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Gluten and Its
Association With Illness
Vitamin D Importance
In Prevention and Treatment of Illness
Allergies & Sensitivities: LDA (Ultra Low
Dose Enzyme Activated Immunotherapy)
Post Traumatic Environmental Stress Disorder
Peace of
Mind: Holistic Approaches to Anxiety and ADD
Bipolar Disorder Can Be Treated With
Medication and Naturally
ALLERGY REDUCTION:
Improving Mood and Energy
Hidden Factors Behind Your Persistent Illness
Adult ADD:
To Medicate or Go Natural
Cancer
– Finding Your Best
Advisor
Overweight - The Risk and the Remedy
Loss of Sexual Interest
Approaches in Helping Bipolar Sufferers
Help for Panic and Anxiety Sufferer
Seasonal Affective Disorder: The Winter Blues
Depression Relief Speeds Health Recovery
Amino Acids & Other Considerations in Depression
Evaluation
Integrative Medicine & Psychiatry
Blood Pressure -
A Wake up Call
Addictions - Breaking the Cycle
Suboxone: For Opiate
Dependence
(for Western North Carolina Residents Only)
Spirituality:
The Core of Healing in Integrative Psychiatry
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Suboxone: For Opiate Dependence
By
Ronald R. Parks, MD
This article is for Western North Carolina residents only and
describes Dr. Parks' office based Suboxone Program and its
requirements.
To benefit those in need of recovery from Opiate dependence (pain
pill use), integrative psychiatry and medicine therapies and
principles are applied, which utilizes a holistic approach along
with the use of Suboxone (buprenorphine). Our office has a unique
and structured outpatient Suboxone program that offers a clear path
with emphasis placed on a gradual tapering and discontinuation of
Suboxone over a six month* to one year period while the individual
gains the necessary skills and support by fully participating in a
recovery oriented learning process -- to help prevent relapses, to
be successful in total abstinence and recovery, and maintain
sobriety.
Once an individual is off opiates that have been abused, Suboxone
acts like a partial opiate, helping to prevent the cravings and drug
seeking behavior for the abused opiates. Suboxone is useful in
detoxification, stabilization and maintenance. Many of the programs
available in the area are primarily maintenance programs based on
the assumption that you need to be on Suboxone for a lengthy period
of time. Though this may be true for some individuals -- who may
need long-term maintenance treatment, who also might be candidates
for a methadone treatment program, residential treatment,
therapeutic community or halfway house program -- long-term
maintenance is not the primary objective of this abstinence oriented
recovery program.
Since Suboxone does have some of the same addictive qualities as
other opiates, clients need their full engagement in learning the
skill of living drug free and in recovery, which means abstaining
from alcohol, opiates, marijuana, cocaine and other addictive
substances (excluding nicotine). Mixing Suboxone with other
medications can be dangerous, especially if taken outside the care
of a physician; deaths have occurred among persons mixing
buprenorphine (Suboxone) and benzodiazepines (for example, Valium,
Klonopin or Xanax).
Accomplishing treatment goals requires the cooperation and active
participation of clients and their families. Lack of cooperation or
any violations of this agreement, including the consent signed by
the client, may be grounds for termination of treatment. What is
covered in the monthly program fee: One visit to see Dr. Parks per
month and the two times per month group meeting with the addiction
specialist. If for any reason your monthly session is delayed or
there is a no show, the cost and charge is still due on a monthly
basis and you will need to make each monthly payment to stay in the
program.
The cost of the program for the initial and follow-up sessions is
due in full at the time of the client's monthly session with Dr.
Parks -- medicare and medicaid is not accepted at this time.
If you have insurance, it will often pay for the cost of the
medication and it may reimburse you for a portion of the cost of
your office visit, depending on the out-of-network coverage and
deductible that your insurance might provide -- we will provide you
with an insurance form for you to submit to your insurance company;
however, we may charge you for any additional services if further
requirements are needed by your insurance carrier (such as corrected
claims, calling the insurance company on your behalf, records
requests, special reports and/or pre-authorizations). No drugs
are kept at our office and Suboxone will need to be purchased
separately by you at your pharmacy.
The three requirements of the program: 1) a minimum of three
NA (Narcotics Anonymous) or AA (Alcoholics Anonymous) 12-step
recovery meetings per calendar month with the completion of meeting
list signatures (1 time per week required, 2 times per week
recommended and 3 times per week or more encouraged), 2) two
group sessions per month facilitated by the addiction counselor who
is working with the program, and 3) one meeting per month
with Dr. Parks -- for review of your medications, your program
progress and for tracking the gradual tapering of Suboxone. Other
related medical or nutritional issues may also be addressed at this
time.
