Q: What is addiction, physical dependence and tolerance?

A: The American Academy of Pain Medicine (AAPM), American Pain Society (APS) American Society of Addiction Medicine (ASAM), and NAABT recognizes these definitions below as the current accepted definitions.

I. Addiction:

Is that primary chronic and neurobiologic disease with genetic Visio social and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following:

* impaired control over drug use

* compulsive use

* continued use despite harm

* craving

II. Physical Dependence:

Physical dependence is a state of adaptation that is manifested by drug class specific withdrawal syndrome that can be produced by

* abrupt cessation

* rapid dose reduction

* decreasing blood level of the drug, and/or

* administration of an antagonist

III. Tolerance:

Tolerance is State of adaptation in which exposure to a drug-induced changes that result in a diminution of one or more of the drug’s effects over time.

In summary physical dependence and tolerance or normal physiology. Addiction is on controllable compulsive behavior caused by alterations of parts of the brain from repeated exposure to hight euphoric responses. Addiction is a disorder that is damaging and requires treatment. And example is a patient who suffers from severe chronic pain due to a terminal cancer might require a large amount of opiate-based pain medication. The patient will become tolerant independent on the opioid pain medications but they are not necessarily addicted to the opioid medication. They will most likely experience with drawl symptoms if they abruptly stop the opioid medications (therefore have a physical dependance on the opioid medication), but they will not seek out medication if no longer needed for pain control.

Q: Why is opioid addiction a brain disease?

A: opioid addiction develops from fundamental long-term changes to the structure and function of the brain. Scientist classify addiction as a chronic disease because areas of the brain or altered from the normal healthy state and long-lasting ways. These are physical changes to the brain that influence behavior not caused by poor morals control my will power more cured by good advice it's a disease as is diabetes or cancer, and it is treatable.

Q: What is Buprenorphine (Suboxone)?

A: at the correct dose Buprenorphine may suppress cravings and withdrawl symptoms and block the effects of other opioids. Buprenorphine in not new. It was first patented in 1969 and has been used in the US to treat pain and in Europe to treat pain and opioid addiction for over 20 years. Buprenorphine is a semi-synthetic opioid and is a partial agonist.

*Opioid Agonists are drugs that cause an opioid effect like heroin, oxycodone, hydrocodone, and methadone.

* Opioid Antagonists are drugs that block and reverse the effects of agonist drugs. Narcan ® is an antagonist and is used to reverse heroin overdoses.

Buprenorphine can act as both an agonist and antagonist. It attaches to the opioid receptors but only activates them partially, enough to suppress withdrawal and cravings, but not enough to cause extreme euphoria in opioid-tolerant patients. When all available receptors are occupied with buprenorphine, no additional opioid effect is produced by taking more. This is called the ‘ceiling effect’. The antagonist property of the medication expels, replaces and blocks other opioids from the opioid receptor sites. Therefore, if the patient decides to misuse opioid drugs after taking buprenorphine, the effects can be blocked, depending on dosage. Alternately, if buprenorphine is taken too soon after other opioids, by an opioid-physically dependent patient, the buprenorphine can precipitate withdrawal. The ceiling effect, blocking ability, and possibility of precipitating withdrawal, contribute to buprenorphine having a favorable safety profile and helps lower the risk of overdose and misuse.

Q: What is Buprenorphine/Nalxone (Bup/Nx) combination?

A: In October 2002 the FDA approved the first two prescription Buprenorphine medications for the treatment of opioid addiction; Subutex®* (buprenorphine) and Suboxone®* (buprenorphine/naloxone). Since 2009

theFDA approved generic Bup and Bup/Nx sublingual tablets and the brand-name Bup/Nx sublingual tablet calledZubsolv®*. Both Suboxone and Subutex tablets were discontinued and replaced with Suboxone Film® which is a Bup/Nx sublingual film. The purpose for the addition of naloxone is to reduce the risk of misuse by injection. If the Bup/Nx combination is injected, the naloxone will help cause immediate withdrawal symptoms in opioid- physically dependent people. However, naloxone is poorly absorbed sublingually. Therefore, when taken as directed, very little naloxone enters the blood. Normally, patients are unaffected by the presence of it, and it is considered clinically insignificant.

Q: How long should buprenorphine treatment last?

A: Opioid addiction is a manifestation of brain changes resulting from chronic opioid use and misuse. The patient’s struggle for recovery is in great part a struggle to overcome the effects of these changes. Brain adaptations take time to develop and take time to reverse. Patients should remain in treatment long enough to reverse the brain changes to the extent possible and learn coping mechanisms for what cannot be reversed. This is accomplished through a deliberate reconditioning effort. Duration of treatment varies from patient to patient. The usual timeframe from our experience varies from 6 months to a year, but some patients often require longer treatment to minimize the risk of relapse.

Q: What is the benefits of Buprenorphine/Naloxone (Suboxone) treatment?

A: * No need to go to a methadone clinic daily. Buprenorphine may be prescribed by a qualified physicians in private practice, protecting your privacy.

* Milder withdrawal and detoxification process than with traditional methods.

* Long lasting. Once maintained, the frequency of prescription is determined by the physician and can vary from weekly to monthly depending on the patient’s needs.

* Safer than heroin or traditional prescription opioids. Buprenorphine alone is unlikely to result in an overdose.

* Reduced health risks, especially for those currently injecting drugs

* Lower risk profile than methadone. Unlike methadone, Buprenorphine can be prescribed by physicians in private practice with specialized training and certification.

Q: Is my medical information confidential?

A: Absolutely!

Our office follows the strict guidelines and requirements of Confidentiality of Alcohol and Drug Dependence Patient Records. The confidentiality of alcohol and drug dependence patient records maintained by a practice/program are protected by federal law and regulations. Generally, the practice/program may not say to a person outside the practice/program that a patient attends the practice/program, or disclose any information identifying a patient as being alcohol or drug dependent unless: The patient consents in writing; The disclosure is allowed by a court order, or The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or practice/program evaluation.

Q: Do you accept insurance?

A: Healthy Life Medical unfortunately does not accept insurance at this time. We hope to accept insurance in the near future. Your pharmacy may accept your insurance for your medication, however you will need to contact your insurance company first to find out what the requirements will be to do so. If you do not have insurance we can point you toward government assistant programs for your medication.

Q: What is the cost?

A: The cost of the first appointment is $200 and all monthly follow up appointments are $250.

Q: How long do I need to be on treatment?

A: The physician will determine the length of time you will be on the program. Each patient has their own special requirements.

If you are interested in this treatment for your opioid addiction please contact us today!