Medication-Assisted Treatment Pioneers
Opioid Use Disorder Treatment
We were among the first private practices in the Bay Area to adopt buprenorphine treatment for opioid use disorder—and we remain experts in its use for both addiction recovery and chronic pain management.
Understanding
Opioid Use Disorder
Opioid use disorder (OUD) can develop from prescription pain medication, heroin, or synthetic opioids like fentanyl. The common thread is the same: physical dependence combined with psychological compulsion that makes stopping extraordinarily difficult without medical support.
Medication-assisted treatment (MAT) is now the gold standard—not a crutch, but a lifesaving intervention that normalizes brain chemistry and allows patients to rebuild their lives. We've seen this work for hundreds of patients.
Whether you developed dependence from chronic pain treatment or recreational use, our approach is the same: expert medical care, psychotherapy, and structured accountability.
Brain Changes
Chronic opioid use alters reward pathways—this is physiology, not weakness.
Physical Dependence
Withdrawal symptoms make quitting difficult without medical support.
MAT Works
Buprenorphine reduces mortality by 50%+ and dramatically improves outcomes.
Recovery is Possible
With proper treatment, many patients maintain long-term recovery.
Buprenorphine Treatment
Dr. Abramson was among the first physicians in the Bay Area to obtain the DEA X-waiver to prescribe buprenorphine when it became available in 2002. We have over two decades of experience with this medication.
Buprenorphine (available as Suboxone, Subutex, Sublocade, and generic formulations) is a partial opioid agonist that:
- Eliminates withdrawal symptoms and cravings
- Blocks the effects of other opioids (preventing relapse from being "rewarding")
- Has a "ceiling effect" that makes overdose far less likely
- Can be prescribed in an outpatient setting (no methadone clinic required)
For Opioid Use Disorder
The primary indication. We typically begin with daily sublingual dosing and adjust based on response. Many patients eventually transition to extended-release injectable formulations (Sublocade) for convenience and to eliminate diversion concerns.
For Chronic Pain
Buprenorphine is also an effective analgesic with a better safety profile than full agonist opioids. For patients with chronic pain who have developed tolerance or dependence on other opioids, buprenorphine can provide pain control while stabilizing their opioid use.
Dual Diagnosis
Many patients have both chronic pain and opioid use disorder—a situation poorly served by traditional pain clinics or addiction programs alone. Our integrated approach addresses both simultaneously.
Additional Medications
Buprenorphine isn't the only option. We individualize treatment based on each patient's situation.
Naltrexone / Vivitrol
For patients who have completed detoxification and want to remain completely opioid-free. Blocks opioid receptors entirely. Available as daily oral medication or monthly injection.
Sublocade & Brixadi
Long-acting injectable buprenorphine formulations that provide steady-state levels for weeks to a month. Ideal for stable patients who want to eliminate daily dosing or for those requiring verified medication compliance.
Adjunctive Medications
We use clonidine, gabapentin, and other medications to manage withdrawal symptoms, anxiety, and sleep disruption that often accompany early recovery.
How Treatment Works
Initial Assessment
Comprehensive evaluation of substance use history, medical conditions, psychiatric comorbidities, and social situation. We'll discuss goals and develop a treatment plan.
Induction
Careful initiation of buprenorphine treatment, typically starting when you're in mild withdrawal. Close monitoring during the first few days to ensure comfort and proper dosing.
Stabilization
Once on a stable dose, we see you regularly to monitor progress, adjust medications, and integrate psychotherapy. Drug testing provides accountability and early warning of issues.
Maintenance & Transition
Long-term treatment with gradual extension of visit intervals. Some patients taper off medication; others continue indefinitely. We support whatever path works for you.
Fentanyl Changes Everything
The contamination of the drug supply with fentanyl means that opioid use is more dangerous than ever. What might have been manageable use of prescription pills or heroin now carries extreme overdose risk. If you or someone you care about is using opioids obtained outside of medical supervision, please reach out—we can help.
Your Treatment Team
Paul Abramson, MD
Medical Director & Founder
Dr. Abramson comes from a multi-generational lineage of physicians. He combines rigorous medical training with a background in engineering from Stanford, bringing sophisticated, data-driven expertise to health optimization.
Kelly Yi, PhD
Psychotherapist
Dr. Kelly Yi completed his doctoral training from the clinical psychology program at Sofia University in Palo Alto, CA. He is currently Associate Chair of the psychology doctoral Program at The Institute of Transpersonal Psychology at Sofia University.
Orion Harris, LMFT
Psychotherapist
Orion Harris completed his masters degree in Counseling Psychology at California Institute of Integral Studies. Orion weaves together mindfulness based cognitive behavioral techniques, humanistic-existential and depth approaches.
Ready to Take the Next Step?
Recovery from opioid use disorder is possible. Contact us for a confidential consultation—we'll assess your situation and discuss treatment options.