Dr James Schaller
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SUBOXONE AND OPIOID DETOXIFICATION:
METHADONE, PERCOCET & OXYCONTIN

I AM PLEASED TO SEE THAT A GOVERNMENT AGENCY HAS MADE A WAY FOR SUFFERING ADDICTS, HOOKED ON METHADONE OR OXYCODONE PRODUCTS, TO NOW BE ABLE TO WORK, INSTEAD OF LIVING IN A METHADONE CENTER. FURTHER, THOSE ABUSING PERCOCETS AND OTHER OPIOIDS CAN STOP SEEKING THEM FROM ILLEGAL SOURCES OR ABUSING AFTER THEIR PAIN IS HEALED.

"The price
of freedom is
constant vigilance."
Thomas Jefferson

I am certified with a second DEA license to dispense Suboxone, which is a very special opioid, which many patients appreciate. In contrast to the struggle many have with tapering off methadone and other opioids, Suboxone is quite good at allowing a comfortable taper. And if you do not want to taper, you can get this medication merely called in, without the troubles associated with other opioids. If you are ever in severe pain, you would simply stop this complex opioid, and go on common pain medications, and then when healed and the pain is low, switch back to Suboxone.

This medication is not recommended with IV benzodiazapines, and oral benzodiazapines have to be used carefully. The number of physicians trained and approved in prescribing this medication nationally, is still quite small. I guess many doctors are too busy fighting all those malpractice lawsuits. Perhaps because physicians fear the state medical boards, the DEA or the FDA, and believe these entities will harass them. Further, some pharmacists have said in word and deed, they "hate" dealing with Suboxone—perhaps due to all the paper work involved, and the fact it only comes in 30 pill units. For example, in my area of Florida, only one other doctor has this certification the last time I checked. It is hoped others will be able to serve you with this medication. In Harrisburg, Pennsylvania, are only two in the entire city.

So if you are accepted into a practice, please try to comply with the basics requested of you. Most physicians want to keep a close eye on you the first few days you are on this medication. Do not complain or try to get the doctor to change their protocol, it beats the alternative! However, after the first week, you should not be required to come in daily. Certainly, having sessions more than weekly with your doctor can be difficult.

Generally, in using this medication, you will stop your opioid and try to go as long as possible without it. Then when having mild withdrawal, you start with 2 mg of Suboxone under the tongue, and add one every hour till relief. If you lose relief and have withdrawal sensations, you take another. It is common, in the first day to need 2 mg every 45 minutes or so. The following day, you start the day with approximately the amount used the day before. Commonly, you will need to tune the dose on day 2 and 3 slightly. Some teach this is a once a day medication, but those that remain on it, and do not wean themselves down, often prefer an am and afternoon dose.

If you find yourself increasing to a high dose which is off label, e.g., 22 mg, consider you might have some other medical problem that could be causing pain, e.g., Lyme disease. And you would need testing from IgeneX to see if that is hindering your drug recovery. Do not consider Suboxone a strong painkiller like methadone or oxycodone. Also, it is not an escape drug, though many feel very comfortable on it.

You likely have issues you need to grow in, and try to not pretend you are a finished product. However, Suboxone is meant to give you a life, not make the doctor your new clinic with merely a different drug.

Best Wishes to Your Health,

Dr. J



Bank Towers, Tamiami Trail, Naples, FL
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