Question 1

Will my insurance pay for physician visits and the medication?

Accepted Answer

Most insurance plans provide coverage for substance use disorder treatment and associated medications. We recommend verifying your plan's mental health or behavioral health benefits to confirm coverage for substance use disorders. If Dr. Chicks is not in-network with your insurance plan, you may be able to obtain authorization for out-of-network care under certain circumstances. These circumstances may include situations where no other MAT (Medical-Assisted Treatment) programs are available to address your condition, waiting lists are prohibitively long, or available MAT programs are located too far from your home. For assistance with obtaining authorization in these situations, please contact For Your Health.

Question 2

Does using MAT increase my success at achieving sobriety and recovery?

Accepted Answer

Yes. Research demonstrates that even following extended rehabilitation programs, sustained sobriety remains elusive for most patients, with only 6.6% successfully completing treatment (Weiss RD et al. Arch Gen Psychiatry. 2011;68(12):1238-1246). Traditional programs are also considerably expensive, making MAT a more effective and accessible treatment option.

Question 3

Isn't the use of medications like Methadone, Sublocade, and Suboxone simply replacing one addiction with another?

Accepted Answer

No. The fundamental difference is that illicit opioids are often used to achieve intoxication, while Methadone, Sublocade, and Suboxone are prescribed to help reduce opioid cravings and withdrawal symptoms. These medications are prescribed or administered under controlled, monitored conditions and can be safe and effective for treating opioid use disorder when used as directed. Unlike heroin and other misused opioids, they work more gradually and help maintain stable medication levels in the brain. Maintenance treatment can help stabilize individuals, allowing them to address medical, psychological, and other aspects of recovery while reducing the risks associated with illicit opioid use.

Question 4

I'm pregnant. Can I still take Sublocade, Suboxone, Methadone, or Vivitrol?

Accepted Answer

Yes. Medical research indicates that treating pregnant women with Sublocade, Suboxone, or Methadone can support healthier outcomes for their infants. MAT with Sublocade or Suboxone can help reduce neonatal withdrawal symptoms and may decrease the infant's hospital stay. Methadone is recognized as an established option for MAT during pregnancy because it has been available much longer than Sublocade and Suboxone, providing more extensive safety data. Less information is available regarding Vivitrol. The decision to use any medication during pregnancy should be based on an individualized risk-to-benefit assessment. When considering whether to continue MAT during pregnancy, you should consult with your treating physicians (OB and MAT prescriber) to determine the best option for you and your baby.

Question 5

Why are Sublocade and Suboxone treatment programs so hard to find?

Accepted Answer

Sublocade and Suboxone are medications used to treat opioid use disorder, and access to treatment can vary based on provider availability and applicable treatment requirements. Physicians and other qualified healthcare providers must meet federal and state requirements to provide these treatments. Many qualified providers may not offer addiction treatment services, which can make programs more difficult to find. Sublocade, Suboxone, and Vivitrol may also be available through appropriate opioid treatment programs (OTPs).

Question 6

How are Sublocade, Suboxone, and Methadone different? How are they the same?

Accepted Answer

Methadone is an opioid medication that fully stimulates opioid receptors in the brain. Sublocade and Suboxone contain buprenorphine, a partial opioid agonist that only partially stimulates these receptors. Both Methadone and Sublocade or Suboxone treatment can be initiated without completing full detoxification from other opioids beforehand.

Question 7

What is the average dose of Sublocade and Suboxone?

Accepted Answer

It is important to understand that the appropriate dose of Suboxone for you is the dose that helps control opioid cravings and withdrawal symptoms. For many individuals, doses ranging from 8 to 16 mg, and occasionally 24 mg, may be sufficient. Sublocade is a long-acting injectable form of buprenorphine, with dosing determined by your healthcare provider based on your individual treatment needs.

Question 8

What if all I want is to be detoxed off of opioids using Sublocade or Suboxone?

Accepted Answer

If detoxification is your treatment goal, we will support you in achieving it. Should you later decide to continue with MAT using Sublocade or Suboxone, that option remains available.

Question 9

I've heard Sublocade and Suboxone are the hardest medications to get off of. Is that true?

Accepted Answer

No. The ease of tapering off Sublocade or Suboxone varies considerably among individuals. Some people find tapering from Sublocade or Suboxone straightforward, while those same individuals may experience significant difficulty with Methadone dose reductions. Some individuals struggle with discontinuing weaker opioids such as hydrocodone (Vicodin), while others experience minimal difficulty discontinuing any opioid. This variability demonstrates why standardized or “cookie-cutter” protocols are often ineffective. You are an individual and deserve treatment tailored specifically to your needs.

Question 10

Why is Methadone only used in Methadone clinics?

Accepted Answer

Methadone was the first medication approved for opiate dependence treatment. Federal law restricts its use for opiate addiction to opiate treatment programs (OTPs). MAT services in OTPs are highly regulated and structured, requiring daily attendance for at least the first 90 days, along with onsite individual and group therapy. When these regulations were developed in the early 1970s, this structure was believed to enhance treatment success rates.

For Your Health-Julie Chicks, M.D.

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