Frequently Asked Questions | Opioid Addiction Treatment Services
Our patients are those suffering from an addiction to opioid drugs such as OxyContin, Vicodin, Percocet, hydrocodone, Codeine, and morphine. Addiction knows no boundaries and attacks individuals regardless of age, sex, race, profession, social class or ethnicity. Our focus is to help these people live drug-free lives. As their lives change, so do the lives of the people around them. We've seen countless families re-established, watched people go back to the work they love, and most importantly, celebrated as people look at life through the lens of hope and happiness again.
Opioids – which are also sometimes called Opiates – are a family of drugs that have morphine-like effects, with their primary medical application being pain relief. Doctors and dentists may prescribe opioids to people with acute or chronic pain resulting from disease, surgery, or injury. In addition, some opioids such as methadone and buprenorphine have been found to successfully help treat addiction to other opioids, such as prescription pain pills and heroin.
We exclusively focus our efforts on treating opioid addictions (although the services our patients receive meaningfully contribute to their recovery from other substances of abuse as well). Some commonly known opioids are prescription pain medications such as: OxyContin, Vicodin, Percocet, hydrocodone, Codeine and morphine to name but a few. Approximately 85% of our patients are addicted to prescription medications
Opioid addiction is a deep-rooted, relapsing disease of the brain that results from the prolonged effects of intense exposure to the drugs. Opioid addiction creates a compulsive, physical need for continued opioid use. As the person becomes addicted to the drug, they must continue taking it or suffer severe withdrawal symptoms. Seeking and using opioids becomes the primary purpose in the life of the addicted person. Important social, employment, and recreational activities are given up or reduced because of this intense preoccupation.
Behavioral Health Group provides opiate addiction treatment services in an outpatient setting. There are two essential aspects to treatment
Medication-assisted treatment using methadone, the “gold standard” for treating serious opioid addiction, to combat the physical effects of the addiction. The patient's physical addiction must be stabilized first in order to begin effective behavioral therapy.
Behavioral therapy (i.e., counseling) that addresses the psychological dependence to stabilize the patient and provide them with the tools to live drug free. We help individuals develop and utilize the necessary coping skills and resources to make their lifelong road of recovery as successful as possible
It is extremely difficult to overcome a drug addiction. Many have tried to “just quit,” but unfortunately, typically fail. Because of the physical effects of prolonged drug usage, the body has become chemically dependent on the very thing it should avoid. We have consistently found, and independent research proves, that by combining medication-assisted treatment with extensive behavioral counseling, our programs give people a tremendous opportunity for success.
Methadone maintenance therapy is much like using “The Patch” or nicotine gum to quit smoking. Cigarette smokers are addicted to nicotine. It is exceedingly difficult to quit smoking by going “cold turkey.” So, instead, many people use “The Patch” or nicotine gum to regulate and control their nicotine cravings while they learn to live without cigarettes. Eventually,they are weaned off of the nicotine replacement and are able to live completely cigarette- and nicotine-free. Methadone treatment is akin to “The Patch” for persons with opioid dependency. Methadone regulates and controls their cravings while they learn to live without drugs and abandon the harmful lifestyle that accompanies drug use. The only difference between a nicotine addiction and an opioid addiction is the substance abused and the nature of the addiction
For more than 45 years, methadone has been used to treat opioid addiction. When taken under medical supervision, long-term maintenance causes no adverse effects to the heart, lungs, liver, kidneys, bones, blood, brain, or other vital body organs. Properly administered, methadone produces no serious side effects, although some patients experience minor symptoms such as constipation, water retention, drowsiness, skin rash, excessive sweating, and changes in libido. Once methadone dosage is adjusted and stabilized, however, these symptoms usually subside.
