Programs & Departments

OFR, Inc. primary focus is to provide high quality treatment to those suffering from the disease of addiction through our premier programs and services. Our agency consists of several departments which specialize in the treatment of addiction.

Programs:

Departments:

About Methadone

Introduction •   Methadone •   Interactions and Side Effects of Methadone
Your Methadone Dose •   Withdrawal From Methadone •   Pregnancy and Methadone

Introduction

The initial goal of methadone treatment is to free an opiate dependent person or heroin dependent person from the periodic withdrawal that prompts the regular use of illicit opiates or heroin. Methadone treatment is not appropriate for those people who are not currently physiologically addicted to heroin or other illicit opiates. A person may be physiologically addicted to opiates if they have been taking heroin or other opiates on a daily basis for extended periods of time and exhibit symptoms of withdrawal when they stop using these drugs. Along with irritability and cravings to use opiates within eight hours of discontinued use, the most common signs of opiate withdrawal are runny nose, large pupils, eyes tearing, sweating, chills, diarrhea, yawning, nausea, cramps, insomnia, joint pain, and gooseflesh. Prior to admitting any new patient for treatment, our physician will conduct a complete physical examination to determine whether methadone treatment is appropriate for that patient.

Methadone is a therapeutic tool of recovery for the opiate dependent person that may or may not be discontinued. For some people, the desired change in lifestyle may occur through a successful detoxification from heroin using decreasing doses of methadone. For other individuals, the use of a methadone maintenance program provides longer-term stability and the opportunity to slowly change many aspects of one’s life. We believe that you can have a happy and purposeful life while on a methadone maintenance program.

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Methadone

Methadone is a long acting synthetic opiate that is taken in a liquid oral form once per day. The proper dose of methadone remains effective for 24-36 hours and does not result in an altering of perceptions or euphoria. A person taking methadone is alert, energetic, able to function well, and feels no withdrawal symptoms between doses of the drug. It is important to note that a person with a pre-existing opiate or heroin dependency does not gain an additional addiction when he/she takes methadone. Methadone satisfies that person’s pre-existing opiate dependency in a safe, legal, and responsible manner under the supervision of medical professionals. Here, patients must participate in treatment as planned and prescribed. Missing a methadone dose may result in discomfort and the start of withdrawal. Once stable on the proper methadone dose, a patient will most likely feel less of a need to inject heroin, thus minimizing the health risks of HIV and hepatitis B and C. Patients who stop using heroin and other drugs can altogether avoid the possibility of overdosing. Methadone treatment is provided in an environment where medical and counseling services are readily available. Here, many methadone patients make changes in their lives and build support systems that allow them to improve their health and stay sober.

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Interactions and Side Effects of Methadone

Methadone may be interactive with other drugs and alcohol. Please tell our physician if you are taking any prescriptions or have a dependency or addiction for another drug. The use of other opiates, benzodiazepines, and alcohol may be dangerous in combination with methadone. You may experience some side effects during treatment but these are usually minimal and short-lived. Please read the list below and notify the medical staff if you experience any of the following symptoms: light headedness, dizziness, extreme tiredness, nausea and vomiting, sweating, ankle swelling, skin rash, restlessness, malaise, weakness, headache, insomnia, agitation, disorientation, visual disturbance, constipation, dry mouth, flushing of the face, low heart rate, faintness and fainting, problems urinating, changes in sexual drive, irregular menstruation, joint pain, joint swelling, and numbness.

Warning: (PENTAZOCINE) TALWIN and RIFAMPTIN cannot be used by patients on methadone.

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Your Methadone Dose

It is the intention of Organization for Recovery, Inc., to have every client on the correct dosage of methadone. We recognize that a dose too low produces unnecessary withdrawal discomfort and invites the risk of heroin use. We also know that a dose too high produces undesirable side effects and provides no additional benefit to the client. Achieving and maintaining the correct dosage requires cooperation between the client and the staff. All clients will be informed of their dosage upon request. Minor dosage adjustments may be made by the nurse in accordance with the standing orders of the physician.

Where a requested dosage change does not fall within the parameters of the physician’s standing orders, a medicating nurse must receive a new verbal or written order from the program physician to change a client’s dose. If a client is experiencing physical discomfort and believes he/she needs a higher dose, the client may request an appointment with the program physician. If, after reviewing the physical symptoms with the client, the physician supports the need for a dose change, a new medication order reflecting the changed dose would be written and presented to the nursing staff.

