Outpatient Program for Opiate Dependence, Phoenix Area: Assisted Recovery Suboxone

Opiate Addiction Treatment with Suboxone® and the "Pennsylvania Model of Recovery"™

Opiates are a class of drugs that are obtained from the opium poppy, and used as pain medications. These drugs are extremely useful to treat acute pain after surgery, fractures, and cancer, etc.

Used correctly under medical advice, these drugs can dramatically reduce pain and improve the healing process. Used inappropriately, the drugs are powerfully addicting. Once addiction occurs, medical intervention is often necessary to get off the drugs.

What is Addiction?
Addiction is a complex neurochemical process that involves the over stimulation of the pleasure pathways of the brain by drugs. The over stimulation forces the brain cells to adapt to these abnormal surges by demanding larger and more frequent doses of drug. This uncontrolled demand is called ‘craving’.

Craving is the most persistent and overwhelming symptom of the disease that can last for years or can resurface unexpectedly and powerfully after being dormant for years. If craving is not effectively controlled, the prognosis for long-term success is poor.

Assisted Recovery Centers of America is pleased to announce that we are now offering a comprehensive and revolutionary opiate treatment program. In October 2002 the United States Food & Drug Administration added the medication Suboxone® to our arsenal of pharmacological weapons, in the battle against drug dependence. The addition of Suboxone® provides a critically needed treatment option for opiate dependent individuals. (Suboxone® is a combination of buprenorphine and naloxone, a form of naltrexone.)

The Assisted Recovery Opiate Treatment Program offers opiate dependent individuals an Out-Patient option that has been “studied in over 2,000 patients and shown to be a safe and effective treatment for opiate dependence”. (US Food & Drug Administration).

Currently, the most readily available treatment for opiate dependence is Methadone Maintenance. Methadone, while effective, must be dispensed in highly regulated and for many, difficult to access clinics. In general, an individual must present himself each morning at a clinic for a daily dose of methadone. Methadone will keep the individual emotionally stable and will prevent the intense physical withdrawal that is associated with opiate dependence.

Suboxone® protocols offer opiate dependent individuals with a wide range of options, including abstinence from all forms of opiates. Treatment is provided in an Out Patient professional setting. With Suboxone®, we can safely and effectively detox an individual from opiate dependence comfortably in an Out Patient environment. Cognitive Behavioral Therapy is provided and is an integral component of the Assisted Recovery Pennsylvania Model program. It fully meets the counseling requirement that is mandated by the Food & Drug Administration for individuals taking Suboxone®.

Components of Opiate
Addiction Treatment

Suboxone® provides options for opiate dependent individuals that have previously been unavailable, for example physician/medically based outpatient treatment, in a setting conducive to recovery. Assisted Recovery offers a one-year outpatient, opiate dependence program that fully embraces the use of effective medical tools, for example Suboxone® and naltrexone. In addition to medications, Assisted Recovery utilizes Cognitive Behavioral Therapy to assist in the transition from opiate dependence, to a fully functioning, happy and productive human being. This type of program is known as a Pennsylvania Model.

While an opiate dependent individual could detox from opiates using Suboxone® in as few as 4 or 5 days, we highly recommend that an individual plan on detoxing gradually and slowly over several months. In starting therapy, the physician determines an appropriate "maintenance" dose for the individual. By a maintenance dose, it is meant that the dose enables the individual to be both physically and emotionally comfortable. The individual will remain at this level for several weeks, while working on recovery issues via both group and one on one cognitive behavioral therapy sessions. The purpose of this is to enable the individual to adjust to Suboxone® with little or no discomfort. At a point determined by the physician, the dose of Suboxone® will be gradually ramped downward, until the individual becomes completely opiate free. Once the individual becomes opiate free, we highly recommend the use of naltrexone for a minimum of one year.

Recovery from opiate dependence, even with the use of effective medical tools like Suboxone®, will not be a "walk in the park". An almost "impossible" task becomes very possible with the assistance of effective medications and counseling. Opiate dependent individuals must maintain a determination to regain control of their lives and to move forward.

