Suboxone Services

Part of Arbour Health System's Substance Abuse Services continuum of care includes outpatient Suboxone Treatment Programs for patients suffering from opioid dependency.

Arbour Counseling Services locations offering Suboxone Treatment Programs include:

• ACS, Jamaica Plain (617) 524-1120

• ACS, Allston (617) 782-6460

• ACS, Malden (781) 322-1503

• ACS, Norwell (781) 871-6550

• ACS, Woburn (781) 932-8114

Suboxone Program Components:

• Medication Management

• Individual Therapy

• Group and Family Therapy

• Structured Outpatient Addictions Programs (SOAP)

• Referral to Community Programs/Aftercare

Suboxone Programs includes several phases as part of treatment:

• Outpatient Detoxification (short and long term)

• Stabilization

• Maintenance

Protocol assignment is reviewed between the client and program physician prior to determination. The type and frequency of treatment outlined below are intended as a guideline for clinical decision-making: in practice, they are individualized and tailored according to need. Patients may be referred directly into the Maintenance program.

Outpatient Detoxification: Short-Term Detoxification treatment generally lasts between two to four weeks, long-term detoxification treatment generally lasts between three to six months. Both treatments consist of three phases including Induction, Tapering and Aftercare. Potential candidates for a successful short-term and long-term detoxification treatment typically:

• Have access to and agree to access solid sober support systems

• Present with a relatively short period of illicit substance abuse/dependence

• Have no seriously persistent mental or physical illness

• Are determined to have a non-medication assisted recovery

• Are motivated despite having failed previous Suboxone or Methadone detox attempts

• Are highly motivated to embrace their treatment plan objectives and recovery

• Must agree to attend self-help program(s)

Induction is typically the first two weeks of treatment and includes meeting with program clinician for completion of Comprehensive Assessment, signing program-specific paperwork, including ‘Consent to treat with Suboxone, providing toxicological sample and meeting with program physician who verifies opioid withdrawal symptoms and/or opioid use disorder, and assigns person-served to a maintenance protocol.

Stabilization occurs generally during weeks two – eight. During this phase protocol includes:

• Meeting with program physician no less frequently than twice a month to ensure proper dose and stabilization

• Attending individual and/or group sessions at a frequency and level of care consistent with medical necessity.

• Providing toxicological sample weekly

• Moving to maintenance phase once stabilized and shows evidence of cessation of illicit opioid use for a period of two or more weeks, but usually no sooner than eight weeks into treatment.

• Stabilization is characterized by no withdrawal symptoms, minimal side effects, no uncontrollable cravings.

Maintenance is typically week nine through an indefinite time period and can include:

• Meeting with program physician generally once a month unless otherwise indicated.

• Attending individual and/or group sessions at a frequency and level of care consistent with medical necessity.

• Providing toxicological sample no less frequently than monthly

At any point during maintenance, a patient can decide to begin a tapering schedule. Factors to consider before initiating a taper include: stable housing and income, adequate psychosocial support, etc.

Tapering rate is determined between the patient and program physician and can be stopped at any point in the event that the patient experiences withdrawal and/or cravings and fears relapse. After successful recovery as evidenced by the patient’s compliance with a treatment plan, toxicological screens that are absent of all illicit substances/alcohol and consistent involvement in sober support systems, the patient is offered the opportunity to receive medication management services (no more frequently than monthly visits with program physician) or referral to community programs including aftercare counseling.

Other Components of Care

Family Intervention Programs are also part of services provided as part of Suboxone Treatment. This gives family members the opportunity to attend Psychoeducation groups which may include:

• The Nature of Opioid Addiction

• The Recovery Process and The Use of Medication

• The Impact of Addiction on the Family/Significant Relationships

• Family Recovery Strategies

Patients are encouraged to invite family members and significant others to attend these sessions beginning in the stabilization phase of treatment.

Aftercare
Aftercare services are also provided and are determined by need. Aftercare can consist of individual, family and group counseling.