Now Accepting Medicaid

Buprenorphine Maintenance

Opioid is the combination of buprenorphine (partial opioid agonist) and naloxone (opioid antagonist –Narcan). The combination is either 2 mg/0.5 mg or 8 mg/2 mg. Opioid is a sublingual film (it dissolves under the tongue). The only FDA indication for Opioid Treatment is for maintenance therapy for Opioid Dependence. The usual dose range is 8 – 16 mg a day. I prescribe the 8 mg film until the end of the detox phase, when the 2 mg film becomes helpful. At 16 mg, 93% of the opioid receptors are blocked in the average person.

Studies have shown that best results with Opioid Treatment maintenance occur after 1 year clean/sober/stable. After that time, we should consider a gradual detox. Even though Opioid is not scored, you can cut the film in half. You may not get exactly half the dose, but it is close. The most common side effect of Opioid is headache. You can take Ibuprofen or Tylenol. You may not want to work on your first day on Opioid Treatment. You do have choices of opioid maintenance treatment of naltrexone or methadone clinics. You cannot take opiates (Oxycodone, Hydrocodone) or benzos (Xanax, Klonopin, Ativan, Valium) while taking opioid. You can keep something in your wallet that says you are on Opioid Treatment in case you are in an accident. You should read the package insert (PI) that comes with your first pill bottle and bring any questions with you to our next appointment. The PI is always available on www.opioid.com


Induction Phase of Treatment

We recommend you not take your first dose of Opioid Treatment until you are in significant withdrawal from your previous opiate or at least 24 hours to avoid precipitated withdrawal (very uncomfortable). We suggest taking your first dose while you are in the comfort of your own home. Take 1⁄2 a film (4 mg) under your tongue and if you do not experience precipitated withdrawal within the first 15 minutes, you can then take the second half. We recommend that you take one film (8 mg) twice a day for the first week. Then, we will meet and discuss the treatment plan. Opioid Treatment has a 37 hour half-life. Most of the patients take two films (16 mg) once a day.

Patient Responsibilities

  • Meet with the Doctor on a weekly basis until the proper dose is established. The right dose means that you are comfortable (not having withdrawal symptoms), and not having cravings.
  • As long as you are clean, sober, stable, and pass the Urine Drug Screens (UDS), we will then add a week to each subsequent appointment up to 4 weeks.
  • Urine Drug Screens will be monitored and will be performed in the office and sent out for confirmation.
  • All urine tests will be supervised.
  • We recommend patients to participate in outpatient therapy at least one hour, every four weeks, which will be billed separately.
  • The DEA and the Doctor check the NC Controlled Substance Reporting System. Do not give away or sell your Opioid Treatment.
  • Diversion is against the law.
  • Bring all Opioid Treatment (Now excepting Medicaid ) Film wrappers with you at each appointment for counts to document compliance and lack of diversion.
  • Protect your meds with a lock-box or safe.
  • All patients must keep their appointments.
  • All patients will be billed for no-shows or cancellations without a prior 24 hours notice.

Instructions on How to Take Opioid Treatment (Now Accepting Medicaid)

  • Always take Opioid Treatment as prescribed.
  • Drink water prior to the dose. The film will dissolve faster if your mouth is moist prior to placing the film under your tongue. After about a minute, most of it will dissolve.
  • Do NOT swallow Opioid. It will only cause constipation or nausea, and it will not work as well.
  • Do not stop taking Suboxone suddenly. You could become sick and have withdrawal symptoms because your body has become used to the medicine. Ask the doctor how to stop using Opioid the proper way.

If you take too much Opioid Treatment Film or overdose, get emergency medical help right away. Also contact Poison.

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