What is a higher level of care?
A patient recently reached out to let me know that he had transferred to a fast tapering program because he required a “higher level of care”. I respect his decision and I want the best for him and his recovery program. I believe that everyone who struggles with opioid addiction has the power to change and stay clean.
The power of community.
One well known abstinence based fellowship states that we cannot do it alone, but together we can. Addiction is a disease of the mind that uses the mind’s own power against itself. It takes a group effort to fight such a monster. Hence, a recovering addict should surround themselves by other successful recovering addicts.
To describe treatment modalities as “levels” is, to some extent, a misrepresentation. We are not playing video games, we are working to save lives. There is no one-size-fits-all solution to this problem. There are different philosophies and methods. So, what works best for you may not be what works best for someone else.
The gold standard of care.
The fact is that medication assisted treatment with maintenance is the gold standard of treatment for opioid use disorder. This is scientifically proven and is the experience of many healthcare practitioners. Maintenance means staying on Suboxone or an equivalent medication for an extended period of time.
You need time to heal.
Typically this is expected to be one year. This gives the patient time to become established in the recovery community. Once you stop the drugs, you need time and space to heal.
Out with the bad and in with the good.
You need to remove yourself from bad friends and influences. Go to meetings, get phone numbers, call friends in recovery, get a sponsor and work steps. Going to a private therapist is also important. Hence, it takes time to build a strong foundation of recovery.
There is more than one path to success.
While medication assisted treatment is the proven safest option, it is not the only solution. It is possible to get clean with an abstinence based program. Non-controlled medication, such as naltrexone is an alternative. Fast tapering with buprenorphine in an inpatient setting works well for some.
Keep an open mind.
Hopefully, proponents of other philosophies will acknowledge that their way is not the only way. If you find that you are not having success trying to get clean in the same way over and over, consider trying something different. So, what you need is not necessarily a higher level of care, just a different method of care which may work better for you.