Bayani Addiction Treatment FAQ

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At Bayani Health & Wellness, we provide outpatient treatment of opioid use disorder using buprenorphine. Buprenorphine is FDA-approved to treat addiction to heroin, morphine, codeine, oxycodone, and hydrocodone. In addition, we provide outpatient treatment of alcohol use disorder using disulfiram, acamprosate, or oral naltrexone.

Our programs are unique in that we view the medications as only one of the necessary facets to achieving total wellness in treating substance use disorder. Along with your prescription for medication assisted treatment, you will receive nutrition guidance, a personalized exercise prescription, daily meditation and stress reduction sessions, and connections to groups that can provide you with support through your healing journey.

In the future, we plan to offer treatment for methamphetamine use disorder.

There are several considerations that can help you assess your situation and determine whether or not you need treatment for opioid use disorder or alcohol use disorder. 

For example, if you find it difficult to stop or limit your use of the substance despite repeated attempts at quitting, this may be a sign you need treatment. Another sign you might need treatment is if your substance use has resulted in neglecting work, school, or family responsibilities, or if personal and professional relationships have become strained or difficult because of your substance use. Other signs include experiencing physical or psychological symptoms when you stop using the substance, or spending a significant amount of time thinking about, obtaining, or recovering from substance use. Please call our office to speak to one of our physicians if you need guidance and support in navigating addiction recovery. 

Buprenorphine (also known as Suboxone) is a partial opioid agonist, meaning that it binds to the same opioid receptors in the brain that heroin or prescription opioids do, but activates them less strongly. It diminishes the withdrawal symptoms and cravings associated with physical dependency to opioids. When taken as prescribed, buprenorphine is safe and effective.  

Prior to starting treatment, you will undergo an evaluation by our board-certified addiction medicine physician. The evaluation includes assessing your medical history, prior history of substance use, physical health, mental health, and current substance use patterns.

Once our physician determines that buprenorphine is appropriate for you, you’ll begin the induction phase; you will need to abstain from using opioids for at least 12 to 24 hours and be experiencing mild to moderate withdrawal symptoms before taking your first dose. We'll also start you on the stress relief / sleep improvement part of your wellness plan and get you connected with some support groups.  

During the stabilization phase, one of our providers will adjust your dose of buprenorphine to achieve a level where you no longer experience cravings or withdrawal symptoms. At this stage, you'll receive nutrition guidance and start your Rx-ercise program. Once your dose is stable, you'll enter the maintenance phase of treatment, which involves maintaining a dose effective to prevent withdrawal symptoms and reduce cravings.

Throughout all phases of treatment, regular monitoring by our physicians is essential. This includes urine drug screens to monitor medication adherence and abstinence from other substances. At some point when you and our physician decide it's appropriate, a gradual tapering of buprenorphine may be initiated to safely discontinue the medication.

Yes, drug testing is commonplace in addiction treatment, and we will order drug testing for you.  However, please remember that we’re not law enforcement, so the purpose of drug testing from our perspective is not a "gotcha" - it's to make sure we know what’s in your body so we can keep you safe and in treatment. Keeping you safe and in treatment is really all we care about.  

There's no medical reason that you can’t continue work or school. However, during the induction phase of buprenorphine treatment for opioid use disorder, you may want to take sick leave for the first few days if that's available to you, since you’ll need to abstain from using opioids for at least 12-24 hours before taking your first dose and therefore will probably be experiencing some mild to moderate withdrawal symptoms. You might also need to take an occasional sick day as your dose of buprenorphine gets adjusted to achieve a level where you no longer experience withdrawal symptoms. We can give you a doctor's excuse for those days, if you need one.

A combination of medication assisted treatment and therapy is obviously ideal - along with other resources such as recovery coaching, support groups, and employment support. However, the reality is that only about 10-20% of people with opioid use disorder are getting adequate treatment for their chronic disease, due to flaws in our healthcare system and shortages in therapists qualified to treat addiction. In addition, treatment with buprenorphine alone - without therapy - has proven to be effective. So, while we do encourage patients to seek therapy with a qualified provider, we won't turn you away if you don’t currently have a therapist.  

Yes, we have a treatment agreement that we'll ask you to sign. Treatment agreements are common in addiction practices and are considered best practice. The purpose of the treatment agreement is to keep the patient and the doctor “on the same page” and in alignment.

The maintenance phase of buprenorphine treatment involves continuing the dose that is effective for preventing withdrawal symptoms and reducing cravings. The length of time for this particular phase varies; it can last for months to years depending on the individual. However, at some point in time when you and our addiction medicine physician collaboratively decide it’s appropriate, a gradual tapering of buprenorphine may be initiated to safely discontinue the medication. This process involves reducing the dose of buprenorphine slowly over time to minimize withdrawal symptoms, and the pace of tapering differs from person to person.

For alcohol use disorder, medication may be continued long-term if effective and well-tolerated. However, in some cases, you and our addiction medicine physician may consider discontinuing disulfiram after a period of sustained sobriety and stability.

Yes, at your follow-up visits we will ask how many tablets or films you have left.  This gives us a general understanding of how much medication you have been taking and helps us when we write your next prescription.