What Are the Stages of SUBOXONE Therapy?
There are 4 major stages of SUBOXONE therapy: 1) Induction 2) Stabilization 3) Maintenance 4) Medical withdrawal Of course, patient education and preparation are important during all four phases of treatment, but they are particularly important when guiding patients through the induction stage. It is critical that the patient understands the need to arrive for induction while in a mild-to-moderate state of withdrawal.6 By discussing a patient’s specific physical withdrawal symptoms during the initial intake interview process, you can readily identify them when the patient returns to the office for induction. Tools like the Clinical Opiate Withdrawal Scale (COWS) [PDF–Size: 46KB] can be helpful when assessing a patient’s level of withdrawal. If a full opioid agonist is still active in the patient’s system when starting induction, SUBOXONE may precipitate severe withdrawal symptoms as buprenorphine displaces the full agonist from the mu-receptors. However, when the patient is in mild-to-
There are several stages of SUBOXONE therapy: induction, stabilization, maintenance, and medical withdrawal. Counseling should be integrated into all phases of SUBOXONE treatment. During induction, the patient should be in a state of mild-to-moderate withdrawal. The healthcare professional, usually the physician, assesses the patient’s withdrawal symptoms and administers the first dose of SUBOXONE. After the medication begins to take effect (within 30 minutes to 1 hour), the patient’s symptoms are reassessed and, if necessary, a second dose may be given. The patient should return to the doctor’s office as scheduled (usually within 24 hours) for continued evaluation of clinical response. The stabilization period provides the time to find the best individualized SUBOXONE dose that keeps withdrawal symptoms and cravings under control and retains the patient in treatment. As a counselor, you may be able to assess whether pharmacotherapy is achieving these goals and recommend adjustments. T