Methadone is a legal medication produced by licensed and approved pharmaceutical companies using established quality control standards. Under a physician's supervision, it is typically administered orally on a daily basis with strict program conditions and guidelines. Importantly, methadone does not impair cognitive functions. It has no adverse effects on mental capability, intelligence, or employability. Properly administered, it is not sedating or intoxicating, nor does it interfere with ordinary activities such as driving a car or operating machinery. Patients are able to feel pain and experience emotional reactions. Most importantly, methadone relieves the craving associated with opioid addiction. While taking methadone as part of a drug treatment program, typical street doses of pain pills and heroin are ineffective at producing euphoria, which in turn reduces the allure of illicitly using opioids and, in so doing, dramatically accelerates the elimination of their use altogether. Ultimately, the stabilized methadone patient is much more receptive to behavioral counseling, which gives him or her a better chance for success.
If a person has an addiction to drugs, his or her body has become chemically conditioned to expect those drugs. When the body is suddenly deprived of the drugs it is expecting, unconscious physical withdrawal occurs. The physical and emotional effects of withdrawal are typically very severe. During this time, a person has little ability to handle daily life, much less the behavioral counseling that must also occur to achieve and sustain recovery. Thus, methadone medication is used to reduce these symptoms and physically stabilize the body. Once stabilized, we are able to begin working with the patient to treat the behavioral factors that contributed to the addiction in the first place.
Methadone is a highly regulated, prescription medicine used to help temporarily replace the body's craving for opioids. It is very similar to prescribing insulin as a replacement or “substitution” therapy for diabetes patients. Methadone treatment has been used this way for more than 45 years and has helped millions of people on their path to recovery. A stable maintenance dose of methadone does not make our patients feel “high” or drowsy. As a result, our patients can socialize, go to work or school, and otherwise carry on a normal life. Vincent Dole, MD, a pioneer in medication substitution therapy said, “There is absolutely nothing wrong with using crutches if it helps the person get back on his feet and move forward in addiction recovery.
Extensive research has been conducted in this area. Studies have routinely demonstrated reductions in illicit opioid use of up to 80% or more after several months of medication-assisted treatment with methadone, with the greatest reductions for patients who remain in treatment more than a year. The time in treatment will depend on the length and intensity of the patient's drug abuse and his or her ability to adopt the behavioral changes necessary to break the addiction. Each case is unique, and the decision to stop treatment is made between the patient and his or her treatment team.
When methadone is prescribed in our treatment program, it is done so in an extensively controlled environment for only those persons who qualify for treatment. In most cases, it is taken orally on-site, and it is highly managed when on-site or off-site to guard against diversion, abuse, or misuse of the medication. Federal and state regulations require that we closely monitor and manage the distribution of methadone to our patients. We are subject to government inspection at any time.
It is the people who are not patients but should be that communities need to worry about. Persons with drug addictions exist in every community, and the addicted individual who does not get treatment is typically the one who makes the evening news. Our patients choose treatment for addiction because they want to get help. They desire to regain their lives; they just need help finding the path.
A stable, maintenance dose of methadone does not make a person feel “high” or drowsy. Our program is designed to help people reduce their dependence on opioids, while providing them with extensive individual and group counseling. Our goal is to help people regain control of their lives as quickly and safely as possible. There have been numerous, well-documented scientific studies that prove methadone treatment has no negative effects on mental capabilities, intelligence, reaction time, and motor functions.
Highly. Our programs are licensed by both state and federal authorities and are accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and the Joint Commission, the same agency that accredits hospitals nationwide.
Methadone is a medication, and like all medications, proper dosing is contingent upon the patient's individual needs. Taken orally, methadone is rapidly absorbed from the gastrointestinal tract, appears in plasma 30 minutes after ingestion, and peaks one hour later. Methadone is also widely distributed to body tissues where it is stored and then released into the plasma. This combination of storage and release keeps the patient comfortable by preventing withdrawal. As is the case for any other medication (such as insulin or anti-hypertensives), proper dosing is determined through the doctor-patient relationship, taking into account the patient's medical assessment, individual metabolic needs, and other medical conditions and existing treatments.
The presence of an Opioid Treatment Program (OTP) is statistically linked with exactly the reverse – i.e., reduced community criminal activity – and decreases in criminal behavior are greater the longer patients are in treatment. The National Institute on Drug Abuse (NIDA) Drug Abuse Treatment Outcome Study found that drug-offense arrests decline because OTP patients reduce or stop buying and using illegal drugs. Arrests for predatory crimes decline because OTP patients no longer need to finance a costly illicit drug addiction and because treatment allows many patients to stabilize their lives and obtain employment. We see this success story played out time and again with our own patients.
