I had the privilege of creating a Suboxone recovery program and administering it under the direction and supervision of a physician psychiatrist. Our program worked because it was designed and conducted properly. All patients were volunteers, and all had the program and the characteristics of Suboxone explained to them before they began. If patients were on methadone, they had to taper to 40 mg/day before starting Suboxone. Patients started at 16 mg/day for 1 to 2 months, then tapered to 12 mg/day. They were instructed to cut their dose 1 week before the next visit so we could assess the tolerence to the lower dose. Patients had a drug screen for the presence of Suboxone and the absence of other drugs every month. Each person received counseling on a monthly basis. At the end of 1 year, 85% of our patients were completely drug-free and living productive lifestyles.

The “pearl” is that when properly administered and with appropriate monitoring and planned decreasing doses, Suboxone is a wonder drug! It blocks the mu receptor for 36 hours, which makes taking narcotics a waste of time because you don’t get high if the narcotics can’t reach the receptor. Strict monitoring helped the individuals stay away from temptation, and monthly counseling helped in attitude change.

Any medication can and probably will be misused/abused, but don’t blame the medication for the failure of the practitioner to properly run an effective program. Suboxone is the best thing that has ever existed to curb drug addiction if it is used correctly.—GEORGE ROLL, PA, MS, MPA, BA, BS, Seagrove, Fla. (216-4)



These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.