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shelwoy
 
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If you were to enter a Suboxone assisted addiction recovery program on an outpatient basis, what do you feel would be the most important aspects of the program-in regards to your obtaining long term recovery?
What would make you more likely to choose a specific program? ( Other than cost/insurance acceptance. I am ooking for responses that gear more towards the inner workings of a recovery program)
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Matt2
 
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To me the best approach would have an intro at induction that made clear to the patient the statistics about the higher success rate of Suboxone maintenance compared to those who taper off and while not trying to discourage anyone explain the succes rate of opiate addicts who aren't on Suboxone/medication assisted recovery. Our culture had me thinking that 12 step programs were the only and best way to get and stay clean. I'm not saying 12 step programs are bad or anything because they can help a select few but when only about 10% of opiate addicts are able to stay clean for a year and after 5 years as Dr. Junig has continually pointed out that the percentage of clean opiate addicts virtually hits 0%. I would make it clear to patients up front that opiate addiction is truly deadly. I always thought I was different and that I was too smart to OD but I wasn't and I did just like can happen to EVERY other using opiate addict. All of this is not to make success sound hopeless to someone trying to get clean. Instead it's intended to have them see how truly difficult it is to stop using. Basically I'm saying that the person trying to get and stay clean should have all options presented to them and the success rates of each. I also am of the opinion that for someone who's chosen Suboxone maintenance don't neccessarily need to attend therapy or go to 12 step meetings. They could find other people who aren't using anymore at a meeting but usually once others find out the person is on Suboxone they then totally shun him/her. Also I can say from experience that the only way a 12 step program kept me clean was not being on Suboxone and being truly and utterly desperate to the point of to the point that they can change who they are and constantly participate in service work and usually daily meetings. After I started Suboxone and attended some meetings I didn't feel like they were hurting me but I really felt "normal" which made me completely unable and unwilling to change who I am. It is soooo much work too as in there are daily things that must be done daily for the rest of your life. It's nearly impossible for someone to fundamentally change who they are. I don't know about anyone else but while someone may say at a meeting that they've "changed" I've noticed many if not most still practicing using behaviors outside of meetings. I guess I'm just saying that any treatment program should educate the patient on success rates of different forms of treatment and success rates, and explaining the actual details and potential consequences of each instead of just throwing all opiate addicts who come in into the more culturally acceptable 12 step programs. Society really has to be able to form a rational perspective on drug treatment options instead of seeing 12 steps good, and everything other choice as bad.
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Dr. Jeffrey Junig, M.D., Ph.D.
  • Board Certified Psychiatrist
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