Absolutely not. Methadone is in no way related to “meth,” which is the nickname for methamphetamine. Methadone is a legal opioid produced by pharmaceutical companies for the relief of pain and for use in the treatment of opioid abuse. Methamphetamine – or “crystal meth” as it is commonly known – is a non-opioid, illegal stimulant and drug of addiction (i.e., “crank” or “speed”). It is typically manufactured in rural areas (or in other countries and imported illegally) in illegal “meth labs.” The effects of the two drugs could not be more different. In much the same way that hydrocortisone and hydrocodone have absolutely nothing in common beyond the prefix “hydro” in their name (the former is a topical ointment for allergic reactions and the latter is an opioid), methadone and methamphetamine have nothing in common beyond the first syllable in their names.
Drug addiction ignores every socio-economic variable and finds its way into all communities. Treating addiction is far less costly than ignoring addiction. Demographic data on patients indicates that the vast majority of patients in treatment have long associations with the community as a person struggling with their disease. It is far better to provide and encourage treatment of the addicted patient than to ignore the problem and live in the community with those untreated. If left untreated, drug use will certainly not go away, and it will impact the community through public health diseases like tuberculosis, sexually transmitted diseases, HIV, and hepatitis. Additional community costs include unpaid emergency room visits, admission to medical and psychiatric facilities, criminal activities of active addicts supporting their addiction, and incarceration.
No. Methadone maintenance therapy is much like using “The Patch” or nicotine gum to quit smoking. Cigarette smokers are addicted to nicotine. It is exceedingly difficult to quit smoking by going “cold turkey.” So, instead, many people use “The Patch” or nicotine gum to regulate and control their nicotine cravings while they learn to live without cigarettes. Eventually, they are weaned off of the nicotine replacement and are able to live completely cigarette- and nicotine-free. Methadone treatment is akin to “The Patch” for persons with opioid dependency. Methadone regulates and controls their cravings while they learn to live without drugs and abandon the harmful lifestyle that accompanies drug use. The only difference between a nicotine addiction and an opioid addiction is the substance abused and the nature of the addiction.
Methadone is not a substitute “high” or short-acting opioid like heroin or pain pills. Methadone is a long-acting opioid, and it simply relieves the patient's physiological opioid craving. Methadone normalizes the body's metabolic and hormonal functioning that was impaired by the use of illicit opioids. Unlike the disruptive nature of short-acting chemicals on the brain, methadone has long-acting properties that provide metabolic stability. In addition, methadone neutralizes the euphoric effects of other opioids, leaving the patient with little desire to abuse illicit street drugs.
Unlike illicit drug use, when methadone is taken as prescribed, long-term administration causes no adverse effects to the heart, lungs, liver, kidneys, blood, bones, brain, or other vital body organs. Some mild side effects may arise during the initial phase of treatment, but they usually subside or disappear as the patient's dosage is adjusted and stabilized, or when simple medication interventions are initiated.
For many individuals, suboxone (buprenorphine plus naloxone) is an effective first-option for opioid addiction treatment, but it does not work for all patients. This treatment modality is very similar to methadone treatment in that it involves the administration of a legal opioid (buprenorphine) to stabilize the biochemistry of the opioid-dependent person. The active ingredient, buprenorphine, is similar to methadone in that it is an opioid pharmaceutical with properties that make it effective for treating opioid addiction.
Suboxone treatment is most typically provided via physician office practices and in OTPs, such as the clinics BHG operates. We offer suboxone in some of our facilities for patients who may want to start with that option. In areas where we do not provide suboxone as an adjunct therapy, we work with non-OTP suboxone providers (who are limited to working only with suboxone in an office-based setting) on a referral basis, as we believe suboxone can be an appropriate first step for less severe forms of opioid addiction.