Suboxone® Breaks the Cycle of Addiction and is effective against a wide variety of Opiates including:

VICODIN®
OXYCONTIN®
LORTAB®
PERCODAN®
PERCOCET®
STADOL®
DEMEROL®
DILAUDID®
CODEINE
HEROIN
METHADONE

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Suboxone®
TREATMENT CONTRACT

As a participant in the Assisted Recovery Suboxone® program for the treatment of opiate dependence, I freely and voluntarily agree to accept this treatment contract as follows:

I agree to keep, and to be on time, to all scheduled appointments, both medical and counseling.
I agree to conduct myself in a courteous manner.
I agree not to present myself for treatment intoxicated or under the influence of non-prescribed medications or illegal drugs. I further understand that my prescription for Suboxone® may not be extended if I present myself either intoxicated or under the influence of non-prescribed medication or illegal drugs.
I agree not to sell, share or give my Suboxone® to another person. I understand that such mishandling of my Suboxone® is a serious violation of this agreement and may result in my treatment being terminated without recourse or appeal.
I agree not to conduct any illegal or disruptive activities while at the treatment program, in either the medical or counseling offices.
I agree that my prescription for Suboxone® can only be given to me at my regularly scheduled appointment. Any missed appointments may result in my not being able to get a follow up prescription for Suboxone® until my next scheduled appointment.
I understand and agree that my Suboxone® is my responsibility, and that I will keep it in a safe, secure place. I understand that lost Suboxone® will not be replaced regardless of the circumstances for such loss.
I agree not to obtain medications from any physician, pharmacy, or other source, without the expressed permission of the Assisted Recovery program physician. I understand that mixing Suboxone® with other medications, especially benzodiazepines, for example Valium, and any other drugs of abuse, is dangerous. I understand that a number of deaths have been reported among individuals mixing buprenorphine (a major component of Suboxone®) with benzodiazepines.
I agree to take my Suboxone® as instructed by the program physician, and not to alter in any way my dosage without first consulting my program physician.
I understand that Suboxone® is an extremely effective tool, which will help me to achieve my treatment goals. Treatment success is not guaranteed. It is not a cure in itself, and that I will fully participate in the Assisted Recovery counseling program.

Cost:
The fee for the one-year Pennsylvania Model program, which includes all professional and medical services, program materials, but excludes the cost of medication is $4,995.

Contact Assisted Recovery today at
(602) 264-7897 or toll free (800) 527-5344

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I found that I don't have to rely on a "higher power."
I have the power to stay clean and be happy.
-ARCA Client

ARCA is fully licensed by
the Arizona Department of Health Services.

You are NOT an drug addict.

You ARE a human being who is opiate dependent.

We do not tear you down
with labels.

We EMPOWER you with tools & knowledge.

Assisted Recovery fully understands that in treating opiate dependence, one size does not fit all.

An individual treatment plan is developed together by both the client and staff.

"Studies conducted at the University of Pennsylvania have demonstrated the effectiveness of outpatient treatment. Indeed the studies has shown that out patient/real world treatment is more
effective then inpatient (cocoon) treatment."

“Life is so much better, I'm not missing out anymore."

....................

Frequently Asked Questions: For Family Members — Suboxone® Treatment Information

What is an opioid?
Opioids are addictive narcotics in the same family as opium and heroin. This includes many prescription pain medications, such as Codeine, Vicodin, Demerol, Dilaudid, Morphine, Oxycontin, and Percodan. Suboxone® is also an opioid, and is used to treat dependence.

Why are opioids used to treat dependence?
Many people wonder why doctors use Suboxone® to treat opiate addiction, since it is in the same family as heroin. Some of them ask, "Isn’t this substituting one addiction for another?" Suboxone® is not "just substitution." Medical studies since 1965 show that treatment helps keep patients healthier, keeps them from getting into legal troubles, and prevents them from getting AIDS. Suboxone® is not a cure for dependence, just as insulin is not a cure for diabetes, but rather it is a tool to be used for treatment. Suboxone® does not eliminate physical dependence, and if it is stopped suddenly, the patient will experience withdrawal symptoms.

What is the right dose of Suboxone®?
Family and friends of patients who have been addicted to heroin or prescription pain medications have watched as their loved ones use a drug that makes them high, or out of touch with reality, or have watched the painful withdrawal which occurs when the drug is not available. Sometimes, family has not seen the ‘normal’ person for years. They may have seen the person misuse doctors’ prescriptions for narcotics to get high. They are rightly concerned that their loved one might misuse or take too much of the Suboxone® prescribed by the doctor. They may watch the patient and notice that the patient seems drowsy, or stimulated, or restless, and think that the Suboxone® will be just as bad as heroin or prescription pain medications.

Every opioid can have stimulating or sedating effects, especially in the first weeks of treatment. The ‘right’ dose of Suboxone® is the one that allows the patient to feel and act normally. It can sometimes take a few weeks to find the right dose. During the first few days, the dose may be too high, or too low, which can lead to withdrawal, daytime sleepiness, or trouble sleeping at night. These symptoms should be noted or even written down. The Assisted Recovery doctor can then use all these clues to adjust the amount and time of day for Suboxone® doses.

