Outpatient Detoxification

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1 Opioid dependence is a challenging and complicated condition, but it can be treated. If you re working to overcome opioid dependence, you know the experience can sometimes be overwhelming. That s why the formulation of your medication should help make your experience convenient. SUBOXONE Film, an innovation in treatment experience and convenience, is indicated for long-term treatment of opioid dependence and should be used as part of a complete treatment plan that includes counseling and support. Take SUBOXONE at home. While buprenorphine-only medication is intended to be given under close medical supervision as treatment begins, SUBOXONE is specially formulated to be taken at home once daily during your ongoing treatment. Opioid dependence: The facts Opioid dependence addiction to opioids such as prescription painkillers or heroin is a challenging and complicated condition. But it can be treated effectively with medicationassisted treatment combined with counseling and support. How counseling & medication work together Better Outcomes If your first thought is that you can go it alone, you may want to consider this: Opioid cravings can occur months and even years after your last use. Their suddenness and intensity can put even the most committed people at risk for relapse. That s one reason why counseling is important. Counseling can help you learn practical ways to cope with events, circumstances, or social situations that you associate with your past drug use. When the treatment includes medication combined with counseling, the likelihood of success is increased. That's because opioid dependence is more than a physical condition. Emotions and behavior are also part of the picture and that s where counseling can help. While SUBOXONE helps you reduce physical cravings associated with the disease, counseling can help you begin to make changes in your behavior and lifestyle that may make it easier to focus on your treatment goals. You should know: Elderly people and people with debilitating conditions should use SUBOXONE with caution. How counseling works In counseling also known as talk therapy you can learn how to recognize events that can 1

2 trigger the use of opioids. You can also learn practical ways to cope with events, circumstances, or social situations that you associate with your past drug use. Getting involved in counseling is easy. Here s how it works: Decide what kind of counseling would work best for you. For example: Private one-on-one therapy with a trained professional Group counseling Online group counseling with a trained professional and a group of your peers Support groups can also make a great addition to therapy with a trained professional. 1. Get a referral from your doctor or use the NAABT (National Alliance of Advocates for Buprenorphine Treatment) Treatment Locator to get a list of counselors near you. 2. Get an appointment for an initial visit, called a consultation. 3. Schedule your appointments and begin. Learning about opioid dependence and how taking action can have a real impact on your life. Find out if you need treatment. Why dependence needs treatment: Opioid dependence - addiction to opioid prescription painkillers such as OxyContin, Vicodin, Percocet, Actiq, or to heroin - can reset the brain s chemistry to think the drug is necessary for survival. When your brain tells you that you can t live without a drug, it can quickly lead to compulsive drug-seeking behavior. The World Health Organization (WHO) and the National Institute on Drug Abuse (NIDA) have defined dependence on opioids - addiction to prescription painkillers and heroin - as a longterm brain disease. Because opioid dependence is a medical condition, it can be treated effectively with medication-assisted treatment combined with counseling and support. Don t let shame or stigma get in the way of getting the help you need. People with other chronic medical conditions such as diabetes, high blood pressure, and asthma also benefit from medical treatment combined with behavioral changes. The goal of treatment is to help opioid-dependent people stop misusing opioids and regain control over their lives. Medication is only one part of the treatment picture. Talk with your 2

3 doctor about how counseling can increase the likelihood of treatment success - and about the importance of having strong support to help you along. Learn how dependence can change the way you act and the way you feel. Why getting help is so important? Becoming opioid dependent can have a serious impact on every part of your life - from your daily routine to your closest relationships. Opioid dependence - addiction to opioid prescription painkillers, such as OxyContin, Vicodin, Percocet, and Actiq, or to heroin - can threaten your plans, ambitions, and dreams. With treatment, opioid dependence can be managed The goal of all treatments for opioid dependence is to enable patients to avoid withdrawal symptoms, stop opioid misuse, and regain control over their lives. Dependence shouldn t be tackled alone Most people wouldn t try to treat diabetes or asthma with willpower alone. As a medical condition, opioid dependence deserves treatment. In fact, the need to satisfy cravings or avoid withdrawal symptoms can be so intense that even when people want to stop taking opioids they find it difficult - even impossible - without help. The good news is, with the right treatment, opioid dependence can be overcome - and help is available. What treatment does - and doesn t do As a medical condition, opioid dependence carries a high risk of relapse. To learn to manage this risk, plan to make a commitment to ongoing treatment, including counseling. Since everyone is different, the treatment plan can be tailored to your individual needs. Length of treatment varies and can last anywhere from weeks to years - depending on what you and your healthcare team decide is best for you. Understand that you are one of many Opioid dependence is widespread Opioid dependence - addiction to opioid prescription painkillers, such as OxyContin, Vicodin, Percocet, Actiq, and others, or to heroin - is more common than people think. In fact, opioid dependence affects men and women of all ages, races, ethnic groups, and educational levels. According to the National Survey on Drug Use and Health (NSDUH), in 2008 Approximately 2 million Americans were dependent on opioid prescription painkillers or 3

