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Gluten and Its
Association With Illness
Vitamin D Importance
In Prevention and Treatment of Illness
Allergies & Sensitivities: LDA (Ultra Low
Dose Enzyme Activated Immunotherapy)
Post Traumatic Environmental Stress Disorder
Peace of
Mind: Holistic Approaches to Anxiety and ADD
Bipolar Disorder Can Be Treated With
Medication and Naturally
ALLERGY REDUCTION:
Improving Mood and Energy
Hidden Factors Behind Your Persistent Illness
Adult ADD:
To Medicate or Go Natural
Cancer
– Finding Your Best
Advisor
Overweight - The Risk and the Remedy
Loss of Sexual Interest
Approaches in Helping Bipolar Sufferers
Help for Panic and Anxiety Sufferer
Seasonal Affective Disorder: The Winter Blues
Depression Relief Speeds Health Recovery
Amino Acids & Other Considerations in Depression
Evaluation
Integrative Medicine & Psychiatry
Blood Pressure -
A Wake up Call
Addictions - Breaking the Cycle
Suboxone: For Opiate
Dependence
(for Western North Carolina Residents Only)
Spirituality:
The Core of Healing in Integrative Psychiatry
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Suboxone: For Opiate Dependence
By
Ronald R. Parks, MD
Updated: 5/13/11
This article is for Western North Carolina residents only and
describes Dr. Parks' office based Suboxone Program and its
requirements.
To benefit those in need of recovery from Opiate dependence (pain
pill use), integrative psychiatry and medicine therapies and
principles are applied, which utilizes a holistic approach along
with the use of Suboxone (buprenorphine). Our office has a unique
and structured outpatient Suboxone program that offers a clear path
with emphasis placed on a gradual tapering and discontinuation of
Suboxone over a six month to one year period* while the individual
gains the necessary skills and support by fully participating in a
recovery oriented learning process: to help prevent relapses, to be
successful in total abstinence and recovery, and maintain sobriety.
Once an individual is off opiates that have been abused, Suboxone
acts like a partial opiate, helping to prevent the cravings and drug
seeking behavior for the abused opiates. Suboxone is useful in
detoxification, stabilization and maintenance. Many of the programs
available in the area are primarily maintenance programs based on
the assumption that you need to be on Suboxone for a lengthy period
of time. Though this may be true for some individuals -- who may
need long-term maintenance treatment, who also might be candidates
for a methadone treatment program, residential treatment,
therapeutic community or halfway house program; long-term
maintenance is not the primary objective of this abstinence oriented
recovery program.
Since Suboxone does have some of the same addictive qualities as
other opiates, clients need their full engagement in learning the
skill of living drug free and in recovery, which means abstaining
from alcohol, opiates, marijuana, cocaine and other addictive
substances (excluding nicotine). Mixing Suboxone with other
medications can be dangerous, especially if taken outside the care
of a physician; deaths have occurred among persons mixing
buprenorphine (Suboxone) and benzodiazepines (for example, Valium,
Klonopin or Xanax).
Accomplishing treatment goals requires the cooperation and active
participation of clients and their families. Lack of cooperation or
any violations of this agreement, which includes the consent signed
by the client, may be grounds for termination of treatment. The cost
of the program for follow-up sessions per month is due in full at
the time of the client's monthly session with Dr. Parks.
No drugs are kept at our office and Suboxone will need to be
purchased separately by you at your pharmacy.
The cost of the program for the initial and follow-up
sessions is due in full at the time of the client's initial
and then at each monthly follow-up session with Dr. Parks.
What is covered in the monthly program fee:
Visits to see Dr. Parks up to two times per month. If for any reason
your monthly session is delayed or there is a no show, the cost and
charge is still due on a monthly basis and you will need to make
each monthly payment to stay in the program. There will be no
refunds if optional or mandatory appointments are missed, which may
also result in not obtaining a Suboxone prescription until the next
scheduled appointment.
Additional Costs Not Included With The Monthly Program Fee:
The cost of any additional visits if needed or requested with Dr.
Parks, which include any make-up or rescheduled visits for missed
appointments, as well as any nutritional supports or supplements --
would be charged according to the current fee schedule, would be an
added or additional expense to you and would not be considered a
part of your monthly program fee.
If you have insurance:
Insurance will often pay for the cost of the medication and it may
reimburse you for a portion of the cost of both your office visits,
depending on the out-of-network coverage and deductible that your
insurance might provide -- we will provide you with an insurance
form for you to submit to your insurance company; however, we may
charge you for any additional services if further requirements are
needed by your insurance carrier (such as corrected claims, calling
the insurance company on your behalf, records requests, special
reports and/or pre-
authorizations).
Medicare and Medicaid is not accepted at this time.
1) Required: one to two meetings per month with Dr. Parks --
for review of your medications, your program progress and for
tracking the gradual tapering of Suboxone. Other related medical or
nutritional issues may also be addressed at this time.
2) Recommended: a minimum of three NA (Narcotics Anonymous)
or AA (Alcoholics Anonymous) 12-step recovery meetings per calendar
month (1 to 2 times per week recommended and 3 times per week or
more encouraged).
Clients must provide an adequate way for office staff to reach
them by phone either directly, by another responsible person and/or
by voice-message -- for either reminders, or in the event that the
appointment needs to be rescheduled by our office staff due to
scheduling conflicts. Failure to comply may mean the loss of an
appointment.
Clients need to keep their Suboxone in a safe and secure place;
lost or stolen Suboxone medication will not be replaced regardless
of the reason.
It is necessary for clients to arrive on time for appointments and
to conduct themselves in a courteous manner.
Termination From The Suboxone Program:
If during the course of the program one is not able to participate
or meet the program requirements, recommendations will be made to
consider a more structured or intensive program: such as inpatient
detoxification and treatment, a residential treatment or therapeutic
community program, a methadone program, an SAIOP program or a long
term maintenance program -- all of which are available in the area
if needed. Your decision at any time to seek out one of these
alternative programs will be respected and honored as long as proper
cancellation notice is given.
Termination from the Suboxone program will occur when 1) a
client does not see Dr. Parks at least once a month. 2) When
more than 2 appointments in a two month period of time are missed
(for clarification, that is 2 or more absences (no shows) in 2
months time).
Click Here for more information about Suboxone detox and
treatment.
*Some will be able to discontinue their Suboxone treatment in a much
shorter period of time; the time frame given is a treatment goal,
not a requirement.
Ronald R. Parks, M.D. practices Integrative Medicine and Psychiatry
in Asheville, North Carolina with a background in Internal Medicine,
Integrative Medicine, nutrition and addiction treatment.
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