the patient will be evaluated for our program and will meet our staff.

 
Douglas A. Brown, MD., FAAFP, Medical Director:

Will conduct a complete physical exam, review substance abuse history, and assess whether the program is right for the patient.

Gloria Brown, RN, Patient Advocate:

Will conduct Program Overview & Patient Responsibilities

Laura Cisewski, Program Administrator:

Will present Program Fees & Financing Options

Not all patients will be admitted into this program. Dr. Brown will assess whether or not the program will meet the needs of the individual patient and determine the patient’s ability to meet the program requirements. Honesty and commitment are critical!


 

Acceptance

Not all patients will be admitted into this program. Dr. Brown will assess whether or not the program will meet the needs of the individual patient and determine the patient’s ability to meet the program requirements. Honesty and commitment are critical!

If accepted into our program, the next steps are to…

  1. Complete the program paperwork.
  2. Pay the program fee.
  3. Schedule Patient Intake. The patient can be admitted to the program immediately, or can be scheduled for another day. However, the patient MUST be in a mild to moderate state of withdrawal before beginning the program.



 

What should I expect once I’m accepted?

  • Step 1:  Induction 
    Patient intake is generally the longest visit and may last anywhere from 1 to 4 hours. The patient will be instructed to arrive for this appointment experiencing mild to moderate withdrawal. If all criteria are met, the patient will be administered their first dose of Suboxone® with continued monitoring utilizing “COWS” (Clinical Opioid Withdrawal Scale). Additional dosing may be required during this visit until the patient’s withdrawal symptoms are stabilized. The patient is then discharged and closely monitored through additional office visits and frequent communication for the next several days.
  • Step 2:  Stabilization 
    During this phase of treatment, patients are seen weekly since dose adjustments are usually necessary. To ensure compliance with the treatment plan, a urine drug screen for Buprenorphine will be obtained at each visit. At the discretion of the physician, additional drug screening may be required. Also, during this phase, the patient will be required to seek individual or group counseling. We will assist in making recommendations and referrals.
  • Step 3:  Maintenance
    This is the longest phase of our treatment program. It refers to the period when the patient is receiving the dose of Suboxone that enables them to be both physically and emotionally comfortable. Patients will attend monthly office visits for continual monitoring of physical and psychosocial concerns which have been identified during treatment.  Other issues that require continual monitoring are related to cravings for opiates and prevention of relapse.
  • Step 4:  Medically Supervised Taper/Withdrawal
    The goal of medically supervised withdrawal is to provide a smooth transition from a physically dependent state to a physically/emotionally nondependent state.  There are many factors to consider when determining the suitability for long-term medication-free status. The physician and patient will jointly determine if the patient is ready. 
    At this time, the dose of Suboxone will be gradually ramped down, until the individual becomes completely opiate free. During this time, the individual continues to work in counseling through any final barriers that may exist. While each patient is unique in the recovery process, our treatment objective is to help the patient accomplish this within 18 to 24 months.
  • To further ensure the patient’s success, we recommend the use of naltrexone for a period of one year or more following discharge.
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Douglas Brown, MD, FAAFP
5000 New Point Road.
#3201
Williamsburg, VA 23188