In limited circumstances, the program physician may also change a medication order by issuing a verbal order to a nurse. Where a physician is providing a verbal order to change a dose without seeing a client, the client shall be required to meet with other involved staff (Clinical Supervisor or Primary Counselor and Nurse) so that additional information may be provided to the physician prior to his/her decision regarding a change in dosage.

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Withdrawal From Methadone

Because methadone has a longer half-life than heroin, withdrawal from methadone takes longer than withdrawal from heroin. With heroin withdrawal, the most substantial symptoms are over within the first three to five days. With methadone, the initial symptoms are frequently less severe, but they can last from ten days to two weeks. The longer duration of methadone withdrawal is not always well tolerated. However, if the patient follows a medically supervised tapering schedule that accounts for and is readjusted to received signs from the patient’s body, withdrawal from methadone may be achieved without extreme discomfort.

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Pregnancy and Methadone

Federal Treatment Improvement Protocols state the following:

Pregnant women users who are in treatment with methadone deliver healthy babies. It is true that babies born to women on methadone sometimes experience some withdrawal symptoms during the first several days after birth. The symptoms are routinely treated by the baby’s pediatrician and do not result in any long-term damage. In addition, babies born to women on methadone tend to have a slightly lower birth weight than babies of non-addicted control mothers. The most important comparison, however, is not how these babies compare with non-addicted controls, but rather how they compare with babies of mothers addicted to heroin. Studies that have compared babies born to mothers in methadone treatment with babies born to mothers who use heroin have demonstrated tremendous benefits from methadone.

Methadone treatment allows the mother to be followed in prenatal care, to receive nutritional supplements, information and to participate in parenting classes. The vast weight of evidence supports the use of methadone with heroin-addicted women to reduce the risk of miscarriage, increase birth weight, reduce infection and HIV risk to fetus, and generally produce a much greater chance for a healthy baby.

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What is Suboxone?

Suboxone is a medication that:

  • Reduces withdrawal symptoms and cravings in people who are dependent on (addicted to) heroin or prescription opioids
  • Helps people stay on course with their treatment
  • Should only be taken under a doctor’s case and used in combination with counseling

Suboxone (sometimes called “bupe”) is a tablet that dissolves under the tongue and is made up of 2 ingredients: buprenorphine and naloxone. Buprenorphine suppresses withdrawal symptoms and decreases cravings. Naloxone is added to discourage misuse of this medication. If the medication is crushed and then injected or snorted, the naloxone may cause withdrawal symptoms. If suboxone is takenas directed, the naloxone will not cause withdrawal symptoms.

Is treatment with Suboxone just trading one dependence for another?

All opioids can cause physical dependence. However, it is important to remember that suboxone is a medication provided to you under a doctor’s care to treat dependence. This medication helps manage withdrawal and reduces cravings so that you can focus on counseling and improving other aspects of life. When the time is right, a doctor can help you come off suboxone by gradually reducing the dose.

How is Suboxone different?

Suboxone may produce less physical dependence, less of a “high,” and milder withdrawal symptoms than many other opioids. For some patients, suboxone may be an alternative therapy. You should consult with your doctor to see if suboxone may be right for you.

What are the risks to consider?

  • Suboxone (buprenorphine hcl/naloxone hcl dihydrate ciii sublingual tablets) indicated for the treatment of opioid dependence.
  • Buprenorphine, particularly when taken by the intravenous route, in combination with bezdiazepines or other cns depressants (including alcohol) has been associated with significant respiratory depression and death.
  • Suboxone has potential for abuse and produces dependence of the opioid type, with a milder withdrawal symdrome than full agonists.
  • Cytolytic hepatitis and hepatitis with jaundice have been observed in the addicted popluation receiving buprenorphine.
  • There are no adequate and well-controlled studies of suboxone (a category C medication) in pregnancy.
  • Caution should be exercised when driving cars or operating machinery.
  • Always store buprenorphine-containing medications safely and out of reach and sight of children. Destroy any unused medication appropriately.
  • The most commonly reported adverse events with Suboxone include: headache, withdrawal syndrome, pain, insomnia, nausea, and constipulation. Please see full prescribing information for a complete list.