WELCOME TO OUR PROGRAM
If you or a loved one are in need of help for Opioid Addiction and Wish to consider utilizing Suboxone with Telemedicine and counseling . Call 800.969.8774 , speak to one of our representatives and let's get you started.
TELEMEDICINE WITH SUBOXONE
We are glad you are here. Let’s get straight to the point. We are pioneering the combination of Telemedicine with Suboxone and counseling. We have helped hundreds across multiple states.
We hope we have a chance to work with you.
Telemedicine with suboxone has two functions:
- For anyone as a temporary bridge to a more traditional or intensive program
- For some as their primary program for a longer duration
When you are ready, call us at 800.969.8774 . Most times, we can start you the same day
As a convenience for you, we have arranged some links to questions and information on this page
Odds are, we will never see you in person, but we will be seeing you plenty. We are accepting new patients seven days a week.
WHAT IS YOUR GENERAL PROGRAM?
The general program is very simple. Once you have decided to start, you complete our online registration process. This is a series of questions, videos, and documents to review, answer, and sign. The online registration process takes about 45 minutes. The entire process can be accomplished through your smartphone.
Once you have completed the online registration process, you will speak with one of our staff members live on a regular phone call. We will discuss whether you want to pay on a weekly basis ($40/week), 2-week ($70), 3-day ($20) or a monthly basis ($125/month to get started). Then, We will work with you on a time, most likely same day, to be on a live telemedicine interaction first with our intake coordinator. Next, a prescription is electronically sent to the pharmacy of your choice.
Now you will be having live interactions with the team on a weekly basis. All sessions are recorded and posted in case you were busy at the time. Congratulations. You are in a treatment program. And you never even had to leave work or home.
TREATMENT PLAN OPTIONS
If you are ready to begin Medication Assisted Treatment (MAT) in a structured program, we can do so today. All from the privacy of your home. All through your smartphone.
TELL ME ABOUT COST, WHAT WILL INSURANCE COVER?
There is good news. To date, not a single insurance for the prescription has been denied. At least, if you have an insurance prescription plan, your medication cost will be covered. Even Medicaid has been good to our people. Sometimes certain insurances will pay for a specific brand or formulation. We are fine with that. We are good with anything that helps our people.
That stated, here is the bottom line – none of the insurances, not Medicare, Medicaid, Blue cross, Humana, none of them will cover the advanced type of telemedicine we offer. As we are about to get even more advanced, we don’t foresee any change in the near future. We are on a cash basis, not by choice, but by necessity. So what we did is smart. The program gets cheaper as you taper down your dosages.
want to pay on a weekly basis month to get started). Then, We will work with you on a To get started, We offer multiple payment options:
- Weekly ($40)
- 2-week ($70)
- 3-day ($20)
- Monthly ($125)
If you are new with us and cash is tight as you may have been buying on the street, or, if cash is just tight for any reason, you may find one of these options to be a helpful one. We want our People paying the lowest monthly payment possible. The two week option can be a transitional step towards that goal
Plenty of people will start with us and make their first payment days later. Plenty of people start out weekly until they become more stabilized and switch to monthly.
TELL ME MORE ABOUT THE REGISTRATION PROCESS
The thinking behind our registration process is simple. Before we even meet with you in person, let’s go ahead and lay out everything we need to know about you and everything you need to know about us and the medications we use.
The first part of registration is just simple demographics. Who are you? Where do you live? What is your date of birth? Address?
Next, we want to know more about your history with addiction, treatment, suboxone, medical, surgical, family, psychiatric, and legal history.
Then there are two documents for you to review in great detail and sign. These are somewhat lengthy but important documents called a narcotics agreement and an informed consent document.
Finally, there is a series of videos for you to watch and answer some fairly specific questions. After all this is completed, you are ready to begin interacting with us through live, real-time telemedicine. Again, all through your smartphone.
WHAT WILL MY FIRST TELEMEDICINE ENCOUNTER BE LIKE?
Now remember, we function from a position of two-way honesty at all times. You be honest with us. We will be honest with you.
We ourselves have been somewhat disappointed and frustrated at times with the current state of telemedicine. Dropped calls, garbled speech, poor connections, feedback (we hate feedback), you name it, we’ve been through it with our people. But we have always found a way to get everything to work for everyone. And the same will apply to your first telemedicine encounter.
But it should be becoming obvious why we want everything reliably documented before we bring in the telemedicine aspect. We are currently working on our own technology. That’s how tough this has been. We are going to fix and create a better process. For now, let’s just all get through it.
WHAT PHARMACY DO I USE? WHAT IF I’M PAYING CASH FOR MY MEDICATION?
We have tried a number of pharmacy models. We have tried a number of ways to help get the cost down. The pharmacy interaction can sometimes be a challenge for both us and our people. But we always get through it.
For the most part, our people overwhelmingly use a pharmacy of their choice. And, for the most part, we have a good relationship with our pharmacy colleagues.