4 heroin An estimated 4.75 million people aged 12 and older misused prescription painkillers Approximately 213,000 people used heroin Opioid dependence can happen to anyone - a friend, a neighbor, a co-worker, a spouse, a brother, sister, or parent. Yet a recent national survey, Prescription Painkiller/Heroin Addiction and Treatment, found that nearly half of the public is unaware that misusing opioid prescription painkillers is as harmful as abusing heroin. Fortunately, as more people come to understand that opioid dependence is a medical condition more people are getting treatment in the privacy of a doctor's office. See how opioid dependence can happen to any one How dependence can begin People who become opioid dependent - addicted to opioid prescription painkillers, such as OxyContin, Vicodin, Percocet, Actiq, or to heroin - move along a path that can look like this: A drug is prescribed for pain, or recreational drug use begins Pain is relieved, with heightened feelings of pleasure Repeated drug use Changes in the brain Cravings and symptoms of withdrawal when drug is absent Inappropriate drug use to end withdrawal symptoms and/or to seek pleasure Drug dependence Opioid dependence is more than a physical condition. Emotions and behavior are also part of the picture - which is why counseling is such an important part of treatment. People who are psychologically dependent may continue to use a drug despite serious negative effects on their lives. Psychological dependence can reach the point where people have uncontrollable cravings for the drug - and are willing to take significant risks to obtain it, regardless of the harmful consequences to themselves, their families, their jobs, or their community. Opioid misuse can lead to opioid tolerance. When a person uses opioids, his or her brain gradually gets used to the drug and becomes less sensitive to it. As a result, he or she needs more of the drug to achieve the desired effects. This is called tolerance. Think you may be opioid dependent? Talk with a doctor near you who is certified to treat opioid 4

5 dependence. Get more facts about opioids, including street names for prescription painkillers. Did You Know? Opioid painkillers are the most commonly abused prescription medication. They can be highly addictive. Crushing and snorting these medications, or mixing them with other drugs, can cause overdose, which can be fatal. Many commonly prescribed painkillers are opioids. These include: Brand name* Percodan, Percocet Roxicodone, Tylox OxyContin Lorcet, Vicodin Zydone Tylenol 3 Fiorinal with Codeine Fioricet with Codeine Demerol Darvon, Darvon-N Wygesic Duragesic, Actiq MS Contin, Avinza Dilaudid Dolophine Lortab Phenaphen with Codeine 3 Stadol Talacen Talwin NX Ultram Generic name Oxycodone Oxycodone Oxycodone Hydrocodone Hydrocodone/Acetaminophen Codeine Codeine Phosphate/Butalbital/Caffeine/Aspirin Butalbital/Acetaminophen/Caffeine/Codeine Phosphate Meperidine Propoxyphene Propoxyphene and Acetaminophen Fentanyl Morphine Hydromorphone Hydrochloride Methadone Hydrocodone and acetaminophen Acetaminophen and Codeine Butorphanol Acetaminophen/Pentazocine Pentazocine/Naloxone Tramadol 5

6 Common street names for prescription opioid painkillers include: Brand name* Generic Common street name Vicodin Hydrocodone Vike, Vic, Watson-387 OxyContin, Oxycodone Oxy, OC, Percs, Cets Percodan, Percocet Durgesic, Actiq Fentanyl Apache, China Girl, TNT, China white, Murder 8, Tango and Cash, Dance fever, Jackpot, Goodfella, China Town Darvon Propoxyphene Dust, Juice, Dillies Demerol Meperidine Dust, Juice, Dillies MS Contin, Morphine Morph, Miss Emma, M Avinza Tylenol 3 Codeine Cody, Captain Cody, Schoolboy Slang used by teenagers and young adults: Pharming: Abusing prescription drugs stolen from medicine cabinets of friends and family Pilz: Prescription medications used as recreational drugs Trail mix: A mix of prescription drugs, sometimes offered at pharm parties in a bag or bowl These forms of prescription drug misuse are dangerous. They can have serious and irreversible medical consequences. What are opioids? Opioids are drugs that work in the body the way opium does. Some are made directly from opium (for example, morphine and codeine), while others are man-made but similar chemically to opium (for example, the painkillers oxycodone, hydrocodone, and fentanyl, better known by such brand names as OxyContin, Vicodin, Percocet, and Actiq ). The illegal drug heroin is also an opioid. All of these drugs are extremely powerful. For people with severe pain, opioids are very effective medicines, and most patients treated for pain with opioids do not become dependent on them. For some people, however, opioid dependence is an unexpected side effect of proper pain treatment. The problem comes when someone is unable to stop using the drug after the pain passes. Could you be opioid dependent? Is it opioid dependence? Take this quiz Answer as honestly and accurately as you can. You can use your results to start a 6

7 conversation about drug dependence with your doctor. These questions refer to the past 12 months: Have you used drugs other than those needed for medical reasons? Do you misuse more than one drug at a time? Are you always able to stop using drugs? Yes No Have you ever had blackouts or flashbacks as a result of drug use? Do you ever feel bad or guilty about your drug use? Does your spouse (or your parents) ever complain about your involvement with drugs? Have you neglected your family because of your use of drugs? Have you engaged in illegal activities in order to obtain drugs? Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs? Have you had medical problems as a result of your drug use (such as memory loss, hepatitis, convulsions, bleeding)? Please submit your answers to Dr. Veliz during your next appointment. References: 7

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