Suboxone medication-assisted treatment (MAT)
 
Help is just a phone call away @ The Infusion Clinic of Ocala (352) 325-5755 
Located at 2801 SE 1st Ave Ste 201 | Ocala, FL 34471

Medication-assisted treatment (MAT) is one way to help those with opioid addiction recover their lives. Medication-assisted therapy is treatment for addiction that includes the use of medication along with counseling and other support. MAT improves outcomes:

  • Saves lives!

  • More likely to stay in treatment

  • Decreases illicit opiate use and other criminal activity

  • Increases patient ability to gain and maintain employment

  • Improves birth outcomes among women with substance use disorders

 

If a person is addicted to opiates, medications such as Suboxone (buprenorphine-naloxone) allow him or her to regain a normal state of mind, free of drug-induced highs and lows. It frees the person from thinking all the time about the drug and reduces problems of withdrawal and craving. These changes can give the person the chance to focus on the lifestyle changes that lead back to healthy living. When properly dosed, there are no adverse effects on patients’ mental, intellectual, or physical functioning.

Taking medication for opioid addiction is like taking medication to control heart disease or diabetes. It is NOT the same as substituting one addictive drug for another. Used properly, the medication does NOT create a new addiction. It helps people manage their addiction so that the benefits of recovery can be maintained.

For MAT, our clinic only uses Suboxone and other buprenorphine containing medications. We do not use methadone.

The Department of Health and Human Services published a short pamphlet that explains MAT.  Click here for a download.

Frequently asked questions

If I call you or make an appointment will anyone else find out?


Keeping your information private and confidential is central to what we do. We will not disclose your participation in our program under any circumstances unless you specifically direct us to do so in writing. There are federal laws that protect information about those who seek treatment. No one at your workplace, in law enforcement, or in your family is entitled to know that you are seeking treatment. You are welcome to call us anonymously to start a conversation.




What will happen at my first visit?


You should allow 45 minutes to an hour for your first visit. Our offices are set up just like any typical doctor's office. We are singular in our treatment, so the only other patients you will see will be here for the same addiction challenges that you are facing. You will check in with our staff and give a urine sample. A medical assistant will take your vitals and ask you some questions about your history. At that point you are ready to see one of our providers. Your first appointment should take about twenty minutes with the provider. During your appointment, your provider will determine what the best course of action will be.




Do I need to be in withdrawal before I take my first dose of Suboxone or other buprenorphine medication?


Patients are recommended to be in "Mild Withdrawal" as defined by the Clinical Opiate Withdrawal Scale (COWS). If you are not experiencing mild withdrawal symptoms, you risk putting yourself into severe withdrawal when you take your first buprenorphine dose. This is called precipitated withdrawal.

The amount of time you need to wait between your last opioid dose and your first buprenorphine dose is not just a function of time (hours or days), but also a function of how long acting the last opioid you took is, and what dose you have been taking.

In general, you should stop taking all opioids 12 hours before your fist dose of buprenorphine. The exception is for patients who have been taking methadone. Patients taking methadone must have been weaned down to < 30 mg/day and have completely stopped taking it at least 36-72 hours before their first dose of buprenorphine.




How often do I need to come in for doctor visits?


It is our goal to get patients to a monthly maintenance schedule. All patients, however, will be required to come weekly to bi-weekly for the first few weeks to confirm that they are doing well. Once you are stable and feeling good about your dosage, you will likely be moved to monthly appointments. Many patients struggle in the beginning and we ask to see them back at shorter intervals until they stabilize. If they cannot be stabilized inside of our program's structure, we will refer them to more intensive programs.

Almost all our patients quickly find themselves visiting us monthly. For patients who need more intensive treatment, we will refer them to intensive outpatient (IOP) counseling. If that is not sufficient, we will work with them to find a more structured program or an inpatient bed. Patients that leave our clinic for more intensive alternatives can come back to us once they are more stable.




What about drug testing?


We collect a urine sample at each visit initially. Once a patient is stabilized, urine samples are collected approximately once a month. Patients have lots of questions on this topic. Below are some common questions and answers:

  1. On my initial visit, what if my urine is positive for drugs? We expect your first urine screen will be positive for whatever opioids that you are coming to address. After your initial appointment, we expect that your urine screens will be positive for buprenorphine and any other prescription medications that you are prescribed, and negative for everything else.
  2. What if a drug test says that I am positive for something that I did not take? We do an initial point-of-care test in our office. Those tests are not as reliable as a licensed laboratory. All samples are sent to our licensed lab for further screening and then all positive results are sent out to an independent confirmation laboratory. Lab results are always available for you to review. Ask your provider or our front desk staff and they can print them out for you. If lab results come back from our confirmation lab and you still think that the results are incorrect just let your provider know. They will likely ask you to come back in a week to give another sample. Treatment is a long process and a single false positive will not impact your treatment at our clinic.
  3. What happens if I relapse during treatment? Relapse is part of the disease of addiction so don’t be too hard on your yourself. Patients relapse for all kinds of reasons; a death in the family, loss of employment, a move, a fight with a significant other or family member, or any other type of stressor. What is most important about a relapse is that you get back into treatment as soon as possible. The risk of overdose and death during a relapse is very high. If you do relapse, call us immediately and we will help you get back into treatment whether it is with us or with a more intensive treatment facility.




Am I trading one addiction for another?


The simple answer is no, but it requires a few definitions. Physical dependence is your body craving opioids to avoid withdrawal. Addiction is dependence plus uncontrolled behavior. The active ingredient in Suboxone is buprenorphine. Buprenorphine is an opioid, but it is what is called a "partial agonist". The partial part is what is important. Taken as prescribed, it does not get you high and allows you to avoid withdrawal and cravings while at the same time allowing you to lead a normal, functional, responsible life. For as long as you are taking buprenorphine, you will remain dependent on opioids. When it is time for you to taper off completely, you will need lots of support and we are here to do whatever we can to help.

