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Buprenorphine Induction

PA Suboxone Doctor

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Buprenorphine Induction: Your Journey Toward Recovery with Dr. Watson

Congratulations! You’ve Taken the First Step 

You’ve completed your initial visit with Dr. Watson and have been prescribed your medication.  Now, it’s time to begin your journey toward recovery.

The first crucial step is the induction process, where you transition from your current opioids to buprenorphine (Suboxone).  

Understanding the Risks

What is Precipitated Withdrawal? 

Precipitated withdrawal can occur if buprenorphine, which has a high affinity for mu receptors, replaces other opioids you may have been using. This can cause severe withdrawal symptoms. 

How to Avoid Precipitated Withdrawal 

  • Ensure Adequate Withdrawal: Wait until you’re in moderate withdrawal (COWS > 12) before initiating buprenorphine. 
  • Start Low: Begin with a lower dose of 2.0mg/0.5mg to 4.0mg/1.0mg. 
  • Reassess: Wait 30-60 minutes before taking additional medication. 

If done correctly, you should go from feeling bad to feeling better.  

Timing Is Key

  • Long-Acting Opioids (e.g., Methadone): Wait 48-72 hours after last use.
  • Short-Acting Opioids (e.g., Heron): Wait approximately 12 hours after last use.
  • Fentanyl: May require more than 12 hours. 

Assessing Your Symptoms

You’re the best judge of when you’re ready for induction. You should be experiencing  symptoms similar to having the flu.  

What is COWS score? 

The COWS (Clinical Opiate Withdrawal Scale) score measures acute opioid withdrawal. A score  of 13 or higher indicates that you’re ready to begin induction.

Interactive COWS Score Links: 

COWS Induction Flow Sheet
Interactive COWS Calculator
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Your Path to Opioid Recovery with Direct Physician Care

Direct Physician Care with Dr. Watson gives you access to a precise and focused route to recovery. This streamlined approach eliminates distractions, providing the best opportunity for a successful and enduring recovery.

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Steps for Buprenorphine Induction

  1. Stop Opioids: Refrain from taking any opioids for 12-36 hours before induction.
  2. Assess Symptoms: Before the first dose, make sure you have at least three withdrawal  symptoms or a COWS score of ≥13.
  3. Initial Dose: Place ¼ – ½ film/tablet under your tongue to dissolve slowly.
  4. Reassess: After 30-60 minutes, reassess your symptoms. You should be feeling better.
  5. Complete Daily Dose: If you’re feeling better, you may take the remaining dose for the day.
  6. Maintenance: Continue with your prescribed daily dose until your next visit. 
12 Hours A Year is All it Takes For Lasting Recovery

When done correctly our patients devote as little as one hour a month, to maintain their sobriety.

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Important Note!

If you begin to feel worse after the initial dose, do not take more, as it can exacerbate your symptoms. The only cure for precipitated withdrawal is time. 

Congratulations! You’re on your path to recovery. If you have any questions, Dr. Watson is just a call away.

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FAQ's About Buprenorphine Induction

Suboxone treatment is ideal for those seeking a convenient and effective opioid dependency treatment that can be managed at home.

Suboxone can be taken at home and focuses on improving your quality of life, unlike methadone, which requires daily visits to a clinic.

Yes, we also provide Zubsolv and various generic buprenorphine options.

Dr. Watson believes in direct physician care; the frequency of appointments will be personalized based on your treatment needs.

Cost varies depending on your treatment plan. Financial options are available to reduce burden.

For more information or to schedule an appointment, contact us today. Together, let’s take the first step toward a life of freedom and well-being.

Helpful Resources

(1) https://www.mdcalc.com

(2) https://www.asam.org