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Treatment Phases



Take the Steps To Overcome Substance Abuse

1. Induction and Early Stabilization
2. Late Phase Stabilization
3. Maintenance and Well Visits

Opiate withdrawal can be mentally draining and physically painful. Based in Malvern, Pennsylvania, Mainline Preventive Medicine focuses on providing a personalized level of care to help you overcome your opiate addiction with as much help as possible. Schedule your visit to get started on your drug rehabilitation. Heal mentally and physically to start living a more productive life.
 


What you can expect in Suboxone Treatment with our office Consultation :

You will first meet with a physician  in addiction medicine to discuss your situation. If you and the doctor feel that suboxone is a good treatment plan for you, you move on the induction phase of treatment.

Induction : To get started, the doctor will instruct you on when it will be best to start taking your first dose of suboxone. The best results occur when you wait until you are in significant withdrawal (very uncomfortable). We suggest that you take your first dose while you are in the comfort of you own home. You will take the first dose, (usually 4mg but may be more or less). If you do not experience precipitated withdrawal (feel increased sickness) within the first 30 minutes, you may then take the another dose. We then recommend that you take the previous day’s total dose the next morning. If you still feel uncomfortable or feel you need a second dose, you may be instructed to add another dose. The next morning you will again take the total dose from the previous day. If you again feel the need to increase your dose because of sickness, you may again be instructed to add another dose after waiting 30 minutes. This will usually be 16mg total or less but this is individualized to your response. If at any time you feel lethargic or unusually tired, you may reduce your dose to the previous day’s dose.

Post Induction Visit #1: You will return to the office one week after your consultation visit and have a urine toxicology (UTOX) done at this and every following visit. You will meet with your doctor and discuss how the medication is working for you, discuss the results of your UTOX, and decide if you are going to continue with the medication and/or if you are going to change the dose.

Post induction Visit #2 : You will continue to meet weekly with your doctor until you establish the proper dose. The proper dose means that you are comfortable (not having withdrawal symptoms), not having cravings, and if you try using on top of the suboxone you should not feel the effects (a blocking dose). So long as you are stable (no substance use of any kind), the doctor will increase your visits from weekly to biweekly and then monthly.

Maintenance : So long as you are stable, you will continue to schedule appointments with your doctor, take UTOXs, and receive counseling on your substance abuse or other problems you may experience. The longest amount of time between visits is 6 weeks while you are taking suboxone.

Relapse : If you relapse, let the doctor know! Relapse is part of the recovery process if we learn from the relapse. If you relapse during the maintenance phase, you will return to weekly appointments and then you can add a week to each subsequent appointment up to 4 weeks.

Taper : Our goal is to have you slowly and successfully complete a medically supervised taper process. Studies have shown that best results with Suboxone maintenance occur after one year clean and sober. After that time, you should start a gradual detox. You will discuss with your doctor what the best taper plan will be for you and how you will be monitored during the process.

Recovery : After you have successfully completed your suboxone treatment, you and your doctor will discuss your options for ongoing treatment. You may choose to take an opioid blocker like naltrexone or you may choose to participate in Narcotics Anonymous (NA) or do some individual psychotherapy.


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Office Policies to Understand: Missed Appointments

A missed appointment can be a sign of serious trouble. In a general medical practice, we expect a message from a patient to inform us of the need to cancel and /or re-schedule an appointment. In addiction medicine, we need to know that a person has not relapsed and is safe. We will not refill suboxone without a valid reason for missing an appointment over the phone. An office visit is crucial to confirm stability. We will, unfortunately, have to terminate any physician-patient relationship where there is no communication regarding a patient's intention to continue treatment with us. We must allocate our resources to our patients that are continuing in treatment and that require our full attention. We will, if asked, provide 30 days emergency treatment, on a week to week basis, to allow patients to seek out alternative source of care. We will work with any patient to find a new treatment source and provide any necessary information to smooth the transition.