What services are available at outpatient facilities near me?
Opioid addiction treatment the primary focus of many outpatient detox facilities and outpatient drug rehab centers. Yet, many outpatient treatment centers also treat other substance use disorders. Alcohol outpatient treatment is also usually offered as well.
Can I detox from opioids in an outpatient facility?
What is inpatient and outpatient detox? The difference between inpatient detox and outpatient detox is that inpatient treatment provides 24-hour, around-the-clock observation and care. If you are admitted to an inpatient detox program, you will be monitored by healthcare professionals throughout your stay. The downsides of an inpatient detox are that you are away from home and your family and the cost is significantly higher. Fortunately, with recent advances in medical treatment, you can go to an outpatient detox to get off of opioids with good results.
Which is better, inpatient detox or outpatient detox?
While you may believe that inpatient detox is clearly the better choice, outpatient detox can be superior in certain situations. This is particularly true when it comes to opioid addiction treatment performed in a private doctor’s office or clinic. In this case, the doctor is providing outpatient detox in a more comfortable and familiar setting. In fact, your own family doctor may be able to provide this treatment. This is known as OBOT or office-based opioid treatment. Outpatient opioid rehab and outpatient alcohol rehab are effective ways to get clean and sober without having extended downtime from your life.
What is outpatient MAT?
When your doctor performs OBOT using medication-assisted treatment (MAT) with Suboxone or buprenorphine, the results can be superior to many inpatient detox programs. While MAT is often associated with Suboxone and similar medications, there are other MAT meds. For example, methadone and naltrexone are also used for MAT. In fact, naltrexone is used for MAT with other forms of addiction as well. Naltrexone, an opioid blocker, can be used to treat alcoholism and opioid addiction. When a doctor provides medication-assisted treatment, they also arrange for the patient to have psychotherapy as well. Therapy is an important part of the recovery process in both outpatient and inpatient treatment.
If an inpatient detox uses Suboxone also, does that make it better than outpatient detox?
Surprisingly, you may still get better results with outpatient detox. This is because many inpatient detox programs use a fast taper method of detoxifying your body from opioids using Suboxone or plain buprenorphine. While this can be effective in the short-term, the rate of relapse can be high. Most addiction specialists agree that medication-assisted treatment with Suboxone works best if it is continued for a longer time period. This may be anywhere from six months to one or two years. For some patients, longer treatment will be the best option.
When is an inpatient detox a better option compared to outpatient detox?
If a patient is addicted to multiple drugs, inpatient detox may be a better option. This is particularly true if the patient is detoxing from alcohol or benzodiazepines in addition to opioids. If the patient is considered to be a high risk for relapse or overdose, inpatient detox may also be the best choice. Another situation where you may prefer to go in for inpatient detox and residential rehab is if you prefer long-term naltrexone treatment over Suboxone.
How is naltrexone different from Suboxone?
Suboxone’s active ingredient is buprenorphine. Both buprenorphine and naltrexone are potent blockers of the opioid receptors in the human body. However, buprenorphine is also an agonist, or activator, of the receptor at the same time. Because of this additional property, buprenorphine is, by definition, an opioid. Naltrexone, a pure opioid receptor antagonist, is not considered to be an opioid.
What are the disadvantages of Suboxone?
As a controlled opioid medication, Suboxone is tightly controlled by the federal government and state governments. Some patients are not comfortable taking a controlled medication, especially when they are trying to get clean from all drugs. If you are involved in 12-step recovery programs, such as Alcoholics Anonymous, or Narcotics Anonymous, you may be determined to practice abstinence-only recovery from addiction. Hence you may choose to not use Suboxone for treatment.
Are there other disadvantages to Suboxone?
While Suboxone is highly effective in providing fast relief from opioid-related sickness and drug cravings and reliable long-term successful treatment, it does have some disadvantages. The most significant issue is physical dependence and prolonged withdrawal symptoms when you decide to quit taking Suboxone. While not all patients have a serious issue with withdrawal symptoms after stopping Suboxone, many patients will experience withdrawal symptoms for several weeks, and even up to a month or two. While this is an issue, it does not mean that you are going to become addicted to Suboxone. The withdrawal syndrome is a physical withdrawal issue and not necessarily a sign of being addicted to Suboxone. It is important to be aware of risks, benefits, and alternatives when considering any medical therapy. In many cases, the benefits of Suboxone treatment will far outweigh the risks, including possible long-term withdrawal symptoms after stopping the medication.
What are the advantages of naltrexone?
Interestingly, some studies have shown naltrexone to be equally effective compared to Suboxone in helping patients to stay clean long-term. The problem is that these studies do not include patients who dropped out before starting naltrexone. The difficulty of starting naltrexone is that you must be clean of opioids for at least a week before you can take your first naltrexone tablet. While this may not seem like a problem to someone who has not gone through opioid withdrawal, the difficulty of staying clean through the intense withdrawal and drug cravings can be overwhelming. However, if you are able to start naltrexone, it has the advantage of not being a controlled drug and it has no withdrawal syndrome. Hence, you do not have to worry about the stigma and complications of taking a controlled medication and you do not have to be concerned about feeling sick after quitting naltrexone.
Why is inpatient detox an ideal place to start naltrexone?
Since the difficulty with starting naltrexone is staying clean for at least a week before taking the first tablet, an inpatient detox program can help you to get clean and stay clean under 24-hour observation until you are ready to start your naltrexone prescription. Medication-assisted treatment should be used for nearly all opioid addiction treatments. The success rate is far higher with MAT compared to abstinence-based treatments that use no medical treatment. Naltrexone provides an option that does not involve the use of a controlled drug.
Why is outpatient detox with Suboxone for opioid addiction still the best choice over inpatient detox?
