FAQ – Share With Family/Friends
How effective is Suboxone?
Suboxone has a number needed to treat (NNT) of 2. This means a doctor only needs to prescribe Suboxone to 2 patients to prevent one major negative outcome (such as an overdose, death, heart attack, stroke, etc.). In comparison, diabetes and hypertension medications have an NNT closer to 200, meaning they need to treat 200 patients to prevent one major negative outcome. Buprenorphine, the active ingredient in Suboxone, is the gold standard for treating opioid use disorder, as recognized by all major U.S. government health organizations (SAMHSA, NIDA) and national addiction societies (ASAM).
What about Suboxone during pregnancy and nursing after delivery?
Suboxone can be safely used before and after delivery and is safe during pregnancy and breastfeeding. There is minimal Suboxone in breast milk, making it very safe for nursing babies.
What is an opioid?
Opioids are addictive narcotics in the same family as heroin and opium. This includes many prescription medications such as morphine, OxyContin, Dilaudid, Demerol, codeine, hydrocodone/Lortab, oxycodone/Percocet, Vicodin, and methadone. Suboxone is also an opioid but only partially activates the opioid receptors, whereas the others fully activate them.
Why are opioids used to treat addiction? Isn’t this substituting one addiction for another?
Many family members wonder why Suboxone is used to treat opioid addiction since it belongs to the same class as heroin. However, Suboxone is not “just substitution.” It blocks the opioid receptors in the body, preventing any response to other opioids while reducing cravings. Studies have shown that Suboxone reduces the chance of relapse. The harm reduction associated with Suboxone also decreases the risk of jail time, improves social and home function, and reduces infections like HIV and Hepatitis C.
What is the right dose of Suboxone?
The right dose is the one that prevents any response to opioids. The dose is not adjusted for pain management.
Tell me about Suboxone maintenance treatment.
Suboxone maintenance can be highly successful if patients are consistent with their appointments and counseling. Since addiction is a chronic disease, it requires ongoing treatment. This may require time and resources, which can lead to frustration among family members. However, it’s important to remember that other chronic conditions like diabetes or hypertension also need continuous care. The benefits of Suboxone maintenance include a significantly reduced risk of relapse. However, mixing buprenorphine with benzodiazepines (e.g., Xanax) increases the risk of overdose.
What about detoxification or medically supervised withdrawal?
Detoxification or medically supervised withdrawal can be used for patients on self-administered opioids or opioid agonist treatment (e.g., methadone). The type of opioid dependence will determine if detoxification involves direct induction or a buprenorphine taper. While detoxification allows patients to get off opioids quickly, it comes with a high relapse risk. Providers will make individualized decisions based on each patient’s circumstances.
Is addiction a chronic disease?
Yes, opioids change the brain, making individuals more impulsive, compulsive, and likely to relapse. It can take years off heroin for the brain to return to normal. Opioid Use Disorder (OUD) is a chronic disease, like diabetes or hypertension. Medications are not stopped if a patient’s condition is stable, and the same applies to Suboxone. Studies show that the longer patients remain on Suboxone and off street drugs, the less likely they are to relapse.
Is telehealth as effective as in-person treatment?
Telehealth breaks down geographical barriers and increases access to care for patients who may not be near a clinic. It eliminates transportation issues and has been shown to improve health due to increased treatment compliance. Studies show that outcomes for telehealth patients are comparable to in-person care, with higher patient satisfaction and retention rates. In 2022, telehealth for addiction care was endorsed by CMS, SAMHSA, and ASAM.
What happens with a missed appointment?
Patients are required to have monthly appointments. If an appointment is missed, the patient may not be able to refill their medication on time, leading to withdrawal and an increased risk of relapse. In some cases, patients may be required to have more frequent appointments and urine drug screens after missing a visit.
Do you treat HIV or Hepatitis C?
We do not provide treatment for HIV or Hepatitis C. Patients requiring these services should contact their local health department for testing and treatment.
Tell me about counseling and therapy.
Patients are encouraged to keep regular counseling appointments. A program counselor will see patients at least twice per month during the Induction or Stabilization phases, and at least monthly during the Maintenance phase. Counseling sessions are conducted via telemedicine or telephone. Counseling is key to successful addiction treatment, and patients may attend outside counseling, though it does not replace clinic sessions. Tennessee Medicaid guidelines allow patients to decline counseling without affecting their ability to receive Suboxone, though private insurance may require monthly counseling sessions.
What about recovery meetings?
Many patients use recovery groups, like AA or NA, to maintain sobriety. Some attend meetings daily or several times a week in the first year of recovery. These meetings complement Suboxone treatment. Family members can also attend meetings like Al-Anon for support.
What about advocacy services?
Providers and counselors will work with patients to identify advocacy services that may be helpful. NAS offers counseling and case management, and attending NA/AA meetings is encouraged.
How is the medication taken?
Suboxone must be dissolved under the tongue, not swallowed, which takes a few minutes. During this time, patients won’t be able to speak easily. Family members will get used to the patient being “unavailable” for a few minutes at each dosing time.
How should Suboxone be stored?
Suboxone should be stored in a secure place, away from children and pets, and in a consistent location to avoid loss. It’s important to keep it separate from other medications to prevent accidental ingestion by family members.
What about church, exercise, and meditation?
Attending church, meditating, and exercising can all help reduce the risk of relapse. Regular meditation helps patients control their impulsive and compulsive behaviors, while exercise releases endorphins and clears the mind. Developing a morning routine that includes meditation, light exercise, and setting daily goals can improve mental focus and resilience.
What does Suboxone treatment mean for the family?
Like other chronic diseases, untreated addiction leads to disability and death. Suboxone maintenance can be very effective when patients adhere to treatment plans. While family members may feel frustrated by the time and resources needed, it’s similar to managing other chronic conditions like diabetes or hypertension. Over time, most families adjust, recognizing the importance of their loved one achieving their full potential.
What is the clinic’s goal for you?
Our goal is the stabilization of your overall functioning and, ultimately, helping you become drug-free. Addiction is a chronic disease, and some risk factors are genetic. Family members of individuals with addiction should consider themselves at risk, especially younger people who start using substances early. When a patient improves, it often gives the family time to focus on their own well-being. Family support is crucial in addiction treatment, as understanding the chronic nature of addiction and the spiritual aspect of recovery can aid in the patient’s success.
Summary:
We aim to assist patients in becoming drug-free. Addiction has genetic risks, and young people are particularly vulnerable. Family members should focus on their own healing while supporting their loved ones through treatment. Understanding addiction as a chronic brain disease that requires both medical and spiritual care is essential to long-term success.
