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METHADONE TREATMENT OVERVIEW
Methadone maintenance is a long-term treatment for addiction. The patient must take medication daily. Once a patient is stabilized on medication, the negative thoughts, associated with addiction, often diminish. The patient’s life tends to normalize and functioning increases, which can include caring for their families, working, achieving educational goals, addressing both mental and physical health co-occurring disorders, and enjoying an active, healthy lifestyle. Achieving a healthier, normal life through methadone maintenance is a valid form of recovery from opioid addiction. Improvement in all areas of health and social integration increase with the length of time in treatment. The greatest positive change comes in the first year of treatment.
Similar to the medicines prescribed for diabetes, high blood pressure other chronic medical problems, methadone is not a cure. No single medication or behavioral intervention can be a magic bullet for all patients seeking help for opioid addiction and the medical, psychiatric, or social problems which may co-exist with it Methadone maintenance treatment has proven to be the most effective way to treat opioid addiction. Research shows that life expectancy, health, and vocational and educational achievement are much improved while substance abuse and criminal activity are greatly reduced for patients in methadone maintenance treatment. Proper use of medication eliminates withdrawal symptoms and the craving for heroin or other opioids and the structure and counseling required and offered to provide an opportunity for patients to address problems and issues related to their addiction.
Methadone Treatment Program
New patients are required to attend the clinic six days a week in Illinois and seven days a week, in Maine. Patients who demonstrate stability in treatment and meet State and Federal requirements may attend the clinic less frequently after the first 90 days. All initial doses will start at 30 milligrams or less and be increased slowly until the patient is no longer experiencing withdrawal symptoms and/or cravings. The goal is to reach a dose of methadone that will suppress opioid craving and withdrawal symptoms for 24-36 hours and reduce or block the effects of other opioids without producing a “high” or other significant side effects. Patients on blocking doses of methadone are fairly well protected from overdosing on opioids. The protective blockade can be overcome with very large doses of opioids, but that is uncommon. Abuse of other classes of drugs or alcohol in combination with methadone can result in a serious and sometimes fatal overdose.
CAP Quality Care clinics provide drug abuse counseling and education, HIV and Hepatitis C-related education, an explanation of the rules and regulations of the clinic, and information regarding the benefits of utilizing both professional and self-help programs offered in the community. Treatment is tailored, whenever possible, to the individual patient’s needs and goals and is adjusted as these needs and goals change. Counselors and patients, working together on what the patient feels is important fosters mutual respect and understanding, which are essential to any therapeutic process. There are some aspects of treatment that are mandated by State and Federal regulations.
Patients are assigned to a counselor and are required to meet with their counselor on a regular basis to monitor their progress. Patients who continue to abuse opioids, alcohol, or other illicit drugs will be offered an array of individually tailored medical and behavioral treatment interventions to meet their needs. If methadone maintenance is not helpful, the staff will assist the patient in finding outside services, other medications, and treatment settings that might be useful alternatives.
When medication-free recovery is the patient’s goal, comfortable, medically managed withdrawal from methadone and strategies to help prevent relapse are provided. Statistics show that 90 percent of people who have been addicted to opioids relapse 12 to 18 months after withdrawal. Ten percent do succeed. At CAP, patients who have trouble with a medication-free recovery attempt, have access to re-stabilization on methadone if relapse occurs or appears inevitable.
SUBOXONE (Buprenorphine) TREATMENT OVERVIEW
Suboxone is used as a long-term treatment for opioid addiction as an alternative to methadone maintenance treatment for patients with a minimal addiction history. Suboxone allows patients to lead normal, productive lives by working, caring for their families, and enjoying an active, healthy lifestyle. Suboxone treatment is voluntary, and the length of time a patient remains in treatment depends greatly upon the patient. The patient will attend the clinic on a monthly basis and receive a Suboxone prescription from a CAP Physician. Suboxone when taken orally under the tongue in an appropriate dose can suppress symptoms of opioid withdrawal while decreasing the craving for opioids for 24 hours in most cases.
Suboxone Treatment Program
Suboxone is a partial opioid agonist, which has limited opioid effects compared to full opioid agonists, such as heroin, morphine, and methadone. Suboxone also contains Naloxone (Narcan), which is an opioid antagonist. Naloxone is contained in Suboxone in order to deter intravenous use of Suboxone. Naloxone will cause immediate withdrawal when injected by a person dependent on opioids including a person on methadone. It does not affect the patient taking Suboxone under the tongue as prescribed for Suboxone treatment.
New patients will meet with a CAP physician on the day of their intake for a full assessment and to determine an initial dose of Suboxone. The patient will then receive a prescription for a few days to assess the patient’s tolerance to the medication or any adverse reaction to Suboxone. The patient will return to the clinic after a few days and receive a prescription for 1-2 weeks of medication to further assess how they are tolerating the dose. When the CAP physician is satisfied that the patient is on a stable dose of Suboxone the patient will only need to attend the clinic once a month thereafter. Patients will be required to provide a monthly urine specimen for a drug screen to detect any continued illicit drug use. Prescriptions for Suboxone are not covered in our intake fee or the monthly fee for the Suboxone Program. The patient must pay for their prescription at the pharmacy through their insurance or out of pocket.
Patients that join our Suboxone Program are not assigned a counselor, but they do have the option of receiving our counseling services at an additional cost.