OPIOID DEPENDENCE SHARES MANY CHRACTERISTICS WITH CHRONICS DISEASES

• The treatment of chronic diseases is not time-limited; these illnesses usually last for the patient lifetime.
• The treatment involves medication, as well as counseling and behavioral changes.
• Relapse rates are high with chronic diseases.

LONGER-TERM TREATMENT MAY BE PREFERABLE FOR PATIENTS WITH OPIOID DEPENDENCE

Time-limited therapy may be inappropriate for opioid-dependent patients.

Treatment is optimized when patients have access to continuous care and monitoring.

Patients receiving longer-term treatment show improved status in control over substance use, psychiatric status, social adjustment, and general quality of life.

Longer-term treatment may afford patients adequate time to learn skills to overcome the psychosocial components of the disease.

An ancillary support system outside of pharmacotherapy and psychosocial coundeling may also increase patient adherence and retention.

Shorter-term treatment may help a patient with physical symptoms associated with opioid dependence, but may not allow enough time for psychosocial adjustments.

THE PHASES OF QUALITY CARE

Each phase of treatment should contain elements associated with Quality Patient Care. This algorithm has been designed to provide the best possible outcomes for opioid-dependent patients seeking treatment with Suboxone.

RELAPSE PREVENTION

Like other chronic diseases, the possibility of relapse with drug dependence is high.

In opioid-dependent patients, establishing a relapse prevention plan is critical to patient success.

Discussions with the patient regarding triggers and stressors may help to determine if a patient needs to be restabilized – Restabilization includes making needed dose adjustments and/or counseling modifications to improve treatment adherence and outcomes.

In the event that a patient relapses, it should not necessarily be viewed as treatment failure. Rather, it should be seen as an opportunity to revisit the patient’s treatment plan, make appropriate adjustments, and encourage the patient to resume treatment.

QUALITY PATIENT CARE DURING MAINTENANCE

Ongoing visits are scheduled:
Ongoing visits during maintenance help determine the efficacy of the patient’s dose and the success of the patient’s psychosocial counseling sessions.

These visits are an appropriate time to query the patient about life changes, stressors, treatment of comorbid conditions, and drug interations that may cause the patient to be at greater risk for relapse.

Visits should ideally occur on a monthly basis, depending on individual patient need.

The patient continues to attend psychosocial counseling:
Successful treatment for opioid dependence with Suboxone includes psychosocial counseling.

Treatment with Suboxone allows for ongoing psychosocial counseling during maintenance to achieve cognitive and behavioral changes. In two studies, one reporting 6-month results, treatment retention rates ranged from 42% to 72%.

The 6-month study showed significant improvements from baseline in:

• Non-use of illicit drugs (excluding alcohol)
• Non-use of injection drugs – related risk
• Employment
• Personal relationships

MEDICAL WITHDRAWAL

The goal of medical withdrawal is to slowly taper the patient off of Suboxone.

The decision to taper the dose of Suboxone is determined by the therapeutic team, generally made up of the doctor, counselor, and patient. Continued psychosocial counseling is recommended if it is mutually decided that the patient is ready to be tapered off of Suboxone.

A physician-supervised, slow taper is recommended. If a patient feels at risk for relapse during a taper, he or she can be restabilized and continue maintenance for as long as needed.

Patients can always restart treatment with Suboxone. Patients should be reminded that if they discontinue medication-assisted treatment with Suboxone, they can re-initiate treatment at any time.

For more information about Suboxone, please visit suboxone.com