Getting a good, reliable, sustainable cash price for our people has been a challenge. Goodrx has helped some. We have a few things planned for 2019 we hope will help also. We do see an occasional pharmacy that will have the generic suboxone below $5/tablet. We want to see an option for our people below $4/tablet.
WHAT ABOUT THE DRUG SCREENING PROCESS?
Drug screening is required by state and federal regulations. We will be drug screening. For the most part, we utilize an oral fluid test that we mail to you, you collect an oral fluid sample and mail it back in to us. The lab will be sending you a bill. If you have insurance, great. If you are in a self-pay category for the lab, know this, we only will work with a lab that that does not “chase” for payment or report a failure to pay to any credit agency. If you have further concerns or questions regarding a lab bill, call us. We simply do not want our people stressed or overly concerned by a lab bill. Again, if you have insurance, great. If not, they will send you a bill but not chase or report you. Simply not something worth stressing about.
IS COUNSELING MANDATORY? AND WHY?
Yes. Simply put, counseling is mandatory. As long as your drug screens and state database queries are normal, we utilize the honor system. If we encounter something unexpected and worrisome, and through our co-management model, we will be seeing you in a live telemedicine encounter.
Stop and think a moment. Some of our people became addicted to opioids accidently after a prolonged exposure to opioids following a medical or dental condition. But others of our people were using the fog of the opioid to try and offset painful realities within their own life. A common example would be the person in a violent, abusive relationship who was using the addiction to escape the harsh reality.
Now with suboxone (buprenorphine/naloxone) comes clarity. The fog of the addiction is lifted. And now this person is directly facing whatever it was that drove them to the addiction in the first place. These people need counseling. Therefore, counseling will always remain mandatory for all.
WHAT DOSE OF SUBOXONE (BUPRENORPHINE/NALOXONE) WILL I BE STARTING WITH?
Excellent question. We could spend a great deal of time on this subject. But let’s just state the facts.
We start the majority of our people on 16 mgms a day of buprenorphine. If you have been stable before on a lower dosage or prefer a lower dosage, just let us know. We will not go over 16 mgms a day. If you need or take more than 16 mgms a day, we are not the right program for you.
Previously, we preferred to see people start on lower dosages, typically closer to 8 mgms a day. But receptor saturation with buprenorphine has a protective effect in a relapse. Fentanyl is everywhere. Thus, for the protection of our people early on while they are stabilizing, we prefer the 16 mgms a day of buprenorphine.
HOW MANY TIMES A DAY DO I TAKE MY MEDICATION?
Excellent question. Buprenorphine is slowly metabolized in your body. Once a day dosing is fine once your body has gotten use to the buprenorphine.
We tell our people to split their dose twice a day for the first two weeks. After the first two weeks, begin to take your medication all just once a day.
There is a very specific reason we do this. Feeling like you need to split the medication into multiple smaller doses spread out throughout the day may be an indication some of the old addiction habits are still lingering with you. Being able to break free of these old addiction habits and taking your medication just once a day, for some, is an indication of moving forward and away from the old addiction habits and thinking.
Ultimately, some people will even be able to taper down to taking their medication once every other day. It’s a worthy goal and is a good indication that a person is really in control of the situation.
Through the proper combination of Telemedicine, Internet broadcasts, and a Smartphone app, we can bring our Medication Assisted Treatment (MAT) provider, counselor, and even a pastor to you , directly through your smartphone. But the medication can begin today, in most cases, within a matter of hours. The nightmare is over.
WHY DOES YOUR PROGRAM FOCUS SO MUCH ON THE TAPERING?
The short answer to this question is that we focus on tapering because stopping the medication, for some, has resulted in a death by relapse.
Now let’s discuss in more detail.
The reality is that many of our people, in fact, most of our people, are going to be on a buprenorphine product for a prolonged period of time. This period of time, for some, will be measured in years to decades. This appears to be due to a methylation of the DNA of the opioid receptor due to a chronic exposure to an opioid.
That’s right. This is a genetic condition that we are dealing with in opioid addiction. Chronic exposure to any opioid, and for any reason, results in a permanent and non-reversible change, actually the addition of a methyl group, to the person’s DNA.
We are not going to overly focus on convincing you of the permanent change to the DNA of a person who was chronically exposed to opioids. Simply google the words and there is an enormous amount of evidence.
We do not know why the methylation of the DNA causes the cravings and behaviors associated with opioid addiction. If you ever felt you just simply could never control the cravings with sheer will power alone, well, now you know why.
We do not understand why the change in the DNA appears to be so permanent. Research into DNA is still in the early phases. We simply don’t have any data into how these DNA changes are passed down to the children of our people. But the methylation of the DNA can be found in the babies who experience withdrawal and what is known as neonatal abstinence syndrome. The severity of the symptoms of the baby appears to be related to the level of DNA methylation found in the baby.
Knowing that the DNA changes in our people appear to be permanent, and knowing there is a significant risk of relapse and death in our people when they stop the buprenorphine for whatever reason and for however long they were on it, knowing all this it would be unethical and irresponsible for us to push and advise our people to ever stop the buprenorphine without a very careful and thoughtful plan in place.