The time and place of the two group sessions, including any changes,
are arranged and communicated to you by the addiction specialist
facilitating the group meetings, which are held at a convenient
place in Asheville.
Clients must provide an adequate way for office staff to reach
them by phone either directly, by another responsible person and/or
by voice-message -- for either reminders, or in the event that the
appointment needs to be rescheduled by our office staff due to
scheduling conflicts.
It is necessary for clients to arrive on time for
appointments and to conduct themselves in a courteous manner. There
will be no refunds if appointments or meetings are missed, which may
also result in not obtaining a Suboxone prescription until the next
scheduled appointment; clients will sign an attendance roster at
each group session and have the Meeting List signed with the
client's name, date attended, addiction group leader's signature and
topic discussed -- as done at all NA or AA meetings attended.
Clients need to keep their Suboxone in a safe and secure place;
lost or stolen Suboxone medication will not be replaced regardless
of the reason.
It will not be necessary for you to call if you do not go to your
scheduled group meeting as the office administrative staff is no
longer involved with outside group scheduling. All participants will
be expected to attend group sessions without reminders, changes or
rescheduling by our office.
It is required that all Suboxone clients hand deliver a copy of the
signed 12-step recovery meeting list (no regular or electronic
mailing as this can become lost and not received) to Dr. Parks at
the office when he sees you for your monthly visit; meeting slips**
will be signed and reviewed in the manner agreed upon by Dr. Parks.
You are also required to bring the signed list for review at the
group meetings with the addiction specialist. The signed meeting
list needs to be dated, signed by the Suboxone group addiction
specialist at your twice a month group meeting along with your
notation of the topic discussed.
In order to remain in the Suboxone program, these meeting
requirements must be completed each month and will not be forwarded
to the next month.
Permitted Substitutions:
If a client is unable to attend a group meeting with the addiction
specialist -- it is the client's responsibility to attend 3 NA or AA
meetings in place of each missed group meeting as this will be a
replacement requirement. Attendance in this way would be an accepted
alternative if your work schedule or other reasons are preventing
attendance at a program addiction group meeting.
In order to remain in the Suboxone program, if you miss both monthly
group meetings and did not attend the required NA or AA meetings per
calendar month with the meeting list signed, you would then have to
arrange to meet individually with the program addiction specialist
at least one time per month at an additional fee.
Additional Costs Not Included With The Monthly Program Fee:
If individual sessions with the addiction specialist are needed,
done in place of, or in addition to a group session -- these will be
arranged with the addiction specialist and will be paid for directly
to the addiction specialist at the specialist's current individual
fee charge. The cost of these additional sessions by the addiction
specialist, and also any additional visits if needed or requested
with Dr. Parks as well as any nutritional supports or supplements --
would be charged according to the current fee schedule, would be an
added or additional expense to you and would not be considered a
part of your monthly program fee.
Termination From The Suboxone Program:
If during the course of the program one is not able to participate
or meet the program requirements, recommendations will be made to
consider a more structured or intensive program: such as inpatient
detoxification and treatment, a residential treatment or therapeutic
community program, a methadone program, an IOAP program or a long
term maintenance program -- all of which are available in the area
if needed. Your decision at any time to seek out one of these
alternative programs will be respected and honored as long as proper
cancellation notice is given.
Termination from the Suboxone program will occur when 1) a
client does not see Dr. Parks at least once a month. 2) A
minimum of three NA or AA meetings per calendar month with the
completion of meeting list signatures, or the permitted substitution
stated in this agreement is not met. 3) When more than 2
addiction group sessions in a two month period of time are missed or
not signed for (for clarification, that is 2 or more absences in 2
months time), or the equivalent 6 of the 12 required NA/AA meeting
substitutes in two months are missed or not signed for, or special
arrangements to schedule individual sessions with the addiction
program therapist who runs the group meetings are not met (at an
additional cost to you).
Click Here for more information about Suboxone detox and
treatment.
*Some will be able to discontinue their Suboxone treatment in a much
shorter period of time; the time frame given is a treatment goal,
not a requirement.
**The Meeting List must be signed with the client's name, date
attended, chairperson signature and topic discussed.
Ronald R. Parks, M.D. practices Integrative Medicine and Psychiatry
in Asheville, North Carolina with a background in Internal Medicine,
Integrative Medicine, nutrition and addiction treatment.
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