During your first visit, you will be taken through a telemedicine evaluation with a licensed clinical professional for a medical evaluation. The treatment procedure should begin as soon as possible and may even occur within one week of your initial visit. In some cases, the treatment can be administered during the initial consultation. The initial assessment will last for approximately one hour and two to three hours if you undergo treatment on the same day.
The standard treatment process occurs in three phases:
1. The Induction Phase: The induction phase is the medically monitored initiation phase of the treatment. In an effort to reduce the likelihood of sickness and acute withdrawal, you are required to be in an early stage of opiate withdrawal. You should also be abstinent of opiates for 12 to 24 hours before induction. You will be given detailed instructions to help you to prepare for your first appointment.
2. The Stabilization Phase: During this phase, you can expect to be taking buprenorphine regularly and to no longer be using or abusing other opiates or illicit drugs. Increases or decreases in dosages may be made if clinically indicated. You will continue with regular counseling, which may eventually be reduced to one visit per month. Attendance at 12-step meetings is encouraged. You can expect to have normal interactions with friends, family members, and work. If you are compliant and no longer using any illicit substances, physician visits for medication refills may be reduced to every four weeks. This contrasts with methadone clinics, where daily attendance and cash payments are usually required.
3. The Maintenance Phase: During this phase, you should be doing well on a stable dose of buprenorphine. The length of the maintenance phase is tailored to the individual patient and could be indefinite in some cases. You can expect your medication dosage to be frequently and gradually reduced. You could wean off of buprenorphine altogether, but this could take many months or even years. Although counseling may often be discontinued in this phase, we recommend continued involvement in a 12-step program or other support groups and activities.