All that stated, tapering just doesn’t seem to carry with it the risk that is seen in completely stopping the buprenorphine. Properly done, never forced, and allowing the individual to be in charge at all times, tapering the dosage slowly appears to be a safe and effective strategy.
Tapering appears to be a safe and effective measure of how an individual is progressing in their addiction treatment. Think of tapering as one of the few yardsticks by which progress in addiction can be measured.
One may ask, “if there is risk, why even taper at all, why not just stay on 16 mgms a day and not worry about it?”. That is a legitimate point and one for which we put forth no argument. In fact, we know, that for a small number of our people, this is precisely the best possible plan of action. For the rest, tapering is well tolerated.
This is exactly why the world health organization states so strongly that treatment programs must be tailored to the individual.
WHEN DO I KNOW IF I AM READY TO TAPER?
Here is our simple advice – wait until three drug screens in a row are free from any unexpected results. Be sure you are ready. Don’t rush the process. For most people this will mean three months. That’s fine.
There is strength in staying on 16 mgms of buprenorphine a day, proving the individual has obtained some level of control over the addiction and relapse process, and then initiating a slow tapering process. This is going to be a lifelong journey. This never was and never will be a sprint to some imaginary finishing line.
WHY WILL YOUR PROGRAM NOT PRESCRIBE SUBUTEX?
First off let’s be clear. This program will not prescribe Subutex (buprenorphine without the addition of naloxone) except in the setting of a written request for buprenorphine by a pregnant patient’s provider.
There are no exceptions to this rule. If an individual needs Subutex for whatever reasons, side-effects, allergy, whatever, then this is not the proper program for that individual.
There is simply too much diversion seen with Subutex.
Treatment should be readily available - World Health Organization
I NEED MORE THAN 16 MGMS A DAY OF BUPRENORPHINE. WHY CAN I NOT GET THE DOSE OF BUPRENORPHINE THAT I NEED FROM THIS PROGRAM?
We are not going to prescribe over 16 mgms a day of buprenorphine through a telemedicine program. We do not doubt there are those individuals who require these higher doses of buprenorphine. But we would not consider these individuals requiring the higher dosages of buprenorphine to be good candidates for a telemedicine program.
WHAT ABOUT BENZODIAZEPINES?
We follow the guidance of the FDA. There is a well-documented risk of death in combining buprenorphine with benzodiazepines such as Xanax, valium, Klonopin, and Restoril. This risk of death will be on you, not on us. You were warned.
But the FDA has stated that we should not withhold buprenorphine from an individual due simply to the presence of a prescribed benzodiazepine.
Our job is to explain the risk of death from the drug combination to you. Your job is to decide what the appropriate action for you is. But the risk is on you. Not us.
WHAT IF I AM CURRENTLY ON METHADONE?
The transition from methadone to buprenorphine can be done. But it is not an easy transition. The difficulty is believed to arise from both the long half-life of methadone (which means it’s slowly metabolized, broken down by the body), and the fact that methadone so readily is absorbed by the fat in the body and sticks around a very long time. By comparison, heroin and oxycodone are metabolized in a few hours and don’t dissolve into the fat of the body.
The standard recommendation is to slowly taper down to 30 mgms of methadone a day. Once stabilized at 30 mgms a day, you are advised to wait 3-5 days before beginning the buprenorphine.
But don’t kid yourself. It’s one of the toughest things you will ever do.
WHY DO YOU RUN YOUR PROGRAM AS A WEEKLY SCHEDULE?
We have tried a number of formats. Quite frankly, daily meetings proved to be a bit intrusive for our people. The overwhelming majority of our people work and have families. The constant daily meetings were too much for many people.
We know there are people who really need a daily meeting. And there are plenty of daily programs at the community level. We encourage participation in these community level programs.
Conversely, monthly meetings proved to be too little. Thus, we have settled onto the weekly format. We currently have our mandatory weekly meeting on Thursday at 10 am. We record these meetings and send the recording out with a series of questions every week.
WHAT IS YOUR CO-MANAGEMENT PROGRAM?
All of our people have a primary provider, a provider who is active in our program and waivered by the DEA to prescribe buprenorphine. The DEA places a strict limit as to how many patients each provider can be prescribing buprenorphine at a given time. We pay close attention to these details.
That stated, when we come across something unexpected, particularly something that is worrisome, we have a program called our co-management program wherein, the individual we are concerned with is first seen by one of our providers and then discussed by our program's addictionologist. The primary question is always “is this someone who may more benefit from a more traditional or intensive program, possibly even an inpatient program”
The purpose and intent is not to be punitive but to do our best to ensure a person is active in the program best suited for their needs.
WHAT IF MY MEDICATION IS LOST OR STOLEN?
We simply cannot be replacing lost or stolen medication through telemedicine. You are asked and are required to keep your medication under lock and protected. Quite frankly, if you cannot keep and protect your medication from others, you may not be a good candidate for a telemedicine program.