Starting Suboxone Treatment
Once you and your doctor have decided the begin treatment with Suboxone (Buprenorphine/Naloxone), you will need to go through “suboxone induction.” This usually involves you spending at least 2 hours at the doctor’s office taking your first dose and possibly a second dose.
Some doctors will give a suboxone prescription and begin some patients at home, but my preference is to begin suboxone treatment in my office. I usually make sure an older person, or someone with separate medical problems see their primary care doctor first for and update on their physical exam. Routine blood work is done to make sure the liver, kidneys, thyroid, and electrolytes are normal. It is wise to get screens for HIV and Hepatitis before starting treatment with suboxone as these are more commonly seen with narcotic addicted individuals. After all this is started we go to the next step.
Other Steps While Starting Suboxone Treatment
The patient has his or her vital signs (Blood pressure, pulse, temperature) taken and the they are must be in significant withdrawal from their narcotics. The reason for this is that Suboxone induction can actually cause withdrawal in persons who are no actually in withdrawal. I’ll write another post on this, but for now just take my word for it.
Once suboxone withdrawal symptoms are confirmed, the first tablet is given. It takes around 90 minutes to get the peak effect from this first dose and most patients come out of withdrawal and are feeling better.
Depending on your doctor, the first dose could be between 2mg and 8mg. After the first 90 minutes, I check in with the patient and we decide whether to give another dose and send home, or to have them stay in the office. If they are sent home, they are told not to drive and should have arranged for a family member or friend to drive them home.
Getting Some Relief with Suboxone Treatment
Some patients want to take a higher dose the first day. I generally like to see significant relief the first day, but not complete relief. The reason is that I’ve given the higher buprenorphine dose in the office and the patient felt fine initially, but then felt drugged that night or the next day. I’d rather them go up on the dose the following day and get further relief with suboxone treatment at that time. We discuss how to increase the dose to the desired effect for this particular patient. I like to see them back in a few day for a check, then another check in 3-5 days.
I can say that I’ve only had a problem with induction with one person who appeared to have an allergic reaction to some ingredients in the pill. Otherwise, I find the induction one of the most gratifying things as a physician to witness.
I tell people when they first come to see me it will fell like a miracle. Every one, bar none, who has not had experience with Suboxone doubts me and wonders “does suboxone work.” That first day they walk out of the office feeling much better and are greatly improved within a day or so.
Gone are not only the withdrawals, but the thoughts and cravings that have been ruling their lives. Some people feel so well they don’t want to address some of the other issues in addiction, including the need for therapy and getting off other mind altering substances.
Find a Doctor in Your Area That Can Start You on Suboxone:
If you feel you need help and are looking for a doctor who prescribes Suboxone, click here for our buprenophine physician registry. If you think you may need more intensive treatment such a methadone detox, other opioid detox, or getting started on buprenorphine inpatient, click here for our state opioid treatment center registry.