5317 Cherry Lawn Rd, Huntington, WV Phone: (304) Fax: (304) Welcome

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1 5317 Cherry Lawn Rd, Huntington, WV Phone: (304) Fax: (304) Welcome Welcome to Starlight Behavioral Health Opiate Dependence program. At Starlight, we believe that addiction is a brain disease. While no one can promise to cure the disease of addiction, our goal is that by working together, we can help our clients manage their illness and return to normal, healthy, and productive lives. Frequently asked questions: 1. Q: What is Suboxone? A: Suboxone is actually a combination of medications. Buprenorphine is the main ingredient. It is an opiate that helps with cravings and can help prevent relapse. It is different from most opiates however in a number of useful ways. First, the effect of buprenorphine is generally not increased by taking higher doses (reducing the risk of overuse) and second it may also block the effects of other opiates (such as Lortab or heroin). It is only absorbed into the body under the tongue. Naloxone is added to the buprenorphine as a safety precaution. It is an opiate-blocker that is not absorbed under the tongue. Combining these two drugs helps to prevent IV use because the naloxone part would if injected, cause immediate opiate withdrawal. 2. Q: but isn t taking Suboxone just trading one drug for another? A: The short answer to this question is yes. Suboxone is an opiate and as such is itself addictive. For many however, Suboxone offers a necessary stepping stone toward the ultimate goal of finally being drug-free. Unlike street drugs it is relatively safe, and it is legal. It is provided in combination with counseling/therapy directed at helping clients to deal with life stressors without turning to drug abuse. 3. Q: What is opiate dependence?

2 A: Unlike the occasional misuse of opiates (which often leads to dependence), dependence is a brain disease in which people become unable to function physically or emotionally without the use of opiates. While many people who take opiates for pain control would find it difficult to function without their opiate medications, those with opiate dependence soon discover that their lives begin to revolve around their need to take narcotics. Their lives are turned upsidedown as they give-up many of the important things in their lives in order to continue their habit. 4. Q: How long will I need to take Suboxone? A: This is different for each patient. Generally, it is recommended that a person continue in the program for at least six months to give them time to be strong enough to taper the Suboxone and remain drug-free. Other patients (perhaps those with a more severe dependence or those in chronic pain) would likely relapse back into illicit drug use without Suboxone and may need it for the rest of their lives. Whenever possible, we strive to help our clients transition into a life without narcotics including suboxone. 5. Q: What if I am unable to adhere all of the rules of this program? A: Unfortunately, drug addiction is a rather severe condition that requires strict rules and regulations for successful treatment. Some patients are able and willing to accept the program requirements while others are simply not yet ready. This doesn t mean that non-compliant folks are bad people. It simply means that they need more time to be ready for the difficult changes that recovery requires. 6. Q: Are there other options besides Suboxone? A: Naturally, Suboxone isn t right for everyone. For some, counseling can be helpful enough, and can lead to a drug-free life. For others for whom Suboxone is not the right drug, Revia (naltrexone) is an option. Revia (Vivitrol), which can be prescribed as a daily tablet or an injection that works for a month, blocks opiate receptors. For patients who have successfully detoxed from opiates, Revia can prevent both cravings and relapses by making opiates inactive if they are taken. 7. Q: Do you have more than one location in which I can receive treatment? A: Yes, Starlight has an office at 100 Erskine Lane in Scott Depot in Putnam County ( ). Office hours are Tuesday and Thursday from 9 to 5:30. Cabell county residents may find us at 5317 Cherry Lawn Rd behind HIMG in Huntington off Route 60 ( ext 101). Office hours are 8:30 to 5:30 Monday through Thursday and 9 to 5 on Friday. Group therapy hours are 2

3 scheduled at times we have found to be convenient to our patients. Evening groups are available to patients who are employed. 8. Q: What insurance providers does Starlight accept? A: Starlight accepts most third party and government insurances including Medicaid, Medicare, PEIA, Blue Cross Blue Shield, Aetna, and others. Patients must have their co-pays and deductibles at the time of their appointments in cash or credit/debit card. We do not accept checks. We do accept private pay patients. In some circumstances private pay patients are eligible for services at a cost equivalent to the Medicaid rate. We do not accept Ohio or Kentucky Medicaid. 9. Q: Can Starlight provide psychiatric services as well? A: Starlight provides a full range of mental health services including treatment for psychiatric illness, behavior disorders in children and adults, and neurological and psychological assessment. We do not provide medication management for children under 12. Our staff includes a nationally prominent psychiatrist who specializes in medication management of adults with autism. Staff are all licensed and/or certified to treat children and adults. If you are interested in stopping drug abuse and you think our program could help, we will schedule you to meet first with one of our therapists to gather some basic information. Then, if you seem like someone who would benefit from our opiate dependence program, we will schedule you to meet with our physician. Together, we will determine a treatment plan that is right for you. That plan may or may not include Suboxone therapy. The Initial Visit First, you will be asked to see one or our therapists who specialize in the treatment of addiction. After you meet with our therapist, we will review your case and decide if you are appropriate for our particular program. Then we will give you a call and let you know what we have decided in terms of what we believe is your best option in facing your addiction. If you are someone whom we believe our program can help, you will be scheduled to see our physician. If we do not think our particular program is right for you, you will be given other options which may work better for you. Our goal is, if possible, to match each individual client s specific needs with the resources and programs that our program offers. Patients must have their picture identification and insurance cards at the time of the first appointment. Starlight does accept West Virginia Medicaid as a payment source, however patients need to be aware that Medicaid regulations require four therapy sessions per month in addition to the physician visit for all new patients. 3

