Frequently Asked Questions (FAQ)

A Deadly Epidemic

Drug overdoses are now the leading cause of death among Americans under 50. Drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States, according to preliminary data compiled by The New York Times.

The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Source

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What are opiates and what do they do?

Answer: Opiates are a class of drugs derived from the opium poppy plant. These substances are used medicinally as pain relievers and recreationally for their euphoric and tranquilizing effects. Opiate agonist such as morphine, codeine, heroin, methadone, oxycodone, hydrocodone, fentanyl, tramadol, and Demerol, bind to opioid receptors in the brain and nervous system to block pain transmission.

When should a person seek buprenorphine/naloxone treatment?

Answer: If you or your loved one suffers from opiate addiction, experiences opiate withdrawal symptoms, has increased cravings, develops a tolerance to opioids, partakes in illegal activities to obtain opiates, shuns work or family obligations, or wants to switch from methadone to buprenorphine/naloxone treatment.

What is combination buprenorphine/naloxone and how does it work?

Answer: The generic combination buprenorphine/naloxone are readily available as brand names Suboxone, Zubsolv, and Bunavail. The component drug buprenorphine is a partial agonist, with an enhanced ability to bind to opiate receptors and in so doing, replaces the opiate drug. Naloxone is an antagonist, it neutralizes the euphoric effects of buprenorphine, if crushed or injected.

How long will I take buprenorphine/naloxone?

Answer: The duration of buprenorphine/naloxone treatment varies upon each individual, their physiology, magnitude of abuse and environmental factors. Withdrawal symptoms could last from 3-7 days after induction. In general, a person diagnosed with an opioid use disorder typically takes buprenorphine/naloxone for 3-24 months or longer, if necessary. Numerous studies have shown that the combination of medications, counseling and family support are the best and fastest means of tackling opiate addiction.

How much is the cost of buprenorphine/naloxone treatment?

Answer: The costs of treating insured patients without an opioid abuse diagnosis versus one with a diagnosis is $3,400 versus $19,000 respectively, according to a major US insurance carrier. Human Resource experts cite a quarter of all workers’ compensation prescription drug costs are related to opioids. Moreover, many of these workers failed to return to work after receiving 3 months or more of continuous opioid pain treatment. The annual costs for a heroin abuser is $25-50k, Vicodin abusers $20-40K a year and Oxycontin abusers cost could range from $50-100K annually. The cost of buprenorphine/naloxone treatment is $8-12k per year.

What does buprenorphine/naloxone “induction” mean?

Answer: Induction is the process of switching from opiate abuse to buprenorphine/naloxone combination therapy. Buprenorphine/naloxone therapy can reduce opiate withdrawal symptoms, cravings or illicit use for a more stable, legal, safe and professionally administered alternative. A major concern of initial induction is sedation. Therefore, newly induced patients are required to demonstrate viable transportation to their residence by a friend, family, taxi, public or private transport. The Induction process takes 2-4 hours and the patient will be given a daily take home prescription lasting 1-2 weeks until stabilized.

What is precipitated opiate withdrawal?

Answer: Immediate and intense opiate withdrawal symptoms caused by a partial agonist i.e. buprenorphine/naloxone replacing weaker binding opiate agonists i.e. heroin or prescription pain pills bound to opioid receptors. Slowly increasing the low dosage buprenorphine/naloxone over a few hours or expanding the amount of time between last opiate use and buprenorphine/naloxone induction reduces or eliminates precipitated withdrawal.

What are common side effects of buprenorphine/naloxone ?

Answer: More common drowsiness, sedation, headaches, constipation, nausea, slowed breathing, and dry mouth. For this reason, verifiable transportation to your home is required during the initial induction phase for your personal safety.

What are the major differences between buprenorphine/naloxone versus methadone treatment?

Answer: Buprenorphine/naloxone anecdotally is less stigmatizing and addictive, with enhanced mental clarity and safety profile, prescriptions can be taken home. Methadone is a full agonist giving it superior pain relief, it is the standard of care in pregnant patients and high dose methadone tends to have better outcomes. Methadone treatment centers are few and heavily regulated by the federal government. Daily attendance at a methadone clinic is often a requirement for several months, as compared to 2-4 visits per month with Suboxone.

Who needs to know that I am taking buprenorphine/naloxone?

Answer: your primary care physician, psychiatrist, pharmacist, pain specialist, surgeon and other critical medical specialties.

How is AMC treatment different from other treatment facilities?

Answer: At AMC, your individualized treatment plan includes a phone interview, free urine drug test, medical history, diagnosis screening, brief physical examination, discounted lab testing, an initial buprenorphine/naloxone prescription for office based treatment and the option to schedule follow up visits with the psychiatrist or a therapist. We offer an affordable all-inclusive monthly fee schedule and a discounted rate after the first month of stabilized treatment.

Does AMC prescribe medications other than buprenorphine/naloxone?

Answer: On occasion, a patient may request a script for up to 30 days supply of psychotropic medications to cover the period to their next scheduled psychiatric visit. This is a significant benefit to have immediate access to a board-certified psychiatrist. All medication requests are fulfilled at the discretion of the AMC physician. For your safety, requests for benzodiazepines, pain medication or psycho-stimulants will not be granted.

Does AMC provide individual or family counseling?

Answer: Yes, individualized counseling occurs at each visit by the doctor. Family counseling with the doctor can be arranged as well.

Does AMC accept my insurance?

Answer: for your convenience, regulatory expediency, reduced administrative cost, and personal discretion, major credit cards or cash payments are welcomed. However, personal checks or private insurance are not accepted.