Frequently Asked Questions
The following are some of the most frequently asked questions that we hear at Central Florida Treatment Centers:
How long do I have to be on medication?
Everyone is different, and there is much more to treatment than taking medication. Drug dependency is a mental, physical, emotional and spiritual disease. Frequently, it has taken years to get to treatment, so the idea that it should only take a few weeks to recover is not realistic.
Ideally, once you are on a stable dose and not having withdrawal symptoms, you should quickly become free of opioids. With the help of your counselor, you should also become free of all illicit drug use and free of alcohol. Once the drugs are out of the system, treatment can truly begin. The goal of medication-assisted treatment is long-term abstinence from mood-altering substances and a rebuilding of a healthy mental, physical, emotional and spiritual lifestyle. Rarely does a patient accomplish this task in less than 6 to 12 months. Once healthy and solid in your recovery, the decision to become a maintenance patient (one who remains at a stable therapeutic dose) or to taper off can be made. For someone tapering from methadone, we recommend no faster than a one- to three-milligram reduction each week with the goal being no withdrawal symptoms. This can take a long time but has been found to be the most successful. If a patient insists, they may taper at a quicker rate.
Can I do a short-term detox?
For us, a short-term detox is a six-month protocol. We have found that a quick detox rarely produces any positive long-term results and more often than not results in the return to illicit drug use. This is a significant disease, and it probably took a long time to get to where medication-assisted treatment is needed, so a quick solution is likely not a good one.
Can I use my insurance to pay for treatment?
Unfortunately, most insurance does not cover medication-assisted treatment with methadone. Some of our patients have been able to submit to their prescription drug plan for reimbursement at an out-of-network rate. We can assist you in this, but most patients are private-pay.
I have Medicaid – will that cover treatment?
Yes, full Medicaid does cover methadone treatment. A share of cost and other Medicaid programs are beyond our billing capabilities and so are not accepted. The cost would be a $2 co-pay per week.
Can I just get a prescription for suboxone?
Not from us. Some private physicians are able to treat opioid dependence in their office using suboxone. We, however, do all of the treatment in our clinics, and while a successful suboxone patient could be eligible for take-homes sooner than a methadone patient, they would not get a prescription. When a suboxone patient is so successful that they no longer need the structure of our clinic, they can be referred to a private physician.
How often do I have to come to the clinic?
Initially, patients attend the clinic seven days a week for dosing. There is a minimum requirement of weekly counseling (we can do more if desired) as well. As a patient is successful in treatment and begins meeting the criteria for take-homes, attendance can be reduced.
What dose will I start at, and will I get dosed the first day?
It depends on many factors. Patients who are assessed as still under the influence may not get dosed the first day, but most patients will receive their first dose on the day of admission. The rule for safety is to start low and increase slowly. Patients will not get an initial dose of more than 30 milligrams as it is considered unsafe to start someone at any higher dose.
What should I bring the first day?
We recommend that a patient come the first day with a picture ID, the intake fee and the first week’s treatment fee (we have found that patients who pay for a week come to treatment for a week, and at the end of a week, everyone feels better). You should also bring proof of income to establish that you will be able to pay for treatment. We also encourage you to bring family members who can help you adjust and support you in your early recovery.
What age do you treat?
Adults over 18 years of age only.
I am pregnant, what should I do?
If you are pregnant and opioid-dependent, then methadone treatment is the best program to protect you and your baby from the risks of illicit drug use: being high, normal, sick over and over, withdrawal, stress and everything that is involved in active drug addiction.
I’ve heard that after 30 days, I can get a take home, is that true?
That is true, but that is not all the information. The first criteria looked at for take-home privileges is time in treatment, and 30 days is the minimum time for the first take-home, but there are seven more criteria that need to be assessed before someone is eligible for a take-home: the absence of drug and alcohol use, regular attendance at counseling sessions, no evidence of behavioral problems, no recent criminal activity, home environment and relationship stability, assurance that take-homes will be safe and properly managed in the home, verifiable proof of legitimate income, and satisfactory progress in treatment. These are the criteria that need to be met to be eligible for take-homes.
Do you have a sliding fee scale?
No, CFTC’s sole source of funding is private patient payment and Medicaid.
Differences between methadone and suboxone
With suboxone, there is a ceiling dose of 32 milligrams, which no one exceeds. It is reportedly a simpler medication to taper off of, and that, combined with the lower dose, makes tapering to zero milligrams a quicker process. Additionally, suboxone is indicated for patients who may have a shorter history of opioid dependence and may not be appropriate for methadone maintenance treatment.
What is Buprenorphine?
Buprenorphine is a partial opioid agonist which means that its opioid effects are limited when compared to substances like Oxycontin or heroin, which are full opioid agonists. Buprenorphine binds to opioid receptors allowing opioid dependent individuals to discontinue use of opioids without experiencing withdrawal symptoms. The safety profile of buprenorphine, pharmacologically, makes it an attractive treatment option for patients addicted to opioids.
What is Naloxone?
Naloxone is an opioid antagonist. Naloxone also binds to brain receptors, but instead of activating, they block receptors keeping them from being activated.
Is there an average length of time that a patient would be on Methadone?
Everyone is different and there is much more to treatment than taking medication. Drug dependency is a mental, physical, emotional, and spiritual disease. Frequently it has taken years to get to treatment so the idea that it should only take a few weeks to recover is not realistic.
Ideally, once you are on a stable dose and not having withdrawal symptoms, you should quickly become free of opioids. With the help of your counselor, you should also become free of all illicit drug use and free of alcohol. Once the drugs are out of the system, treatment can truly begin. The goal of Medication Assisted Treatment is long-term abstinence from mood-altering substances and a rebuilding of a healthy mental, physical, emotional, and spiritual lifestyle. Rarely does a patient accomplish this task in less than 6 to 12 months. Once healthy and solid in your recovery, the decision to become a maintenance patient (one who remains at a stable therapeutic dose) or to taper off can be made. The length of treatment varies with each individual patient and is affected by many factors such as abused drug of choice, length of addiction and level of dependency, and previous treatment and relapse history.