Your 1st visit is generally the longest, and may last anywhere from 1 to 4 hours. When preparing for your 1st office visit, there are a couple of logistical issues you may want to consider.
• You may not want to return to work after your visit—this is very normal, so just plan accordingly
• Because SUBOXONE can cause drowsiness and slow reaction times, particularly during the 1st few weeks of treatment, driving yourself home after the 1st visit is generally not recommended, so you may want to make arrangements for a ride home
It is very important to arrive for your 1st visit already experiencing mild to moderate opioid withdrawal symptoms. If you are in withdrawal, buprenorphine will help lessen the symptoms. However, if you are not in withdrawal, buprenorphine will “override” the opioids already in your system, which will cause severe withdrawal symptoms.
The following guidelines are provided to ensure that you are in withdrawal for the visit. (If this concerns you, it may help to schedule your first visit in the morning: some patients find it easiest to skip what would normally be their first dose of the day.)
• No methadone or long-acting painkillers for at least 24 hours
• No heroin or short-acting painkillers for at least 4 to 6 hours
Bring ALL medication bottles with you to your 1st appointment.
Before you can be seen by the doctor, all of your paperwork must be completed, so bring all your completed forms with you or arrive about 30 minutes early. In addition, you will need to pay the doctor’s fees prior to treatment.
Urine drug screening is a regular feature of SUBOXONE therapy, because it provides physicians with important insights into your health and your treatment. Your 1st visit will include urine drug screening, and may also entail an alcohol test and blood work. If you haven’t had a recent physical exam, your doctor may require one either now or soon afterwards. To help ensure that SUBOXONE is the best treatment option for you, the doctor will perform a substance dependence assessment and mental status evaluation. In addition, you and your physician will discuss SUBOXONE treatment, what it involves, and what your expectations of treatment are.
After this initial intake, your doctor will give you an initial dose of SUBOXONE. Your response to the medication will be evaluated after 1 hour and possibly again after 2 hours. Once the doctor is comfortable with your response, you will be given a prescription for SUBOXONE to fill at your pharmacy. You will then be allowed to go home. The doctor will schedule your next visit and give you directions for taking your medication at home. In addition, you will receive instructions on how to contact your doctor in case of emergency, as well as information about your treatment.
CHECKLIST FOR 1st VISIT:
□ Arrive with a full bladder
□ Arrive experiencing mild to moderate opioid withdrawal symptoms
□ Bring completed forms (or come 30 minutes early)
□ Bring ALL medication bottles
□ Fees due at time of visit (cash or credit to be paid prior to consulting the physician)