Addiction Medicine Services

Opioids/Fentanyl

We prescribe buprenorphine for the treatment of opioid use disorder. We specialize in starting buprenorphine in people with fentanyl use and can review the science showing three options to start buprenorphine - low dose (microdose), high dose (macrodose), and standard inductions. We prescribe all medications for opioid use disorder except methadone. We also administer injections.
Patients will undergo an initial evaluation of their medical history. The focus is usually on how to most comfortably start buprenorphine to alleviate your withdrawal.
Buprenorphine is a scheduled medication that is tightly regulated by the federal government. Our clinic has several program requirements. These include showing up to regular visits, drug tests, and a commitment to stay substance free.

Naltrexone, acamprosate, disulfiram (antabuse), gabapentin, topiramate (topamax), baclofen. These medications can be prescribed for a range of goals based on patient preference. These goals include reducing heavy drinking, moderating drinking, or stopping drinking. The medications work by promoting abstinence, reducing cravings, preventing relapse, and diminishing the pleasurable effects of alcohol. We can use the Sinclair method with Naltrexone. Our clinic does not have the capacity to administer injections.
Patients will undergo an initial evaluation of their medical history. We work with patients regardless of their drinking goals. Patients do not have to have an addiction to benefit from treatment. Some patients will simply want to gain more control over their drinking. Others may need treatment of their withdrawal symptoms. Treatment plans are individualized to each patients individual circumstances.
Patients meet for medication management and to help organize goals for treatment. If helpful for patients, we encourage using support groups, therapy, treatment programs, and other treatment modalities where appropriate.

Chantix, Combined Nicotine Replacement, and Zyban are medications use to help people quit smoking.
Patients undergo an initial medical evaluation. This includes smoking history and previous quit attempts. Treatment plans are individualized for patients.
Patients are followed during their quit attempt to help them keep track of their goals. Program is individualized to the needs of patients. We encourage patients incorporate smoking cessation programs and coaching along with their medications.

Wellbutrin plus Naltrexone has been shown to help people reduce their meth use. We do not prescribe stimulants to treat stimulant use disorders.
Patients will undergo an initial evaluation of their medical history and substance use disorder history. The prevalence of psychosis associated with stimulant and meth use is high. Since our clinic is not equipped to treat severe psychiatric illness, patients with severe mental illness, schizophrenia, or psychosis will be referred to psychiatry or a higher level of care.
Patients are encouraged to enter into a treatment program in their community along with their medication management at our clinic. Treatment programs and contingency management are more important interventions than medications for stimulant use disorder. As such, an emphasis will be placed on these interventions while patients undergo a medication trial.

Gabapentin has been shown to be helpful in reducing cannabis use.
Patients will undergo an initial evaluation of their medical and substance use history to see if they qualify for medication management for cannabis use disorder. The prevalence of psychosis associated with cannabis is increasing. Since our clinic is not equipped to treat psychosis, patients with severe mental illness, schizophrenia, or psychosis will be referred to psychiatry or a higher level of care.
Patients are encouraged to enter into a treatment program in their community along with their medication management at our clinic. Treatment programs and individual/group therapy are more important interventions than medications for cannabis use disorder. As such, an emphasis will be placed on these interventions while patients undergo a medication trial.

Withdrawal medications exist for opioids, alcohol, cannabis, and nicotine.
Patients who present for the treatment of substance use disorder will have an evaluation to assess and treatment withdrawal when appropriate.
Withdrawal can last days to weeks. Minor withdrawal symptoms can persist for longer periods and can be treated accordingly. Patients who do not have a substance use disorder will be treated in our tapering program.