Medication Assisted Treatment
Suboxone Maintenance

At Guardian IOP we believe our clients should have access to every effective tool they can have to combat against drug and alcohol addiction. Opioid addiction in particular is extremely dangerous and potentially fatal. In 2020 the United States saw its worst year on record for fatal drug overdoses; According to the Center for Disease Control, roughly 93,000 individuals lost their lives to overdoses nationwide. The Opioid Epidemic was first declared a national emergency in 2017 by then President Donald Trump. The emergency status was renewed in 2018, and the epidemic has only gotten worse since then.

At Guardian IOP we feel it is critical individuals afflicted with an opioid addiction have access to quality addiction treatment programs built on evidence-based methodologies. One evidence-based method for treating opioid addiction is utilizing Suboxone, a medication that when used in conjunction with addiction treatment, has been shown to greatly reduce relapse, prevent overdoses and increase the odds of recovery.

At Guardian IOP’s addiction treatment facilities in New Brunswick and Hoboken New Jersey, we utilize Suboxone as part of a comprehensive treatment strategy. Our location in Delray Beach is not currently utilizing Suboxone Maintenance, but does utilize other forms of medication assisted treatment. For more information on Suboxone Maintenance or our IOP addiction treatment programs in New Jersey and Florida, contact us any time.

What is Suboxone Maintenance?

Suboxone is an opioid partial agonist that binds to the brain’s opioid receptors to both curb intense opioid cravings and block the brain’s receptors from receiving other opioid drugs. This means an individual is unable to get high from other opioids — such as heroin, fentanyl or prescription pain medications — while also experiencing far less cravings to use opioids. Suboxone also contains an active ingredient, naloxone, which inhibits an individual’s ability to experience an overdose. This means that even if an individual does relapse while on Suboxone, they will likely not die.

Suboxone has been shown to greatly improve an individual’s odds of staying sober in early recovery. According to Dr. Tamer Wasseff, Guardian IOP’s chief psychiatrist in New Jersey, the use of medication assisted treatment like Suboxone reduces an individual’s chance of relapse within their first year of sobriety from about 80 percent (with no medication), to about 15 percent with medication.

Suboxone Maintenance refers to the use of Suboxone for several months while an individual is learning how to be sober. The client is slowly weaned off Suboxone as they grow stronger in their recovery and learn the tools and coping mechanisms necessary for long-term sobriety.

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Utilizing Suboxone in Conjunction with Treatment

While Dr. Wassef says he believes wholeheartedly in the effectiveness of Suboxone in the treatment of opioid use disorders, he had a change of heart about two years ago on how the medication should be utilized. He came to believe that Suboxone should not be used as a standalone treatment option, rather it should only be used in conjunction with a professional addiction treatment program like the one offered at Guardian IOP.

“I used to do Suboxone Maintenance without a treatment program but I stopped,” he said. “The main reason is because I felt that by giving patients the drug without having a program to teach them new skills was kind of like re-enforcing their drug use behavior. Eventually those patients started to do tricks and experiment and get high. So I stopped. I decided that medication has to be given only when the patient is in a program.”

Without an addiction treatment program, Dr. Wassef said using Suboxone is like using a life vest without learning how to swim.

“If you are not learning how to swim or learning any new skills, then once I remove the life jacket you will sink,” he said. “That’s exactly the same with Suboxone. Suboxone is a tool but it needs to be used by experienced addiction professionals in a program.”

Suboxone buys us time. It buys us time so that we can teach our patients new skills and help them change their lifestyles, experience less hectic lives, less stress and less craving.

One of the common criticisms of Suboxone Maintenance is that individuals are exchanging one addiction for another. This is only accurate if an individual is not in a program, continuously tapering the dose down and learning new coping skills and recovery behaviors. At Guardian IOP, clients take part in a full schedule of individual therapy, group therapy, family therapy, 12-Step program education, holistic treatments and life skills workshops that help them learn the tools they need to stay sober long-term. By the time an individual graduates from Guardian’s IOP program, they have been tapered off of Suboxone and have practice living life sober without its aid.

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What Happens After Suboxone Maintenance Ends?

At Guardian IOP, once a client has been tapered off of Suboxone over the course of several months, they have the option to transition to another evidence-based medication called Vivitrol. Vivitrol is a monthly shot that also blocks opioid receptors from receiving other opioids, which prohibits a person from getting high and prevents overdose.

Unlike Suboxone, Vivitrol contains no opioid so it is slightly more challenging than Suboxone in terms of an individual’s experience of opioid cravings. However, mentally an individual knows that if they try to use opioids while on Vivitrol, they will not experience any of the drug’s euphoric effects. This is a powerful motivator to avoid obtaining drugs.

Utilizing Vivitrol after the use of Suboxone adds one more layer of protection to an individual’s sobriety before going fully unmedicated. This buys the individual more time to establish new patterns of thinking and behavior in recovery. All the while, these individuals are learning new emotional coping mechanisms, healing old emotional wounds that could trip them up in early sobriety, creating a recovery support community, building meaningful relationships and bettering their life circumstances.

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What is the Suboxone Maintenance Timeline?

The dose and duration of Suboxone varies from person to person depending on the amount of opioids the individual was using prior to coming to treatment, the severity and length of their addiction and their current life circumstances. At Guardian IOP individuals are assessed by our clinical professionals to determine the best course of action for their unique case.

Generally an individual is on Suboxone for anywhere between 2-8 months, slowly tapering their dose down over time until they are weaned off completely. Then the individual can opt to get a Vivitrol shot, or can continue with their IOP treatment without the use of medication.

Dr. Wassef recommends individuals participate in some form of addiction treatment for one year — meaning from the time an individual detoxes off their drug of choice in a medical detox facility, to the end of their subsequent treatment choices (usually residential inpatient followed by and intensive outpatient program like Guardian’s). This means individuals spend one full year supported by addiction treatment professionals and a close-knit recovery community.

What Does IOP Treatment Entail?

While in IOP treatment, clients partake in 3-5 days of treatment for approximately 3-5 hours at a time. Guardian IOP facilities generally have a morning and evening track to accommodate different schedules. Clients are free to go to work, attend school and live at home or in sober living while attending treatment.

The IOP program consists of a wide variety of activities including individual therapy, group therapy, family therapy, life skills education, recovery meetings, community service projects and holistic treatments such as yoga, meditation and breathwork. Our IOP program tackles addiction at every level — emotional, physical, mental and spiritual.

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    If you or someone you love has been struggling with an opioid use disorder or heroin addiction, there is hope. Our program of recovery has been highly successful at helping individuals get sober, stay sober and build meaningful lives in recovery. Because of the serious consequences of opioid addiction, it is critical to seek help as soon as possible. Addiction is a progressive condition that, over time, gets worse. So there is no better time to call than now.

    When you contact us, you will reach a compassionate, knowledgeable Treatment Advisor who will learn about your situation and help you craft a strategic plan for recovery. They will help coordinate with your health insurance company, arrange transportation and make the admissions process as easy on you as possible. Long term recovery is possible. All you need to do is get the ball in motion by contacting us today.

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