Typically involves history, exam, discussion of new or old concerns. urine drug testing
Urine sample is collected in the office
Frequency of follow up is decided based on Suboxone dose, previous history of relapses, presence of risk factors, compliance with appointments and other factors.
New patients who are already on Suboxone and are transitioning service over to us, won’t typically have to start from the beginning unless there are other concerns.
If the patient fails 3 urine drug screens over 3 month period, then as per contract, we will have to terminate the services and would recommend inpatient rehab.
We may request the patient randomly to visit our office for pill count and / or urine drug screens. Pill count can also be done on live audio / video HIPAA compliant platform.
Decision to further wean Suboxone dose depends on multiple factors including patient’s motivation, willingness, current social and job situation, previous history of failed wean, history of multiple drugs abuse in the past and any ongoing opioid withdrawal related medical issues. Typically this can take months.
Sometimes, in order to keep the craving suppressed, some patients prefer to be on a low dose of Suboxone for a long time before being completely off.
Psych counseling is equally important during this time period.