Before induction: (Buprenorphine ONLY)

Heroin, prescription painkillers, and methadone all belong to a family of drugs called the opioids. Before you start on buprenorphine, your provider will ask you to stay off all opioids for a little while--usually less than a day, Vivitrol is typically longer between 7-10 days. The exact amount of time you'll need to stay off opioids depends on what kind of drugs you've been taking and how much you use per day.

After going for a day or two without using opioids, you will be in the early stages of withdrawal. You may feel uncomfortable for a little while, but you will feel better when you start taking buprenorphine. Vivitrol clients may need to enter a local detox program to maintain opiate free prior to induction.

If you do slip up and use an opioid during this time, you run the risk of going into sudden, intense withdrawal. Tell your provider if you used opioids, and he or she will reschedule your induction.

Miami Valley Recovery Requirements:

• 24 Hours of Opiate Withdrawal
• (2) day induction process
• History and Physical Examination
• Have a trusted individual pickup your medication at a local pharmacy during induction day 1
• Make sure you have transportation setup with a trusted individual, bus, or through your insurance

During induction:

Over the course of a few days (usually 1-3 days), your provider will gradually increase your dose of buprenorphine until he or she finds your ideal dose.

• During this time DON'T use any opioids --you will probably go into withdrawal and be very uncomfortable!
• DO expect to spend an extended period of time (2-4 hours each day) in the provider's office --your provider will need to keep you under observation while you adjust to the medication.
• DO be prepared for a few days of craving -- you may crave opioids until the buprenorphine begins to kick in, but it is very important that you do not use them!
• DO be honest with your provider how you're feeling --your provider needs to know about your mood, your level of craving, and your physical state to accurately determine your ideal dose of buprenorphine.

Induction Day 1:

Plan on spending (4) hours minimum at Miami Valley Recovery. Your induction process will go as followed:

• Arrive 20 minutes early to your scheduled appointment. This will allow you to provide a urine screen and be checked by the nurse.
• Nurse evaluation – COWS scale
• Meet with the doctor for approximately (60) minutes.
• Post doctors visit, your trusted individual will pick up your medication at the pharmacy
• Maximum does for Buprenorphine will be 12/mg your first day.
• Client will start at 4/mg and be re-evaluated every 30 minutes.

Induction Day 2: (Buprenorphine ONLY)

Plan on spending up to (2) hours at Miami Valley Recovery.

• DO NOT take any Buprenorphine prior the day (2) appointment. This will determine if you need to adjust your medication.

Orientation (All Clients): Your medication will be called in until your Orientation session has been completed. Make sure you schedule your orientation session prior to you leaving your Day (2) induration. Orientation is a REQUIREMENT and is a (1) time session.

After induction:

• DON'T stop using buprenorphine without talking to your provider --you will go into withdrawal.
• DO tell your provider if you experience side effects due to the buprenorphine or if you crave opioids --your dose may need to be adjusted if you do.
• DO take advantage of therapy and other resources that can help you stay drug free and stable!

Ongoing Treatment: (All Clients)

Group Therapy: Based on your determined LOC (Level of Care) at Assessment, you will be required to attend a minimum number of groups per week. You will have the opportunity to pick your group days and times as long as your group days are not (3) or (2) consecutive days. Please arrive (15) minutes early, make sure you schedule transportation appropriately. Do NOT be late for Group Therapy!

Individual Therapy: Individual sessions will be a minimum every other week. You must provide a urine PRIOR to your session. Show up (15) minutes early to your session.

Family Sessions: These are NOT requirements but do provide extreme therapeutic value through the course of your recovery. Discuss this with your counselor if you are interested in a Family Session.

Doctor Follow up Appointments: Your doctor’s visits will be scheduled every (30) days or once a month. If you miss your doctor’s appointment your medication CAN’T be called in. If you have a scheduling conflict, you may have the ability to see the doctor a week prior.

Case Management: Case Management services can be provided “as needed” during the course of your treatment.

Toxicology Services: Urine collection will be a requirement.

By signing below I agree that I have received a copy of this document and understand the necessity of complying with all of the above requirements for my continued participation at Miami Valley Recovery.