The FDA approval of Subutex and Suboxone for the treatment of opiate dependence led to significant changes in addiction treatment, with a major shift to outpatient based care. Individuals seeking sobriety suddenly had many more options than just inpatient treatment. These medications are based on the active ingredient Buprenorphine, which is classified as a partial opiate agonist/ antagonist, which dramatically suppresses opiate withdrawal symptoms and opiate cravings without creating the same intoxication created by conventional opiates. Subutex and Suboxone can be used both for relapse prevention maintenance treatment and opiate detoxification.
Suboxone is the medication preferentially used for relapse prevention maintenance. Suboxone maintenance, in motivated patients who are also involved in structured relapse prevention programs, has extraordinarily high success rates with both short and long term sobriety. In patients with a history of multiple failed detox attempts and very limited periods of sobriety, Suboxone maintenance is considered an appropriate treatment choice. Subutex is usually not used for maintenance, unless the patient has certain medical conditions that would specifically require the use of Subutex instead of Suboxone. Contrary to certain extreme opinions that are not based on clinical data, individuals on prescribed Suboxone maintenance are considered to be fully clean and sober, so long as they remain abstinent from all illicit substances and behaviors. It is the immediate gratification from an intoxicating substance or illicit behavior that creates a breach in sobriety, not the suppression of cravings created by Buprenorphine. Suboxone maintenance can even be managed effectively in a properly structured sober living facility.
Sober living homes can function effectively while having individuals on Suboxone maintenance for relapse prevention. This requires a well-supervised setting, a direct affiliation with an outpatient medical facility, and appropriate structure. The proper structure involves management of the Suboxone itself by the outpatient medical facility, while the living facility provides overnight accountability and a supportive environment. Frequent drug and alcohol testing is required, to verify compliance with the Suboxone and to assess continued abstinence from other substances. The Pheonix House Suboxone program was specifically developed to provide the appropriate structure and support for individuals that are early in in their recovery and on Suboxone maintenance. The program is directed by Raul J Rodriguez MD, DABPN, DABAM, MRO, a double Board Certified Psychiatrist and Addictionologist that has extensive experience and expertise in the clinical applications of Suboxone in the treatment of opiate addiction. All Pheonix House Suboxone program participants are under the direct care of Dr Rodriguez.