Suboxone Treatment in Fort Lauderdale, FL
What is Suboxone treatment, and how does it help a person stop opioids?
Suboxone is a prescription medication that combines buprenorphine with naloxone, taken as a film that dissolves under the tongue or against the cheek. Taken every day, it holds off opioid withdrawal sickness and quiets the cravings that make quitting on willpower alone so hard. The generic versions come as films and tablets, and on this page Suboxone stands in for all of them, because they work the same way.
People arrive at opioid dependence by many paths, and it is rarely a matter of character. For a great many patients it begins with a legitimate prescription for opioid pain medication after an injury or an operation, taken exactly as directed, until the body can no longer do without it. Others are first exposed through heroin or, increasingly, fentanyl.
However it begins, opioid dependence is a treatable medical condition. Cravings are the intrusive thoughts and plans that enter your mind uninvited, along with the feeling that unless you use again you will never be rid of them. Suboxone takes most of that away, and it lets a person get through a normal day without chasing a drug through it.
Suboxone was approved for opioid dependence in 2002, and it has been the workhorse of office-based treatment ever since. So, what does the medication actually do in the brain, and why is it not simply one opioid standing in for another?
How does buprenorphine work?
Buprenorphine is a partial opioid agonist. While it is classified as an opioid, it is not a typical one. It binds tightly to the opioid receptor and holds on, blocking other opioids from getting in, while activating the receptor only part of the way. That partial activation is enough to stop withdrawal and cravings, and it is not enough to produce the rush a person gets from heroin, fentanyl, or oxycodone.
There is also a ceiling. Past a certain dose, more buprenorphine does not do more, which is why an overdose on buprenorphine alone is far less likely than with a full opioid. Yet, the Suboxone label carries a plain warning that mixing it with alcohol, benzodiazepines, or other sedatives can dangerously slow breathing. That warning deserves to be taken at face value, and a patient who already takes a benzodiazepine should never stop it cold on their own, because the two medications are managed together with the doctor.
Patients on a stable dose often say that it feels like nothing at all. That is the point. The naloxone in Suboxone is there to discourage injecting the medication. Taken under the tongue as directed, very little of it is absorbed and it does nothing.
Dr. Leeds has called buprenorphine the broccoli of opioids. It is good for you, and it is nobody’s idea of a good time.
Taking Suboxone as prescribed is not trading one addiction for another.
Physical dependence is not addiction. A person who takes Suboxone every day will get sick if they stop it suddenly. That is physical dependence, and it is the same thing that happens when a beta blocker for blood pressure or an antidepressant is stopped cold. Addiction is a pattern of behavior: the obsession, the chasing, the using in spite of the damage. Suboxone treats that pattern, and it does not cause it.
“Clean” is a twelve-step word, not a medical one. In fact, a person taking prescribed buprenorphine is in recovery, with no asterisk. Unfortunately, many patients are told otherwise by a family member, a sponsor, or a rehab, and in Dr. Leeds’ experience the most common reason Suboxone treatment fails is that the patient was pressured into stopping it before they were ready.
While the twelve steps help many people, and nothing on this page argues against a meeting that is working for you, your medication is between you and your doctor. It is an outside issue.
When the time comes to stop, Suboxone is tapered slowly. Buprenorphine leaves the receptor slowly and stays in the body a long time. So, the tail after the last dose is gradual rather than abrupt. The last dose should be small, and it should be arrived at gradually. Patients who finish a gradual taper often report that they had some withdrawal symptoms for a while and no craving for opioids at all. That is the difference between dependence and addiction.
How does Suboxone treatment compare with other kinds of opioid treatment?
There is no one-size-fits-all treatment for opioid dependence, and the level of care should fit the person, not the facility’s marketing. Every facility, as it happens, recommends the level of care it sells. The honest question is what a particular person needs right now.
While they are the most disruptive option, residential programs and day programs make sense for someone who has had a serious overdose, who is using several drugs at once, or who has no safe place to be while the first weeks pass. Methadone is an effective medication and a good fit for some people, but it is dispensed through federally regulated clinics, and at least in the early weeks most patients take their dose at the clinic every day, under observation.
Fortunately, office-based buprenorphine treatment, often called medication-assisted treatment, or MAT, is the option that lets most people keep their job, their family life, and their privacy. The prescription is filled at an ordinary pharmacy, the visits are with a doctor, and there is no daily line to stand in. A person can get well and still be treated like a human being.
What some programs sell as a fast way off opioids is usually a buprenorphine taper compressed into a week or two, and relapse after a fast taper is common. Naltrexone, an opioid blocker taken as a daily tablet or a monthly injection, is another option for people who are already fully off opioids, and buprenorphine itself also comes as a long-acting injection (Sublocade and Brixadi). Dr. Leeds does not provide the injections, but he can discuss them in a consultation.
What does office-based Suboxone treatment with Dr. Leeds look like?
Dr. Leeds offers buprenorphine treatment, meaning Suboxone and its generic films and tablets, to new patients by telemedicine anywhere in Florida, with in-office visits available in Fort Lauderdale. Care is private and one-on-one. Every visit is with Dr. Leeds, never a substitute.
While the first dose, known as induction, is the step people worry about most, it is done at home with phone support. Buprenorphine has to be started after the last opioid has begun to wear off, because taking it too early can set off precipitated withdrawal, a sudden withdrawal caused by buprenorphine pushing the other opioid off the receptors. When fentanyl is involved the timing is trickier, because fentanyl can linger in the body longer than people expect, and Dr. Leeds uses a low-dose start when that risk is present.
