What to Expect When Starting Suboxone

By July 16, 2019Medication

In 2016, in the United States:

  • 51,969 persons died from an opioid overdose
  • 1 million people suffered from an Opioid Use disorder
  • Yet only about 20% of these individuals received treatment for this chronic brain disease

In 2017, Virginia saw:

  • 1,534 fatal drug overdoses, most of which were related to opioids
  • 1,227 opioid overdoses were reported last year, a 7.8 percent increase from 1,138 in 2016

At Insight Into Action Therapy in our Ashburn office we use evidence-based medical approach called Medication Assisted Treatment (MAT) that has demonstrated success in treating people struggling with opiate use. We use the medication buprenorphine/naloxone (Suboxone) in combination with therapy so that we can offer you the best chance of attaining a life free of addiction.

Here’s how it works. On your first visit we will:

  • Review your physical and mental health
  • Collect a detailed history of your substance use
  • Order lab tests (HIV, hepatitis screen, complete blood count, and metabolic screen) to assess your current health
  • Submit a urine drug screen

After receiving your lab work, I will electronically send a prescription for (Suboxone) to your pharmacy. You will then bring the medication, unopened, to your Induction visit. If desired, I can also provide you with some comfort medications for nausea, insomnia and anxiety.

On your next visit to our Ashburn office, we will do an induction of the medication. These are the steps we will take to start you on Buprenorphine/Naloxone (Suboxone):

  • Arrive to the visit in mild withdrawal. It is not necessary to start treatment in severe withdrawal and have you experience extreme discomfort.
  • Assess at beginning of visit, at one hour and at two hours using the Clinical Opiate Withdrawal Scale score (COWs). The areas rated will be: heart rate, sweating, restlessness, pupil size, bone or joint aches, runny nose/tearing, gastrointestinal upset, tremor, yawning, anxiety/irritability, and/or goose flesh bumps. These are all signs of withdrawal. When your score is > or = to 7 you are in mild withdrawal and the induction can start.
  • If your COWs score remains elevated, you take another buprenorphine dose under my direction.

Over the next week we will:

  • Assess the right dose of medication
  • Refer you to an appropriate therapist

Once you have the right dose, you will no longer crave opiates. In the first month you may be seen on a weekly basis. Based on your progress, appointments will then occur on a monthly basis. At each appointment you will submit to an observed urine screen and the Prescription Monitoring Program will be checked as a part of best practices.

Many people are on Suboxone for a period of eighteen months. The decision to taper is based on many factors. You and your prescriber will make this decision together.

Gwen Davis, FNP, MSN-BC provides MAT as well as medication monitoring. She can be reached at 703-646-7664 x16 or gdavis@insightactiontherapy.com.





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