FAQs: Patients

What is IntegraMedical of North Carolina?

IntegraMedical of North Carolina is a newly-formed company committed to addressing heroin and prescription opioid abuse and dependency in rural and underserved communities throughout North Carolina. Every month, we will visit a community near you with a mobile medical unit (MMU), staffed with trained professionals, to provide medication-assisted treatment (MAT) and counseling to those who are ready to get help.

What is medication-assisted treatment (MAT)?

Medication-assisted treatment (MAT) is the treatment of heroin or opioid dependency or addiction with buprenorphine. Brand names of buprenorphine include SubutexButrans, BelbucaBuprenex; brand names of buprenorphine in combination with naloxone include SuboxoneZubsolv, and Bunavail.

What is buprenorphine and how does it work?

Buprenorphine is an opioid partial agonist. This means that, like opioids, it produces effects such as euphoria or respiratory depression. With buprenorphine, however, these effects are weaker than those of full drugs such as heroin and methadone.

Buprenorphine’s opioid effects increase with each dose until, at moderate doses, they level off, even with further dose increases. This “ceiling effect” lowers the risk of misuse, dependency, and side effects. Also, because of buprenorphine’s long-acting agent, many patients may not have to take it every day.

What is naloxone?

Naloxone is added to buprenorphine to decrease the likelihood of diversion and misuse of the combination drug product. When these products are taken as sublingual tablets, buprenorphine’s opioid effects dominate and naloxone blocks opioid withdrawals. If the sublingual tablets are crushed and injected, however, the naloxone effect dominates and can bring on opioid withdrawals.

Isn’t treating addiction with buprenorphine just trading one addiction for another?

Absolutely not! Opioid addiction is a chronic disease, the same as diabetes and asthma are chronic diseases. Treating a disease with medication is a common practice, with the ultimate goal being to control the disease and to prevent a relapse.

Will I have to take buprenorphine forever?

In some cases, yes, the same as a diabetic has to take his or her medication forever. Some patients, though, do enter treatment with the ultimate goal of completely eliminating opioids from their life. With proper care, these patients can achieve that goal.

What are the risks of taking buprenorphine?

This is not a full list of the risks of buprenorphine. Please refer to the printed insert of the specific drug you are prescribed for a complete list of the risks associated with the use of that drug. While buprenorphine is an effective drug for the treatment of opioid dependency, it does have some potential for abuse. Chronic use can lead to physical dependency. Tell your doctor about any liver-related health issues you may have so your doctor can monitor those issues.Taking buprenorphine other than as it is prescribed can lead to loss of consciousness or even death; it should never be taken in combination with benzodiazepines or other medications that act on the nervous system (such as sedatives, tranquilizers, or alcohol); it should not be taken by anyone who is not opioid dependent.

What is the treatment process?

Buprenorphine treatment happens in three phases:

1. The Induction Phase is the medically monitored startup of buprenorphine treatment performed in a qualified physician’s office using approved buprenorphine products. The medication is administered when a person with an opioid dependency has abstained from using opioids for 12 to 24 hours and is in the early stages of opioid withdrawal. It is important to note that buprenorphine can bring on acute withdrawal for patients who are not in the early stages of withdrawal and who have other opioids in their bloodstream.

2. The Stabilization Phase begins after a patient has discontinued or greatly reduced their misuse of the problem drug, no longer has cravings, and experiences few, if any, side effects. The buprenorphine dose may need to be adjusted during this phase. Because of the long-acting agent of buprenorphine, once patients have been stabilized, they can sometimes switch to alternate-day dosing instead of dosing every day.

3. The Maintenance Phase occurs when a patient is doing well on a steady dose of buprenorphine. The length of time of the maintenance phase is tailored to each patient and could be indefinite. Once an individual is stabilized, an alternative approach would be to go into a medically supervised withdrawal, which makes the transition from a physically dependent state smoother. People then can engage in further rehabilitation—with or without MAT—to prevent a possible relapse.

What if I have withdrawal symptoms after taking my first dose of buprenorphine?

You must wait until you are experiencing the early symptoms of withdrawal before taking your first dose of buprenorphine. If you experience severe withdrawal symptoms after taking your first dose, you should go to your local emergency room. It is likely that you didn’t wait long enough for opioids to clear your bloodstream. Taking more buprenorphine will not make the withdrawal symptoms go away.

Why do I have to pay $50 to make an appointment?

The initial $50 fee is to cover the cost of your initial dose of medication so that we can have it available for you at your first appointment. You will have to visit with a doctor prior to getting your prescription; the doctor will examine you, evaluate your situation and decide if you are a candidate for MAT. If you are a candidate, the doctor will write you a prescription and a pharmacist will be available to fill it for you right away.

What happens if the doctor decides I can’t start buprenorphine treatment? Will I get my money back?

Yes, we will refund your money to the credit card or debit card with which it was paid.

What happens if I don’t show up for my appointment? Will I get my money back?

No, we won’t be able to issue you a refund if you don’t show up for your appointment.

How much does each appointment with a doctor cost?

Each office visit with a doctor is $175.00.

Do I have to visit the MMU every day to get my medicine?

No. Treatment with buprenorphine is not like treatment with methadone. You do not have to visit the MMU every day to get your medication.

How much does the medication cost?

The cost of the medication varies for each person and depends on the dosage and frequency. For a month’s worth of medication, you should expect to pay between $300 and $1,000.

How do I pay?

We only accept credit cards or debit cards. We do not accept cash or checks.

Do you take insurance or Medicaid?

At this time we do not accept any third-party payers. However, we will provide you with the documentation you need to request reimbursement from your insurance company.

What if I can’t afford the office visit or the medication?

Ask a friend or family member to help you. Friends or family may be willing to help with the cost of a loved one trying to get help for substance dependency.

 

Some of the information included on this page was reproduced from the SAMHSA website.

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