While the above scenario would be ideal, in practice, inpatient detox facilities are not sending patients home with naltrexone prescriptions. Why not? This is unclear. It seems to be due to a fundamental misunderstanding of what naltrexone is. Naltrexone is a non-controlled medication that has no abuse potential and no withdrawal syndrome that is highly effective as part of a comprehensive addiction treatment program for opioid addiction. In fact, it also works very well for treating alcoholism. It may even be useful in treating other forms of addiction, from cocaine and methamphetamine addiction to gambling, sex, and food addiction. In spite of these clear advantages of naltrexone as part of an inpatient detox program, it is rarely prescribed in these facilities. Because of this, relapse rates for short-term opioid detox tends to be high. Patients often cycle through inpatient detox programs repeatedly, their insurance plans being billed over and over again.
Is outpatient detox with Suboxone replacing one addiction for another?
Patients who take Suboxone tend to do very well. Within a few weeks to a month, many patients have a dramatic turn-around in their lives, going from hopeless desperation and degradation to having peace of mind and hope for the future. Their minds are clear, free from the cloudiness of opioid abuse, free from intense, around-the-clock cravings, and free from the obsession of when they can take the next drug to avoid feeling withdrawal sickness. To put it simply, many patients describe the experience as feeling as if they were never addicted to opioids in the first place. They are able to work and be with their families.
Suboxone provided at an outpatient treatment center is not a cure for opioid addiction.
Because Suboxone is so effective and free of negative effects, if you take Suboxone, your family members may believe that you have been “cured”. They want to know when you will be done with taking Suboxone. They start reading social media posts on Suboxone and conclude that you have simply traded one addiction for another. The fact is that Suboxone, when taken as prescribed, is not an addicting drug. This is reflected in your behavior and thinking. You are no longer having addictive thoughts. You are not displaying addictive behavior. Suboxone is a unique medication that treats addiction, it is not itself an addicting drug. The withdrawal symptoms that people experience when they stop taking Suboxone is due to physical dependence. This is not an addiction. Physical dependence is common with many medications and it can be overcome with medical management and time.
How can I find an outpatient detox near me?
If you are interested in outpatient detox with Suboxone, simply look at one of several online directories. SAMHSA is the government agency that oversees Suboxone treatment in the US. Their website has a treatment locator that can help you to find Suboxone doctors and Suboxone clinics in your area. Another excellent resource is Treatment Match, which you can find at treatmentmatch.org. This is a service provided by NAABT to match doctors and patients who are in the same area. It may take some time to make a few phone calls to ask questions and determine which doctor or clinic you should go to, but it will be worth it. You will be taking the first steps towards changing your life for the better, getting past the misery of opioid use.
What kind of outpatient treatment for alcoholism is available?
As I noted before, naltrexone can be used as a treatment for alcoholism as well as opioid addiction. On method that your doctor may discuss with you is The Sinclair Method or TSM. This form of alcohol use disorder treatment is unique in that the patient does not stop drinking right away. While this may seem to be counterintuitive, TSM is known to have at least a 78% success rate. The Sinclair Method is also ideally suited to be administered at outpatient rehabs.
How can I find outpatient rehabs near me that are either low cost or free?
Everyone deserves a chance to get clean from drugs. Medication-assisted treatment with buprenorphine is quickly becoming the gold standard of addiction treatment for opioid addiction. Unfortunately, treatment can be expensive and there is a shortage of doctors willing and able to prescribe buprenorphine. People who are indigent, homeless, or simply cannot afford treatment may be concerned that MAT with Suboxone is not available to them. Fortunately, with increasing public funding for Suboxone pilot programs, access to care is increasing in nearly all regions of the US. The problem is that these programs tend not to advertise, so they can be difficult to find. Here is a page on this website where we have an ongoing discussion in the comments section about free programs. Here is another similar page on my podcast website with an ongoing discussion about various free programs in the US. The good news is that these free and low-cost programs do exist and patients who cannot afford to get treatment at a private doctor’s office or clinic are getting affordable care in these programs.
What if there are no outpatient rehab centers near me?
This is a problem in rural areas of the US. There are not enough doctors in many towns to provide outpatient detox services to patients who need help. For now, the best answer may be to travel to the nearest doctor for treatment. Fortunately, Suboxone treatment can be provided with monthly visits, rather than the daily visits required by methadone clinics. While driving 50-100 miles to a doctor’s appointment is not pleasant, doing so once a month is not quite as bad. Also, telemedicine, or telehealth, is going to be widely available soon in most states. This means that you may be able to get outpatient detox and outpatient rehab from the comfort of your home without having to travel great distances to a Suboxone clinic.
What if there are many outpatient centers near me that can prescribe Suboxone?
That’s great! It is always best to have choices when it comes to getting medical care. If you are fortunate enough to live in a region that has a high concentration of outpatient detox programs, my advice is to take your time and do your research. Find the best detox program to meet your personal needs. We are all different and recovery from addiction is not the same for everyone. It may help to make a consultation appointment with several doctors. You can sit down with each doctor and have a conversation about their philosophy of addiction treatment and recovery. Even if you have been seeing a Suboxone doctor for a while, you may want to consider changing to another doctor or clinic if you are not comfortable with the direction of your treatment plan.
Can I see Dr. Leeds for an appointment for outpatient detox?
I am Mark Leeds, D.O., osteopathic physician. My medical practice is a concierge-type, private doctor’s office in Fort Lauderdale, Florida. My patients are come from the surrounding areas, including Palm Beach County, Broward County, and Miami-Dade County, also known as the Greater Miami Area. If you are interested in a quiet, safe place, where you can see a doctor who will listen to you and focus on helping you overcome your addiction, you may be interested in scheduling an appointment to see me. You can reach me by using the contact form on this website or by calling me at 954-776-6226.