Suboxone (Buprenorphine) Treatment Program​

What makes the Barrier Islands program different?

We offer a comprehensive outpatient Buprenorphine Treatment Program for opioid (pain pill) addiction. Our program includes Suboxone induction and maintenance with close monitoring. Our physicians are experts in prescribing Suboxone. Group therapy specifically designed for patients taking Suboxone is incorporated into the program, and individual therapy is offered as well. Emotional problems and inability to think clearly are interconnected with addiction.

At Barrier Islands Psychiatry, we assess and treat co-occurring disorders and focus on restoring full mental and physical functioning, and we individualize treatment for each patient.

 

What is Suboxone?

Suboxone (buprenorphine) is an FDA approved medication to treat opioid dependence. Opioids are narcotic pain medications like oxycodone, hydrocodone, and morphine and illegal drugs like heroin. Suboxone relieves cravings and withdrawal from opioids and helps prevent relapse so that patients can engage in therapy and return their lives to normal.


​How Does Suboxone Work?

Suboxone (buprenorphine) is a type of opioid that binds to the opioid receptor in the brain and nervous system, partially activating it. By activating the receptor it prevents cravings for opioids and the withdrawal symptoms from opioids. Since it only activates the receptor just a little (unlike opioid pain killers that activate it all the way), it typically does not produce a “high” that people with addiction get from opioids. When dosed correctly, it usually has much less side effects than other opioids. Also, it also acts as a opioid receptor blocker, preventing opioids from binding the receptor in case of relapse.


Is Suboxone addictive?

Suboxone replaces body’s physical dependence on opioids with physical dependence on buprenorphine. If Suboxone is stopped, the body will go through withdrawal. However, physical dependence is just one component of addiction. Addiction is characterized by loss of control over use of the drug, damage to physical and mental health, and loss of functioning in relationships, family life, and work. When Suboxone is used correctly, it helps restore physical and mental health and normal functioning.  Patients on Suboxone are not “trading one addiction for another.”  Suboxone is helping them engage in therapy and live a fulfilling life.


Are there generic alternatives to Suboxone?

Yes. Suboxone is a branded film, but it is available as a generic buprenorphine/naloxone tablet (also placed under the tongue) that may be cheaper depending on insurance reimbursement and promotions available from the Suboxone manufacturer. There is also a competitor to Suboxone called Zubsolv that can be cheaper depending on manufacturer promotions and insurance reimbursement.


How much does Suboxone cost?

The cost of medication varies depending on the dose, brand, insurance reimbursement and pharmacy pricing. For those paying out-of-pocket, expect to pay $150-300 per month for the medication. A pharmacy price checker like GoodRx is a useful tool.


What are the alternatives to Suboxone?

Suboxone (buprenorphine) maintenance is a highly effective treatment, but it is not indicated for everyone. Alternatives we use at Barrier Islands include detoxing with Suboxone and tapering and stopping Suboxone after the withdrawal phase. Vivitrol (naltrexone) is also an effective treatment of opioid addiction that does not result in physical dependence. It is a monthly injection that helps reduce cravings for opioids and fully blocks the opioid receptor, preventing opioids from being active and the “high” in case of relapse. Individual and group psychotherapy are incorporated into treatment as well. We can refer patients to inpatient treatment or residential rehabilitation as necessary.

 

  • Where can I find out more about Suboxone (buprenorphine)?
  • FDA information on Suboxone/Subutex (buprenorphine)
  • Suboxone manufacturer’s website
  • FAQ from National Alliance of Advocates for Buprenorphine Treatment
  • Vivitrol (extended-release naltrexone) information from the manufacturer

Explanation of First Visit

Your first visit is generally the longest and may last anywhere from 1 to 4 hours.

When preparing for your first visit, there are a couple of logistical issues you may want to consider:

You may not want to return to work on the day of your visit – this is very normal, so just plan accordingly. Because the medication can cause drowsiness and slow reaction times, particularly during the first weeks of treatment, you may want to make arrangements to have someone drive you. They can also pick up your prescription while you are still in office.

It is very important to arrive already experiencing moderate opioid withdrawal symptoms. If you are in withdrawal, the medicine will lessen the symptoms. However, if you are not in withdrawal, the medicine will “override” the opioids already in your system, which will cause severe withdrawal symptoms.

 

  • No long-acting painkillers for at least 24 hours.
  • No heroin or short-acting painkillers for 24-48 hours.
  • For your safety, you must notify the office if you have used Methadone within the last 2 months.

 

Bring ALL medication bottles or a list of them (including dose and strength) with you to your first visit.

Arrive 30 minutes early to your appointment. Before you can be seen by the doctor, all paperwork and a Urine Drug Screen must be completed. Urine screening is a regular and required procedure of treatment.

After meeting with the doctor, they will administer your first dose. Your doctor may have you fill the prescription at the pharmacy and return so that you can take the medication under observation.

Once you take your first dose, you should begin to feel better within 30 minutes. It is important that you are honest about how you feel during your induction so that the appropriate dose can be prescribed for you.

When you leave the office, the doctor will likely give you a prescription that will last until your next appointment. The doctor may also want to discuss counseling with you, since medication plus counseling has been shown to produce the best results.