We like to think about buprenorphine as a bridge between using opioids to get high and being completely free of all opioids. For some period of time (and it depends on the patient), buprenorphine allows patients to get their lives back in order. Eventually, with the help of counseling, patients may be ready to take the final step and completely stop use of their replacement therapy.




What is the difference between Methadone and Suboxone?


Methadone was the first opioid replacement therapy to be employed in addiction treatment. The biggest difference between the two is that some patients report a "high" from their use of methadone, while Suboxone patients do not. The two share a fundamental objective, which is to move people from the dangerous addiction habits they have when they are taking opioids toward a life of independence.

Methadone and Suboxone are also prescribed differently. Methadone clinics generally require patients to report daily to take their medication. Suboxone can be prescribed so that patients can administer their doses in the privacy of their own homes.




Are all patients a good fit for our clinic?


Our program is designed to provide medication assisted treatment services for patients who are independent and can be responsible for their own day-to-day living. We are not designed to support patients with severe mental illnesses that co-occur with their addiction. We have an excellent referral network and we will do our best to redirect such patients to facilities that are better able to address their illness.

In addition, it is important to note that our clinic is set up to move patients to monthly maintenance visits with a doctor or other provider as quickly as possible. Our patients appreciate the independence that provides. People at different stages of recovery may require different levels of intervention. If you have any concern that you may not be able to stick to a regimen on your own, please let us know and we will refer you to a more intensive treatment provider.

Our doctors and healthcare providers are always on the lookout for signs that our program may not be working and will address this with you if you are not compliant. There should be no shame in this, it is only important to find patients the best place for them at each stage of their recovery.




What do I do if I need help between visits?


We answer the phone 352-325-5755 Monday, Wednesday, Thursday, and Friday 8:30 am to 5:30 pm. We are also available by email at info@infusionclinicocala.com. We try to be proactive and check in with all of our patients within a day or two of their first appointments to make sure that they are doing ok, but please don't wait if you are experiencing discomfort or have questions. If you are having a health emergency, please call 911 immediately and then contact us so that we can provide needed support.




How can I carry my medication with me?


Ideally, our patients leave their medication at home in a secure (preferably locked) place. If you must take your medication with you, please take the fewest tablets or films that you can. Always bring the original box or bottle with your printed prescription and leave the remaining medication at home. Suboxone and other buprenorphine products are Type III controlled substances and law enforcement works hard to control the illegal diversion (selling) of prescription medications. As long as you have your printed prescription, there should never be a problem.




What do you charge for treatment?


The total cost of treatment is less than what you would spend on drugs. If you can afford drugs … you can afford treatment.

  • Initial enrollment - $150

  • Follow-up visits (if monthly) - $150

  • Follow-up visit (if every 2 weeks) - $80

  • Follow-up visit (if weekly) - $50

  • Urine drug screens - billed to insurance

  • Medications - paid to pharmacy

  • Emergency prescription - $195




Payments and Insurance


Payment is may be made by cash, money order, or debit/credit cards. We do not accept personal checks. Fees are payable at the time of service. Fees cover the medical evaluation and management by the provider, and do not cover medications or lab tests.

We do not participate in any insurance program, private or government funded. We provide you with a superbill (an itemized receipt) that you use to file with your insurer using an app, Reimbursify, which makes it easy to file out-of-network claims with your program. There is no guarantee, however, that you will be reimbursed.

Your prescriptions and lab tests may be covered by your insurance or your prescription plan. You must check with them as to the conditions for coverage. Typically, there is a limitation to the dose and duration for which it is covered. The program may require that you attend counseling regularly to be eligible for the prescriptions. Some programs will not cover the prescription if it was prescribed by an out of network provider.

If your prescription program requires preauthorization, you will need to complete the form yourself and we will certify and sign off where needed.




Current medication dosage protocol


We do not dispense medications but provide you with a prescription that you fill at your pharmacy.

Patients who have never been on Suboxone or other buprenorphine medications are typically started at 16 mg/day. We DO NOT provide prescriptions for doses higher than 24 mg/day. Sorry, no exceptions. When you are ready to taper, we gradually reduce your dose while also providing you with oral clonidine to help ease any withdraw symptoms.

Patients receive medication support for as long as they need it. Some patients prefer to stay on medication for years, rather than risk a relapse and the downward spiral that results from it. Patients who do not demonstrate satisfactory progress, have frequent relapses, etc., … will be referred to higher level of care, such as an intensive outpatient program (IOP).

We have a no tolerance policy for diversion, which is giving or selling your medication to others. If you divert, you will be discharged from our program. No exceptions.




Medication costs


Cost of Suboxone … it varies from $5 to $10 for each 8mg tablet/film so please ask around, some pharmacies may honor discount cards. Some pharmacies allow you to obtain a partial fill of your prescription, typically half now and half later.

You can compare costs at area pharmacies from the website or app:

GoodRx.com

The manufacturer of Suboxone provides a discount coupon through their website:

Suboxone




About us


At The Infusion Clinic of Ocala, our mission is to help you get out of the Pit of Despair, whether it is due to mood disorders, addiction, or both. We've been there and understand where you are coming from. We treat you with love and respect, offering hope rather than judgement. You can recover and we'd like to help you today! Dr. Eric Milbrandt is our doctor. He is board-eligible in Addiction Medicine and a Certified Trauma Professional, having completed over 200 hours of training in the most effective trauma therapy techniques. Unresolved trauma is one of the most common reasons for treatment-resistance in depression and recurrent relapse in addiction. Trauma-focused care is a powerful tool to help people work through their trauma and can be the pivotal change that brings lasting recovery.