Once the right dose is found, it is important to take it on time in a regular way, so the patient’s body and brain can work well.

How can the family support good treatment?
Even though Suboxone® treatment for opioid dependence works very well, it is NOT a cure. It is a tool, if appropriately used, will help the individual to achieve a goal, whether that goal is maintenance or detoxification and freedom from opiates all together. This means that the individual must follow program protocols, especially for the use of Suboxone®. The best way to help and support the patient is to encourage regular contact with the Assisted Recovery program.

1) Regular medical care
Most patients will be required to see the physician for ongoing Suboxone® treatment every four weeks. If they miss an appointment, they may not be able to refill the medication on time, and may even go into withdrawal, which could be dangerous.

2) Counseling
Individuals who are recovering from dependence need counseling in order to learn how to adjust to life without the opiates. Assisted Recovery has scheduled regular appointments with an individual counselor, or for group therapy. These appointments are key parts of treatment, and work together with the Suboxone® treatment to improve success in treatment for opiate dependence. Sometimes family members may be asked to join in family therapy sessions, which also are geared to improve addiction care.

3) Taking the medication
Suboxone® is unusual because it must be dissolved under the tongue, rather than swallowed. Please be aware that this takes a few minutes. While the medication is dissolving, the patient will not be able to answer the phone, or the doorbell, or speak very easily. This means that the family will get used to the patient being ‘out of commission’ for a few minutes whenever the regular dose is scheduled.

4) Storing the medication
If Suboxone® is lost or misplaced, the individual may skip doses or go into withdrawal, so it is very important to find a good place to keep the medication safely at home – away from children or pets, and always in the same location, so it can be easily found. The doctor may give the patient a few ‘backup’ pills, in a separate bottle, in case an appointment has to be rescheduled, or there is an emergency of some kind. It is best if the location of the Suboxone® is NOT next to the vitamins, or the aspirin, or other over-the-counter medications, to avoid confusion. If a family member or visitor takes Suboxone® by mistake, he or she should be checked by a physician immediately.

What does Suboxone® treatment mean to the family?
It is hard for any family when a member finds out he or she has a disease that is not curable. This is true for dependence as well. When chronic diseases go untreated, they have severe complications that may lead to disability and death. Fortunately, Suboxone® can be a successful treatment, especially when it is integrated with counseling and support for life changes that the individual has to make to remain ‘clean and sober.’

Chronic disease means the disease is there every day, and must be treated every day. This takes time and attention away from other things, and family members may resent the effort and time and money that it takes for Suboxone® treatment and counseling. (It might help to compare dependence to other chronic diseases, like diabetes or high blood pressure. For example, in the case of hypertension, it takes time to make appointments to go to the doctor for blood pressure checks, and it may annoy the family if the food has to be low in cholesterol, or unsalted. But most families can adjust to these changes, when they consider that it may prevent a heart attack or a stroke for their loved one. )

Genetics and dependence
Another very important issue for family members to know about is: dependence can be partly inherited. Research is showing that some persons have more risk for becoming dependent than others, and that some of this risk is genetic. So when one member develops opiate dependence, it means that other blood relatives should consider themselves ‘at risk’ of developing dependence or alcoholism. It is especially important for young people to know that alcohol or drugs at parties might be dangerous for them (that is, they may be more likely to ‘get hooked’), even more than for most of their friends.

It is common for people to think of dependence as a weakness in character, instead of a disease. Perhaps the first few times the person used drugs it was poor judgment. However, by the time the patient is dependent, and using every day, and needing medical treatment, it can be considered to be a ‘brain disease’ rather than a problem with willpower. In fact, research brain scans clearly show the difference between a "dependent" individual and a "normal" individual.

Sometimes when the patient improves and starts feeling normal, the family has to get used to the new "normal" person. The family interactions (sometimes called ‘family dynamics’, or ‘system’) might have been all about trying to help this person in trouble, and now he or she is no longer in so much trouble. Some families can use some help themselves during this change, and might ask for family therapy for a while.

In summary:

Support of family and friends can be very helpful to patients on Suboxone® treatment. It helps if the family members understand how dependence is a chronic disease that requires ongoing care. It also helps if the family gets to know a little about how the medication works, and how it should be stored at home to keep it safe. Family life might have to change to allow time and effort for ‘recovery work’ in addiction treatment. Sometimes family members themselves can benefit from therapy.