Frequently Asked Questions
What are opioids?
Opioids, also known as "opiates," are a class of drugs with powerful pain-relieving properties. When prescribed by a doctor and used responsibly, opioids can reduce pain and treat other symptoms. However, opioids can change the way the brain works and cause dependence and strong cravings that lead to addiction. Natural opioids (Morphine, Codeine, Opium, etc.) are substances that are derived from the opium poppy. Semi-synthetic opioids (Heroin, OxyContin, Vicodin, Dilaudid, Percocet, etc.) are produced in a laboratory from natural opioids. Synthetic opioids (Fentanyl, Methadone, etc.) are manufactured in a laboratory.
What is CleanSlate's philosophy regarding opioid dependence?
At CleanSlate we believe that opioid dependence is a chronic disease and much like asthma, diabetes, and heart disease, it is best treated through harm reduction. Sterile needles are an example of harm reduction for injection drug users. Suboxone can reduce harm in patients with chronic opioid dependence by decreasing relapse and eliminating symptoms of withdrawal.
What is medication-assisted treatment?
Medication-assisted treatment is the use of medications, in conjunction with behavioral therapy to treat addiction. This form of treatment is often the best approach for combatting opioid addiction and can be highly effective in treating alcohol addiction and other substance use disorders. Suboxone and Vivitrol are examples of the medication prescribed for this treatment.
What is Suboxone?
Suboxone (buprenorphine) is a revolutionary form of physician-supervised treatment for opioid addiction. Suboxone succeeds where Methadone and other methods have failed by providing the convenience and privacy of self-administration, reduction or elimination of cravings, and a clear mind and improved cognitive function enabling the user to continue to make positive choices. Combined with counseling and other support, patients have an excellent opportunity for sustained abstinence from addictive opioids.
Who can prescribe Suboxone?
Not all physicians can prescribe Suboxone. To prescribe Suboxone, a physician must either be an addiction specialist or must have completed the certification training to act as a Suboxone provider. All of the CleanSlate Physicians, Nurse Practitioners, Physician Assistants and Counselors are experienced in Addiction Medicine and manage our patients' treatment course collaboratively.
Can Suboxone be taken during pregnancy?
Suboxone is not FDA approved for use in pregnancy. For this reason, women of childbearing age must have a pregnancy test performed each month. If the test is positive, treatment with Suboxone will have to be stopped immediately and the patient will be screened to determine if she is a candidate for continued outpatient treatment with Subutex.
What is Vivitrol?
Vivitrol is an FDA approved medication for the treatment of opioid and alcohol addiction and is administered once each month by injection in a CleanSlate office. Like Suboxone, Vivitrol eliminates the possibility for patients to experience the “high” associated with the use of alcohol and opioids.
Which is better, Suboxone or Vivitrol?
At the initial appointment the patient and CleanSlate provider will work together to determine whether Suboxone or Vivitrol is the better treatment option. The final decision is based on the patient's unique circumstances, and factors include current or previous treatment with Suboxone or Vivitrol, completion of inpatient detoxification, extent of substance abuse history, etc.
Why does CleanSlate require patients to be in Therapy?
Research has shown that successful treatment of opioid dependence requires a combination of medical management (Suboxone, Vivitrol) and behavioral therapy (counseling, intensive outpatient therapy, etc.) to maximize the likelihood of long-term abstinence. Medication alone can reduce cravings and withdrawal, but recovering from addiction requires a rewiring of the brain. An experienced counselor/therapist will be able to teach techniques that will undo some of the brain changes and habits that developed as a result of addiction. Therapy helps the patient rebuild relationships, repair finances, get a job, resume family responsibilities, decrease stress, anxiety and depression, and supports the patient in making other meaningful changes to achieve and maintain remission.
Does insurance cover treatment provided by CleanSlate Centers?
CleanSlate accepts most insurance plans and the vast majority of insurers do provide coverage for this treatment. Patients are responsible for treatment co-payments and for medication co-payments.
What happens if opioids are used while taking Suboxone or Vivitrol?
At CleanSlate Centers, we understand the nature of chronic opioid dependence. Relapse can be part of the disease and rather than terminate a patient's participation, we instead increase the frequency of CleanSlate visits and the extent of behavioral health support. Generally patients report that if they try taking opioids while they are on Suboxone or Vivitrol, they have no euphoria, or “high.” This is because the medication is blocking the brain receptors, preventing the opioids from binding. For this reason treatment with Suboxone and Vivitrol is very successful in preventing relapse. If opioids are necessary for a medical, dental or surgical procedure, we work with the physicians or other providers to guide them about appropriate Suboxone/Vivitrol dosing when used in conjunction with medications for pain relief.
Is Suboxone safe?
Although rare, because some Suboxone patients are at risk for elevated liver enzymes (hepatitis), CleanSlate regularly monitors these levels. In the event that hepatitis develops, the Suboxone dose may need to be lowered or stopped. Shooting Suboxone or mixing the medication with alcohol or any substance that depresses brain activity (Valium, Ativan, Xanax, Klonopin, sleeping pills, tranquilizers, etc.) can result in death.
Does Suboxone have any side effects?
All medications have side effects. Signs and symptoms of a severe allergy include difficulty breathing and a rash and require immediate medical attention (911 and the closest emergency room). Less serious side effects include feeling faint/dizzy, jaundice (skin turns yellow), loss of appetite, sleepiness, sleeplessness, constipation, and headache.
Does Vivitrol have any side effects?
The FDA has reported that side effects associated with Vivitrol use include nausea, dizziness, vomiting, fatigue, decreased appetite, joint pain, muscle cramps, headaches, depression (including suicidal thoughts), rashes, hives, swelling around the face, liver damage, and pneumonia.