The prescription is filled at a community pharmacy. Not every pharmacy stocks buprenorphine or treats the person picking it up kindly, and part of a private doctor’s job is knowing which pharmacies do.
Treatment continues for as long as it is helping, at the patient’s pace and never on a deadline. There are no mandatory group meetings. Dr. Leeds talks with his patients during their visits, which is where much of the real work happens, and he refers to an outside therapist when a patient wants one. Counseling is never a condition of the prescription.
How has access to Suboxone changed?
For two decades, prescribing buprenorphine for opioid dependence required a special federal permission called the X-waiver, created by the Drug Addiction Treatment Act of 2000, along with a training course and strict caps on how many patients a doctor could treat. Congress eliminated the X-waiver at the end of 2022, and the change took effect in 2023. Today, any prescriber with a standard DEA registration may prescribe buprenorphine for opioid use disorder, with no patient cap, where state law permits.
That removed a real barrier. Yet, prescribing Suboxone well takes more than a registration. It takes a doctor who understands opioid dependence, listens carefully, and stays available over time. (For the difference between the two buprenorphine formulations, see Subutex vs Suboxone.)
How do you find the right Suboxone doctor?
Finding a Suboxone doctor is easy now. While a search will turn up prescribers in most parts of Florida, finding the right one takes more work. And, it is worth doing before the first appointment rather than after.
Ask the questions that matter. Does the practice offer telemedicine, or must you be seen in person? Will you see the same doctor every time, and how easy is it to reach that doctor between visits? How is induction handled, what should you expect in the first week, and who answers the phone if something goes wrong?
Then look past the website. Read what the doctor has written, because a doctor who writes about opioid dependence has usually thought about it. Call the office and notice how the staff treat you on the phone. Use a consultation, if one is offered, to find out whether the doctor listens, shows genuine understanding, and takes you seriously.
Of course, price matters, but it should not be the only thing that matters. A doctor who has been through addiction personally is not automatically the right doctor either, since some carry a “tough love” approach from their own recovery that is not right for everyone. In the end the questions are simple. Is the doctor open-minded, and will they change course when a plan is not working for you?
Asking for help is the single move that raises your odds the most. And, buprenorphine treatment is the help with the best track record.
Frequently Asked Questions
Is Suboxone the best treatment for opioid addiction?
Buprenorphine and methadone are the two medications with the longest track record in opioid dependence, and medication treatment is the gold standard for opioid dependence, not a second-tier option behind abstinence-only programs. Which of the two is best depends on the person, and there is no shame in either. For most people who want to keep their life running while they get better, office-based buprenorphine is the practical choice.
Can someone on methadone switch to Suboxone?
Yes, but not from one day to the next. Methadone is long-acting, and starting buprenorphine before enough of it has cleared can precipitate withdrawal, so the switch has to be planned with the doctor, usually with a period of lowering the methadone dose first. It is one of the harder transitions in opioid treatment, and it goes best with a doctor who has done it before.
What if I am on Suboxone and I need surgery?
Surgery is a fair concern, and it deserves a plan. While every case is different, the mechanism is the same in all of them. No doctor can promise in advance how a particular surgical team will handle it.
Buprenorphine occupies the opioid receptors. So, the pain medications given during and after an operation may not work the way the surgical team expects unless they know about it in advance. Tell the surgeon and the anesthesiologist that you take buprenorphine, and ask them to coordinate with your prescribing doctor before the day of the operation. One common approach is to continue the buprenorphine and add other kinds of pain relief on top of it, but the right plan depends on the operation and on you.
Does Suboxone get you high?
When you drive your car, do you get high from the gasoline in the tank? Gasoline can certainly be misused, but used for what it is made for, it moves the car and nothing else. While this is not a perfect analogy, Suboxone is the same. Taken as prescribed by a person who is dependent on opioids, it does not get anyone high, and partial activation and the ceiling effect see to that.
Someone with no opioid tolerance who tries it might feel a mild effect the first time, and more likely will feel sick. Suboxone is a Schedule III controlled substance, and it can be misused. So, the honest answer is not “never” but “not in the way anyone is looking for.” Patients describe feeling normal, not medicated.
Suboxone does get sold on the street, and that gets used as proof that it is a drug of abuse. Patients who bought it before they found a doctor have told Dr. Leeds the same story, almost without exception: it was to hold off withdrawal sickness on a day when a prescription was out of reach, not to get high. The answer to that is easier access to a prescriber, not tighter restrictions on the patients who already have one.
The film and the tablet are made to dissolve in the mouth, under the tongue or, for the film, against the cheek, and there is no other way to take Suboxone. Injecting it gives an opioid-tolerant person almost nothing, because of the ceiling. The naloxone is less of a deterrent than its makers suggest, since it wears off long before the buprenorphine does, and none of that changes the arithmetic. Injecting multiplies the risk of overdose, hepatitis, HIV, and infection of the heart valves. Fortunately, if you take Suboxone the way it is prescribed, none of this applies to you, and your medication is doing exactly what it should.
How long does Suboxone treatment last?
As long as it is helping. Some patients taper off after a year or two, and many stay on buprenorphine for years, which is no more a failure of treatment than staying on a blood pressure medication is. The decision to taper belongs to the patient and the doctor together, and it is never made on a calendar.
Where can you get Suboxone treatment in Florida?
Dr. Leeds provides private, concierge Suboxone treatment by telemedicine to patients throughout Florida, with in-office visits in Fort Lauderdale. If you are ready to stop opioids, or you are already on buprenorphine and want a doctor who will listen, contact Dr. Leeds to schedule a consultation.
This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.