Medication assisted treatment is an umbrella term used to describe the use of medication to assist in the treatment of opioid use disorder.
There are many medications available, including buprenorphine (Suboxone, Subutex, Sublocade), Vivitrol (injection, extended-release naltrexone), and methadone (must be prescribed from a methadone clinic).
Our job as a physician or nurse practitioners is to help our patients live healthy, happy meaningful lives. We do that by helping guide patients to the right medication for the treatment of their opioid addiction. We provide all of the above treatments except methadone, which must be prescribed by a methadone clinic. However, we do have experience transitioning patients from methadone to buprenorphine.
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Which Medications are Best When Treating Opioid Addiction?
Opioid dependence and addiction treatment is best when it is customized to the individual patient. That means that one-size-fits-all treatment programs are never optimal, and the doctor that you see should determine the specifics of your situation, and then help you decide which medication is right.
There are many things to consider when making this decision, including access to the clinic, efficacy, individual preferences and risks, how far someone lives from our office in Sacramento, and what other services are needed, among other things.
Are All Opioids the Same? Do All Opioids Cause Addiction?
Opiates all work similarly, but they are not all the same. Opioids include illicit compounds such as heroin and many prescription painkillers.
Some, such as heroin or fentanyl, are more potent than other opioids, such as hydrocodone. Some, like Oxycontin, last much longer in the body.
Other opioids, such as heroin or fentanyl, are much shorter-acting. Essentially any chemical that produces euphoria (feeling high) can lead to addiction, and this is true of essentially all opioids as well.
Stopping using feels great. However, moving away from drug use you have used every day for months or years is a big change.
What's the Difference Between Suboxone & Subutex?
Suboxone and Subutex are both trade names for two prescription medications containing buprenorphine, a medication used in opioid addiction treatment.
Suboxone also contains a medication called naloxone, which makes it slightly more difficult to abuse.
However, some people also side effects of naloxone, such as upset stomach or headaches. Subutex is also buprenorphine, but without naloxone.
Both formulations of buprenorphine are effective opioid addiction treatment options and work similarly in the treatment of opioid dependence.
Do You Prescribe Suboxone or Subutex?
When you see someone in our office, we are focused on your health. We spend time understanding what we need to do to treat drug abuse and addiction.
If Suboxone is the best option, we will prescribe that— but if Suboxone is not the best option to treat the problem, we will use something else.
If we think about opioid addiction as a brain disease, rather than a moral failing, then the choice of medication is really about what is the most effective treatment for that brain disease.
As a patient moves into recovery away from an active opioid use disorder, we start working to build treatment services and plans that can fit your unique situation.
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What's Involved in Substance Abuse Treatment?
Your recovery journey starts with registering for care and making an appointment. At that initial appointment, you will meet with a doctor or nurse practitioner, who will get to know you and assess where you are with your substance abuse disorder.
This includes what opioids you are using, how this use has affected your health and your life (as well as the lives of those around you), what other drugs you are using (if any), assessing current withdrawal symptoms, and understanding what you hope to get out of the program. We usually start patients on medication, such as a Subutex prescription, at the first appointment.
After the first appointment, patients continue to follow up at the clinic with our team. We work with you to support you in your recovery.
The specifics look different for different people— for some, it’s more about therapy and support, for others, it’s about developing recovery goals and then sticking to them. Mental health issues are every bit as important as physical ones when it comes to our treatment process.
Every person has a unique recovery journey, and the goal of visits to the clinic is to help you on that journey and help you develop the tools you need to live a healthy, happy, meaningful life.
I'm Scared of Withdrawals, But I Want to Do MAT, What Do I Do?
It is true that before starting buprenorphine, patients much undergo a short period of opioid withdrawal.
This is because of how buprenorphine works— starting it too soon will actually cause worse withdrawal, and this is why doctors make sure there is a short detox period before writing a prescription for buprenorphine.
However, there are many ways to manage these symptoms, and management of symptoms is a part of treatment.
There are many strategies that we can use to address this, and helping you through this period is part of the care we provide (even after hours, if needed).
Facing the Fear of the Unknown
A lot of the initial fear about starting recovery is really fear of the unknown— will this work? What does recovery look like? How does buprenorphine work?
Will I be judged or made to feel like a bad person? What happens if something happens after hours? Will these doctors care about me? Starting recovery takes courage— courage that you have.
Are There Requirements for Being Part of the Program?
Yes— and no. By law, everyone in a MAT program must be receiving counseling. However, what that means in practicality for the treatment process is variable, and we want our program to work for you and your life. Should not have to stop your life or change your job to fit the program.
We want to be easy to contact and to help you address the challenges you are facing, rather than forcing you to follow the dictates of a provider.
We believe in treating adults like adults and tailoring our services to help people live in the real world.
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On this free call one of our doctors will answer any questions you have about our practice and approach.
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We’ll work together to identify the best care to fit your unique addiction recovery needs.
A Happier, Healthier Life.
Our accessible approach to healthcare means you can stop worrying about your healthcare and start enjoying your life.
Helping Families Partner in Treatment
Many people have a family and a substance abuse problem. There is tremendous stress when you are trying to be a parent, and are struggling with opioid addiction.
Many of our patients are also parents, and our doctors are comfortable with this aspect of treatment. In fact, many of our patients seek out treatment because they want to be better parents to their kids.
At our clinic, we do not believe in making people feel bad for having a substance abuse disorder. Instead, we want our message to be one of hope and healing.
We work best with patients that want a partner in treatment. If you are looking for a big company dictating decisions, we are probably the best clinic for you.
Research has shown that treatment is most effective when families are involved. While we will also respect the confidentiality of our patients, we also recognize that care is more effective when families are involved and a part of the recovery journey. In fact, restoring that sense of family cohesion and belonging is an important part of treatment.
Paying for Treatment at Sequoia MD
There are many ways to think about paying for treatment. Probably the most expensive, and worst option, is to forgo addiction treatment.
The cost of continuing to use— on your physical health, your mental health, your family, your relationships, and your career, are all tremendous.
There is also a huge financial cost to not entering treatment— most people are paying huge amounts of money for opiates from the street, and spending hours per day just to stay well.
There are suboxone doctors or methadone clinics that you can see with your insurance if you have it. Instead of having insurance as a middleman in your care, we charge a simple, monthly subscription for our services (link).
This model frees our doctors to structure care in a way that is adaptable and personalized, rather than what the insurance company requires.
It also means that if you switch jobs or change insurance, you can continue your care uninterrupted. It means our doctors can focus on treating you as a person, not a number, and focus on your health and needs.