Suboxone, Subutex and Buprenorphine Treatment for Opiate Dependence and Pain

vicodinOpiate dependence is both an extremely common problem in our society, and very difficult to overcome without professional help. Use of opioid pain medications or street drugs like heroin often begins in a seemingly benign way, but by the time the extent of the problem becomes clear, it’s too late to easily stop.

We realize that opioid addiction can happen to anyone, and take a compassionate approach to individualized treatment without judgment.

Stay-at-Home Rehab: Outpatient Program for Opiate Withdrawal

Stay-at-Home Rehab is a revolutionary new approach compared to the more traditional idea of “rehab” in that comprehensive opioid dependence treatment is undertaken as a structured outpatient program.

This means the patient usually stays in either their home environment while continuing to work and attend to their other responsibilities. In more severe cases, we may recommend an initial period in a more supervised setting before transitioning back to an outpatient program.

Note: while our program is a non-12-step approach, it can also work in harmony with more traditional 12-step detox and rehab programs.

What Kinds of Opioid Addiction Do We Treat?

We specialize in the compassionate treatment of addiction to:

  • Norco / Vicodin / hydrocodone
  • OxyContin / Percocet / Roxicodone / oxycodone
  • Dilaudid / hydromorphone
  • Ultram / tramadol
  • Fentanyl
  • Methadone
  • Heroin

Dr. Abramson also has experience and specific methods for treating co-occurring addiction to alcohol or benzodiazepines.

We typically require that our doctor assume prescribing of all controlled substances while a patient is under our care.

The Suboxone Treatment Program – What to Expect

A team of addiction specialists, led by Board-Certified addiction medicine physician Paul Abramson MD, treats those suffering from addiction to opiates in a highly structured process that includes:

  • Comprehensive medical, psychological and addiction evaluation by our expert team;
  • Individualized treatment plans customized to the patient’s unique situation;
  • A discreet and private office in the heart of downtown San Francisco;
  • Integration of treatment services to produce superior results;
  • A focus of maintaining and improving the ability to function in life during treatment;
  • Assistance to negotiate serious family, employment, regulatory and legal situations.

Opiate Withdrawal Relief

Opiate withdrawal is a very unpleasant situation that often motivates people to get into treatment.

Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Late symptoms of withdrawal include:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

Buprenorphine can be used to rapidly relieve opiate withdrawal symptoms and provide stability so that the affected individual can function better, take care of essential life tasks, and make preparations for their longer term goals. Information about opiate withdrawal is here.

Opioid Dependence Treatment Plans

Each person’s treatment plan is individually customized based on their needs and situation. A typical opioid dependence treatment plan may include some, or all, of the following:

  • Medication-assisted opiate detox, stabilization, and maintenance treatment;
  • Individual and/or group psychotherapy therapy for addiction;
  • Diagnosis and treatment of co-occurring physical health problems;
  • Diagnosis and treatment of co-occurring mood issues and other psychological problems;
  • Coordination of family support and family therapy;
  • Nutritional support and functional medicine augmentation of treatment;
  • Self tracking with quant coaching support;
  • Other modalities such as animal-assisted therapy, physical training and sleep coaching.
  • Smooth transition from “detox” phase, and on to an ongoing maintenance plan.

Medication-Assisted Opiate Addiction Treatment

Buprenorphine, also known as Suboxone and Subutex, is a prescription medication indicated for the maintenance treatment of opioid dependence, available only by prescription from a specially-certified Suboxone doctor. The active ingredient, buprenorphine, has also been produced under the Subutex brand.  Buprenorphine is an opiate partial-agonist which effectively substitutes for regular opiates and typically stabilizes opiate addiction so the patient can function better.  While not a cure for opioid addiction, substituting buprenorphine for a full agonist opioid such as those listed above often stabilizes a person’s brain chemistry, stops the development of further opioid tolerance, and buys time so that the person can get their life and health together in preparation for getting off opioids altogether.   Buprenorphine has other favorable pharmacologic properties and is well-tolerated by most.  It is part of a harm reduction strategy and we have found it to be an extremely helpful adjunct to comprehensive treatment of opioid addiction.

There are also many nuances and controversies about treatment methods such as Suboxone and other opiate detox drugs.

Our Team of Addiction Specialists

A Board Certified addiction medicine specialist, Paul Abramson MD, leads our team of experts and is licensed to prescribe buprenorphine, Subutex or Suboxone for opiate addiction. We utilize a highly integrative approach that can also include nutritional support, dietary supplements, acupuncture, personal training and other modalities as appropriate.

Meet our team:


How Long Do I Need to Be On Suboxone Before Tapering Off?

The answer to this question is very individual. But we usually recommend at least 2-3 months of stabilization while other personal and lifestyle changes are implemented.  While a rapid opiate detox often seems attractive, we discuss the pros and cons of that at the initial consultation visit. For those wishing to optimize their chances of remaining opioid-free after tapering, we offer an integrative addiction treatment program involving some combination of psychotherapy, group support, mindfulness training, nutrition, physical exercise and acupuncture, tailored to each patient’s individual needs, brain chemistry, preferences and budget.

Psychotherapy and Counseling

We also offer advanced addiction psychotherapy using cognitive-behavioral and supportive counseling strategies to help improve the chances of success in treatment.

Need More Information About Our Addiction Treatment Program?

Our full range of addiction treatment services is available during regular business hours. For urgent situations after hours or on weekends, please use the option through our regular number to page the doctor on call. Depending on the situation, a team may be able to be mobilized for urgent after hours situations, or we can help you figure out the appropriate next steps.

To Schedule an Appointment or for More Information

Call us today on (415) 963-4431 or send us an email enquiry.


Suboxone Treatment was last modified: January 29th, 2018 by Paul Abramson MD

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