4 The First Doctor s Visit During this visit, our doctor will meet with you and together we will decide on a treatment plan that will best meet your specific needs. Please show for your appointment 30 minutes early so that you can complete some paperwork which will help in this determination. Also, please plan to spend about an hour with our doctor. Because of the way Suboxone works, you will need to be in opiate withdrawal during this first visit. If it is decided that Suboxone could help you, we will be unable to provide you with a prescription for it if you are not experiencing withdrawal symptoms during this visit. If you are on Methadone, you will need to be at most taking 30mg a day for at least one week prior to being seen. Taking Suboxone without first going through some withdrawal can make people rather ill, so please be honest (you will be evaluated for signs of withdrawal during this visit). For most narcotics, 48 hours without any drug use is sufficient to produce the necessary level of withdrawal. As with any doctor s visit, please bring with you any medications or a list of medications including dosage that you are taking and be prepared to discuss any medical problems which you may have. As part of your initial evaluation with our physician, you will be asked to have some routine lab work done. This is necessary to insure your safety and must be done prior to your subsequent appointment with our doctor. Because drug abuse confers risk of contracting Hepatitis C and/or HIV, you may request these tests at any time during your treatment. Unless your insurance company requires otherwise, only Suboxone strips are prescribed by Starlight s Opioid Treatment Program. Patients discovered to be diverting their Suboxone by selling it or giving it to other individuals will be immediately terminated from the program. How our Program Works: We must be able to reach you. Patients must have at least one working phone number on file with our office. This must be checked at least daily for messages from us. Patients are given 24 hours to return any messages left by our office. Not returning the call for any reason (voice mail full, inactive phone account, dead battery, etc.) will result in dismissal from the program. Random drug screens and strip/ pill counts 4

5 Each week, some patients will be called and asked to come in for a random drug screen and a medication (unused Suboxone) count. Patients are generally given 48 hours to get this done. Patients will be asked about the use of other drugs (relapse) before each drug screen. Honesty, not perfection, is required. If patients have relapsed back into drug abuse since being seen last, and they are honest about it, the Suboxone will not be given. However, the patient will often be allowed to return to the clinic in 3-5 days for another appointment. In other words, unless it is a repeating problem, they will often be allowed to stay in the Suboxone program. They will not get their Suboxone during that particular visit. If patients have relapsed back into drug abuse since being seen last and they are dishonest about it, they will be dismissed from the program when the drug screen results are reported to us. Addictive or illegal drugs are not permitted Marijuana and alcohol are not allowed to be consumed; Benzodiazepines (such as Xanax, Valium, Klonopin, Ativan) are not permitted and in fact can be deadly when taken with Suboxone. Starlight will not prescribe Benzodiazepenes for patients in the Suboxone program, nor may they be taken as prescribed by other physicians. Addictive medications are not permitted to patients in the program, even if they are prescribed. Let your other doctors/providers know that you are taking Suboxone The patient is required to inform their other providers that they are taking Suboxone to avoid potential drug interactions. Refills Generally, all refills will be written at the time of the appointment. If a refill does need to be called in, patients are required to call two days in advance of the scheduled expiration of your prescription (i.e. don t call us the day you are out). No refills will be called-in on weekends, holidays or after office hours. Lost or stolen Suboxone No early refills will be given if Suboxone is lost or stolen. The patient is however required to let us know if this has happened. It is your responsibility to ensure that Suboxone is safely stored away from children in your household. 5

6 Therapy is required Therapy is a required part of the program. Patients are expected to attend their scheduled therapy sessions. If a therapy session is missed and is not made up, reduced (or no Suboxone) will be given at the next appointment. You must receive telephone permission from your therapist to participate in any other therapy session than the one you are assigned after your original meeting with the physician. Do not come late for therapy sessions. You will not get credit for the session. Do not bring children to therapy sessions. Do not bring friends to therapy sessions without permission from the therapist. Therapy is an important aspect of the recovery process. You must participate fully in order to benefit. Therapy when performed correctly is hard but productive work. Other important points Patients are sometimes asked to bring family members or close friends to some of their appointments. Sometimes their involvement in the patient s treatment is necessary for continuation in the Suboxone program. Women should avoid becoming pregnant while taking Suboxone since the effects it may have on a fetus are not known. If a patient becomes pregnant while in treatment, they must report it immediately to our treatment team. Sometimes Suboxone impairs one s ability to drive. Patients are asked not to drive or operate machinery until they know how the Suboxone affects them. Client Signature Date Staff Signature Date 6

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