Importantly, our OTPs are much more highly regulated than the typical non-OTP suboxone practice. This is important, since suboxone – like any opioid – carries with it a potential for diversion, misuse, and overdose. Contrary to some claims, many communities have experienced problems with illicit or “street” forms of suboxone. Our OTPs are also much more comprehensive in terms of the services that are required for patients. Our patients are required to participate in behavioral therapy (counseling) as part of their treatment plan. This is not the case with most suboxone-only providers, who typically offer no such option.
Thus, suboxone can be effective for less serious addictions, but it tends to be less effective as a treatment for persons with more serious and long-term opioid addictions, and it does not work for many patients regardless of their addiction severity. As various authorities and government agencies have noted, “buprenorphine is unlikely to be as effective or more effective than optimal-dose methadone, and therefore may not be the treatment of choice for patients with higher levels of physical dependence on opioids.” (U.S. Food and Drug Administration. FDA Talk Paper: Subutex and Suboxone approved to treat opiate dependence.) These studies further conclude that without the close monitoring, psychosocial therapy, and other rehabilitative services provided by OTP clinics, the long-term benefits of buprenorphine/suboxone for many patients must be cautiously considered. We have consistently found that a treatment program must treat both the chemical dependency and the behavioral issues to give persons struggling with addiction the optimal chance for success.
In the end, both methadone and suboxone are highly regarded as effective tools for opioid addiction, and to suggest anything less is to create a false choice between the two that only undermines the needs of patients.
This question could be applied to many different types of healthcare companies. Why are physicians and many hospitals for profit? Why are dialysis centers and insulin manufacturers for profit? As is true for many healthcare and social services, it is not only appropriate, but preferable, to have for-profit providers as an option for patients, for many reasons:
Higher competitiveness is one reason that the private sector succeeds in healthcare. The private sector is often more efficient (and, thus, lower cost) than the public/non-profit sector. In BHG's case, instead of relying on donations or taxpayer revenue to exist, our treatment facilities must be self-sustaining. As a result, we are very diligent when it comes to site selection and maintaining efficient operations. This also keeps us focused on customer satisfaction and on providing effective, prompt, and courteous service to patients. As a result, patient outcomes and satisfaction scores for private, for-profit entities often surpass those of public or non-profit entities.
In addition, BHG is built to last. If a non-profit or government program runs out of donations or taxpayer revenue, they are forced out of business. As a self-sustaining, for-profit business, we will be able to continue to serve our patients regardless of outside circumstances. We'll be here for our patients as long as they need us.
- Medical histories, annual physical examinations, and blood chemistry analyses.
- Routine drug testing and medical treatment planning for the abuse of alcohol and non-opioid drugs.
- Diagnosis of and referral to other healthcare matters where applicable.
- Testing, treatment / counseling, and education for TB and HIV/AIDS.
- Health awareness, wellness, and nutrition education.
Social and Human Services
- Assessment and individual treatment planning to address psychosocial, substance abuse, and life needs.
- Crisis intervention, supportive counseling, group and family therapy, drug relapse prevention, cultural and gender sensitive support groups, and life skills training.
- Assistance in accessing applicable entitlements, legal advice, financial support, and stable housing.
- Therapeutic community and twelve-step fellowship approaches in confronting alcoholism and abuse of non-opiate substances.
Mental Health Services
- Assessments to identify mental health problems.
- Coordinating the use of other mental health medications for patients (with the patient’s non-BHG physician).
- Linkages with resources and colleagues in the mental health community.
Educational and Vocational Services
- Diagnostic skills testing, education/equivalency assistance.
- Help with job finding skills, resume preparation, and patient referrals to training and job placement programs.
Assistance for Children and Families
- Family counseling and parenting education.
- Services to children of patients through “Children of Substance Abusers” (COSA) projects.
- Enhancement of healthy pregnancy outcomes for methadone treated patients.
- HIV counseling, prevention, and risk-reduction education.
- Support groups for persons who are HIV-positive.
- Liaison and advocacy with other agencies involved in delivering health, mental health, housing, and legal services to persons with HIV or AIDS.