Why must I see the doctor so often?
Most recommended guidelines suggest that the physician see the patient weekly until the person is stable and free of illicit drugs. This is to make sure the person is doing well and is on the correct dose of buprenorphine. The goal of therapy is to be on the lowest dose of Suboxone that is effective. Effectiveness relates to decreasing craving and symptoms of opioid withdrawal, and remaining abstinent of other opioids.
Also, the U.S. Drug Enforcement Agency ("DEA") working with state authorities scrutinizes physicians who prescribe buprenorphine for opioid use disorder under DATA 2000. These regulatory agencies expect a requisite level of care from prescribing physicians to monitor therapy.
Do I always need weekly visits?
No. This practice requires weekly visits until the patient is stabilized on a moderate dose of buprenorphine/naloxone. Generally, this means that a person must have urine drug tests negative for illicit substances and alcohol for three months. The goal is to gradually decrease the number of visits from weekly to every two weeks, and eventially to three times a month,
Do I have to participate in a "program" or go to group meetings?
The idea behind prescribing buprenorphine in an office setting for opioid use disorder is to provide an alternative to traditional 'drug programs.' Your particular plan is individualized to your needs. You may benefit from attending a support group. You may consider self-help groups like Narcotics Anonymous or SMART Recovery. If you need individual counseling beyond the brief counseling sessions offered by Dr. Simon you may be referred to another qualified counselor, therapist or physician. Occasionally it is necessary to refer to an outpatient treatment program in addition to being prescribed buprenorphine/naloxone here. Usually, however, such referrals are not necessary. The point is, in this practice there is no cookie cutter approach to treatment. Different people sometimes do better with different treatment approaches.
This treatment seems too expensive.
Many people come to us spending $70-100 per day buying drugs off the street to support their habit. If you spend $70 a day on drugs, that's equal to $2,100 per month. For patients without health insurance treatment through this office will cost $830 to $980 of professional fees the first month, and then $510 to $600 per month until stabilization permits less frequent visits. If you have accepted health insurance you will pay considerably less out-of-pocket for treatment.