If you’re exploring options to treat opiate addiction, you should consider the use of buprenorphine. In Fresno, some medication-assisted treatment programs offer both methadone and buprenorphine are available.
Buprenorphine is the generic name for the brand-name drugs, Suboxone, Subutex, and Zubsolv. Suboxone and Subutex are both manufactured by the same company, Reckitt Benckiser Pharmaceuticals. Suboxone is a combination of buprenorphine along with naloxone; the naloxone curbs the desire for use of opioids. Subutex is buprenorphine, plain and simple. It’s often the medication of choice for pregnant women who struggle with addiction. Zubsolv, marketed by Orexo, also contains a formulation of buprenorphine and naloxone. While there is slightly more medication contained in Suboxone than in Zubsolv, they both contain the same four-to-one ratio of buprenorphine to naloxone. You might opt for Zubsolv for treatment with buprenorphine in Fresno, if your insurance approves Zubsolv but not Suboxone, as is sometimes the case.
California Society for Addiction Medicine Guidelines
The California Society for Addiction Medicine (CSAM) is a professional organization representing some 400 physicians in California who work to make addiction treatment available to the people who need it. These physicians believe that some three-quarters of a million people throughout California need substance abuse treatment and are not getting it. Buprenorphine in Fresno and other locales is increasingly available, and the CSAM follows the lead of the federal Substance Abuse and Mental Health Services Administration (SAMHSA) in promoting guidelines for buprenorphine use.
Precautions for Use of Buprenorphine
Doctors in CSAM—and the SAMHSA guidelines—make reference to contraindications for buprenorphine. Here’s what you should know if you’re thinking of treatment with buprenorphine in Fresno:
- Avoid buprenorphine treatment if you’re also using benzodiazepines or alcohol. The combination is deadly with the potential to push your body into deadly respiratory arrest. The same applies to methadone.
- If you have epilepsy or a history of seizures, you may want to consider methadone instead of buprenorphine. Buprenorphine can alter the efficacy of anti-seizure medications such as phenytoin (Dilantin), carbamapezine (Tegretol), valproic acid (Depakote), and others. It can also be dangerous to take buprenorphine or methadone in combination with barbiturates used to treat seizures.
- Patients with HIV should use buprenorphine cautiously. The combination of HIV medications with buprenorphine can mitigate the effectiveness of either drug. Treatment with buprenorphine is not impossible, but it must be monitored closely.
- Patients with co-occurring psychiatric diagnoses may not be good candidates for buprenorphine treatment. No decision should be made on that without discussing it with the doctor.
- If a patient has tried repeatedly for recovery with buprenorphine and failed, the doctor will generally offer methadone, as it represents a longer term of therapy.
Phases of Treatment With Buprenorphine in Fresno
There are three phases of treatment described by SAMHSA: induction, stabilization, and maintenance. Here’s what to expect with each one during your treatment with buprenorphine in Fresno:
- Phase One involves your induction, which refers to your switch from your opiate drug of choice to the buprenorphine. The doctor will decide what dose you need based on your history of use and the intensity of your withdrawal symptoms. Most people are started on 8 mg, but some start on half that dose and others take twice as much. The induction period lasts for about a week. The doctor will most likely have you return to the office within two days of your first dose to assess how you’re doing. He can determine how your transition to buprenorphine is going and evaluate whether or not your dose is adequate.
- Phase Two is called stabilization. Once the doctor has determined that you are responding appropriately to your treatment with buprenorphine in Fresno with no withdrawal symptoms or cravings, you will come once a week, see the doctor, and get a new prescription. You should also be seeing the counselor assigned to your case. Research shows that regular contact with the doctor and also one-on-one face time with a counselor as well as participation in 12-step meetings all contribute to successful recovery.
- Phase Three refers to your maintenance, and it can last for just months or for years. The idea that buprenorphine treatment in Fresno or elsewhere should be short-term therapy is now much less rigid. Previously, people who chose long-term medication-assisted therapy stayed on methadone, but buprenorphine therapy has also been accepted for long-term treatment.
You may want to verbalize a treatment goal with your doctor or counselor in the beginning. Some people receiving treatment with buprenorphine in Fresno just give a general goal—“I want to stay on buprenorphine until I get my life straightened out.” Others prefer not to say at all until they see how they do. There’s no pressure there. Your doctor will watch you to see if you remain sober over a long period of time, if you resolve legal issues, and if your social and family life becomes stable.
Buprenorphine for Pain
The idea of taking opiate pain medication when you’re in pain becomes a thing of the past when you undergo buprenorphine therapy. However, discuss options for pain control with your doctor. In some cases, they may recommend what they call multimodal therapy. That sounds ominous—but it simply means you can take ibuprofen and acetaminophen together.
If you are in treatment with buprenorphine in Fresno and you have an upcoming painful procedure—for example, childbirth, dental extractions, or some minor surgery—your doctor might opt to adjust your buprenorphine dose. It’s definitely something to talk about with the doctor.
Buprenorphine for Pregnancy
Pregnant women who request treatment for opiates with buprenorphine in Fresno will receive immediate attention. The government requires all licensed opiate treatment programs to induct pregnant women into therapy as soon as possible in order to protect the unborn baby. Heroin and other opiates are very dangerous for the baby, as are injecting drugs plus other habits of people who are actively using.
Buprenorphine is a partial agonist, which means that you can’t get high from it. It stops the receptors in your brain from responding to other opiates, but it doesn’t bring on that same euphoria itself that methadone can cause if it is abused. Also, methadone is a full opiate agonist, and so buprenorphine remains the treatment of choice for pregnant women.
However, you will take the Subutex rather than the Suboxone or Zubsolv. Subutex does not contain naloxone, which is present in Suboxone and Zubsolv, and so that’s one less drug for the baby. You will stay on Subutex throughout your pregnancy and even while you’re breastfeeding. Not much of the Subutex will pass into the breast milk, and so it offers a good option.
Get Help Now
Research shows that treatment is more successful when counseling takes place along with the buprenorphine. In Fresno, you will find AA meetings taking place every day of the week. Your buprenorphine therapy will be successful as long as you keep your appointments regularly, attend your counseling sessions, and go to 12-step meetings. Think of the way you hate your daily life right now, struggling with addiction. Your relationships with the people around you are crumbling. Getting into treatment can turn your life around. Pick up the phone right now and call your local treatment center to get started on buprenorphine in Fresno.