What is Suboxone Treatment?

Who is eligible for Suboxone treatment?

Who is NOT eligible for Suboxone treatment?

How do I begin Suboxone treatment with CFEL?

What is the duration and length of treatment?

What fees are involved with treatment?

What are the requirements for continuing Suboxone treatment with CFEL?

What is Suboxone Treatment?

Suboxone treatment is a medically supervised method for reducing physical dependence on opioids.  Suboxone tablets reduce cravings and withdrawal symptoms without creating the euphoric “high” that other opioids create. 

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Who is eligible for Suboxone treatment?

• Any client who is physically dependent on short- or long-acting opioid drugs.
  Short-acting opioids: heroin, oxycodone, hydrocodone, meperidine, propoxyphene, morphine
  Long-acting opioids: methadone, LAAM

• Any client who has an extensive history of opioid drug use (but many not be physically dependent) and who has failed other treatment modalities. 
• Any client who has recently been released from a controlled environment (inpatient rehabilitation center, prison, etc…), who have a known history of opioid addiction and who has a high potential for relapse.

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Who is NOT eligible for Suboxone treatment?

• Individuals who do not meet the full criteria for opioid dependence
• Individuals who are not willing to adhere to a substance abuse treatment program
• Individuals who can not or will not follow proper safety precautions when storing medication
• Individuals with untreated significant psychiatric disorders
• Individuals with active suicidal or homicidal ideation or attempts
• Individuals who are pregnant or are at-risk to be pregnant
• Individuals with alcohol or sedative-hypnotic abuse issues.  There is a high risk of lethal overdose when suboxone is combined with alcohol or sedatives. 

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How do I begin Suboxone treatment with CFEL?

In order to determine eligibility, all clients must participate in a comprehensive assessment performed by one of our counselors.  This assessment includes providing a complete history of drugs used, including determining the primary type of opioid abused.  This assessment will be a 2 ½ hour visit. 

If client is determined by the counselor to be eligible for Suboxone treatment, then the counselor will refer the client to the prescribing psychiatrist.  The psychiatrist will make the final determination for client eligibility after meeting with the client.  All first appointment times are Saturday morning.  The psychiatrist will prescribe one dose of medication and the client must fill this dosage and return to the center in order to be monitored by center staff for two hours.  After the two hour period, the psychiatrist will prescribe two more doses for the client.  The client must return for a follow-up visit on Monday.  The client must commit to this treatment schedule in order to begin the Suboxone program. 

At the time of the initial evaluation, the counselor will determine what level of substance abuse treatment is appropriate for each client.  These levels range from individual counseling to intensive outpatient programs (clients requiring inpatient treatment will be referred to an inpatient treatment center and are not eligible for Suboxone treatment at the Center for Effective Living).  All clients must adhere to the recommended level of treatment at the Center for Effective Living.  The Suboxone program is only available to active clients at the Center for Effective Living; clients wishing to complete their substance abuse treatment at a different location are not eligible.  The Center for Effective Living runs an intensive outpatient alcohol/drug treatment program that is ODADAS approved.  In addition, a weekly outpatient group specific to Suboxone patients will be established as necessary in order to provide additional support for clients.

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What is the duration and length of treatment?

At the beginning of treatment, clients will typically be monitored weekly by the psychiatrist in order to determine the proper dosage and monitor withdrawal symptoms.  Clients are required to fully disclose their drug use and take toxicology screens.  Continued drug use does not automatically terminate services.  After stabilization, client appointments will be every 2-6 weeks. 

For those patients addicted to long-acting opioids, minimal dosages must be maintained prior to beginning treatment.  If patients are receiving treatment at Opioid agonist treatment agencies, coordination is essential in order to begin Suboxone treatment. 

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What fees are involved with treatment?

Fees for all appointments must be paid before commencement of the appointment.  Only credit cards, cashier’s check and cash will be accepted for payment.  Evaluation and psychiatric services are not covered by insurance claims at this time.  Clients may choose to submit claims to their insurance companies directly for reimbursement.  These forms are available through the office.  Substance abuse treatment may be eligible for insurance coverage; determination of eligibility will be made at the start of treatment.  The following is the fee schedule:

Evaluation - $200
1^st psychiatric appointment - $250
2^nd psychiatric appointment - $145
All other psychiatric appointments - $85

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What are the requirements for continuing Suboxone treatment with CFEL?

• Must be compliant with prescribed medication and prescribed treatment regimen.
• Must be compliant with scheduled appointments.  A fee may be assessed for missed appointments.  Repeated missed appointments will lead to termination from program. 
• Must keep medication in a safe and secure location.  Lost medication will not be replaced regardless of reasons for such loss. 
• Must not give or sell medication to other individuals.  Misuse of medication will result in immediate termination of the program. 
• Must be honest about drug history.
• Must be honest about current use (active use does not mean automatic termination from program).
• Must abstain from other drug use while being treated with Suboxone, particularly use of alcohol and sedatives.  Use of alcohol or sedatives may result in severe medical complications, or even death.
• Must remain in active substance abuse treatment program at the Center for Effective Living.