The following are some of the most frequently asked questions that we hear at Central Florida Treatment Centers. If your question is not covered below, use the button below to send us a message.
Everyone is different, and there is much more to treatment than taking medication. Drug dependency is a mental, physical, emotional and spiritual disease. Frequently, it has taken years to get to treatment, so the idea that it should only take a few weeks to recover is not realistic. Ideally, once you are on a stable dose and not having withdrawal symptoms, you should quickly become free of opioids. With the help of your counselor, you should also become free of all illicit drug use and free of alcohol. Once the drugs are out of the system, treatment can truly begin. The goal of medication-assisted treatment is long-term abstinence from mood-altering substances and a rebuilding of a healthy mental, physical, emotional and spiritual lifestyle. Rarely does a patient accomplish this task in less than 6 to 12 months. Once healthy and solid in your recovery, the decision to become a maintenance patient (one who remains at a stable therapeutic dose) or to taper off can be made. For someone tapering from methadone, we recommend no faster than a one- to three-milligram reduction each week with the goal being no withdrawal symptoms. This can take a long time but has been found to be the most successful. If a patient insists, they may taper at a quicker rate.
Unfortunately, most commercial insurance either does not cover medication-assisted treatment with methadone or has not contracted with us. Some of our patients have been able to submit to their prescription drug plan for reimbursement at an out-of-network rate. We can assist you in this, but most patients are either private-pay, Medicaid, or Medicare.
For us, a short-term detox is a six-month protocol. We have found that a quick detox rarely produces any positive long-term results and more often than not results in the return to illicit drug use. This is a significant disease, and it probably took a long time to get to where medication-assisted treatment is needed, so a quick solution is likely not a good one
Most likely, full Medicaid does cover methadone treatment. In addition, most patients with Florida Medicaid are on an HMO. Central Florida Treatment Centers is in network with many HMOs, but they vary from region to region. It is best to contact the clinic you are looking to go to and verify that they are in network with your Medicaid HMO.
All Central Florida Treatment Center programs are Medicare enrolled providers. Medicare does pay for the cost of treatment services at a fully covered bundled rate once the annual deductible for Medicare has been reached. The 2020 deductible for all Medicare patients is $198 which may need to be paid prior to Medicare covering your services. Understand that Part B Medicare is what covers our services. Patients who have a Medicare Advantage Plan (any Part D plan) will not be eligible to have us bill Medicare for treatment as these are similar to HMOs in that each one would have to contract with us independently for us to be able to bill for services. At this time, no Medicare Advantage program has contracted with us for services. We are always working to contract with different insurance options, feel free to contact the clinic you are interested in to see if they have contracted with any Medicare Advantage company.
Some private physicians are able to treat opioid dependence in their office using Suboxone. We, however, do all of the treatment in our clinics, and while a successful Suboxone patient could be eligible for take-homes sooner than a methadone patient, they would not get a prescription. When a Suboxone patient is so successful that they no longer need our clinic, they can be referred to a private physician.
Initially, patients attend the clinic seven days a week for dosing. There is a minimum requirement of weekly counseling (we can do more if desired) as well. As a patient is successful in treatment and begins meeting the criteria for take-homes, attendance can be reduced.
It depends on many factors. Patients who are assessed as still under the influence may not get dosed the first day, but most patients will receive their first dose on the day of admission. The rule for safety is to start low and increase slowly. Patients will not get an initial dose of more than 30 milligrams per state law as it is considered unsafe to start someone at any higher dose. Most patients receive between 20 and 30 milligrams the first day.
Everyone is different and there is much more to treatment than taking medication. Drug dependency is a mental, physical, emotional, and spiritual disease. Frequently it has taken years to get to treatment so the idea that it should only take a few weeks to recover is not realistic. Ideally, once you are on a stable dose and not having withdrawal symptoms, you should quickly become free of opioids. With the help of your counselor, you should also become free of all illicit drug use and free of alcohol. Once the drugs are out of the system, treatment can truly begin. The goal of Medication Assisted Treatment is long-term abstinence from mood-altering substances and a rebuilding of a healthy mental, physical, emotional, and spiritual lifestyle. Rarely does a patient accomplish this task in less than 6 to 12 months. Once healthy and solid in your recovery, the decision to become a maintenance patient (one who remains at a stable therapeutic dose) or to taper off can be made. The length of treatment varies with each individual patient and is affected by many factors such as abused drug of choice, length of addiction and level of dependency, and previous treatment and relapse history.
We recommend that a patient come the first day with a picture ID, the intake fee and the first week’s treatment fee (we have found that patients who pay for a week come to treatment for a week, and at the end of a week, everyone feels better). You should also bring proof of income to establish that you will be able to pay for treatment. We also encourage you to bring family members who can help you adjust and support you in your early recovery.
Adults over 18 years of age only.
If you are pregnant and opioid-dependent, then methadone treatment is the best program to protect you and your baby from the risks of illicit drug use: being high, normal, sick over and over, withdrawal, stress and everything that is involved in active drug addiction.
That is true, but that is not all the information. The first criteria looked at for take-home privileges is time in treatment, and 30 days is the minimum time for the first take-home, but there are seven more criteria that need to be assessed before someone is eligible for a take-home: the absence of drug and alcohol use, regular attendance at counseling sessions, no evidence of behavioral problems, no recent criminal activity, home environment and relationship stability, assurance that take-homes will be safe and properly managed in the home, verifiable proof of legitimate income, and satisfactory progress in treatment. These are the criteria that need to be met to be eligible for take-homes.
CFTC’s sole source of funding is private patient payment, Medicare, and Medicaid. While we are working on programs to get funding for such slots and to increase access to Medication Assisted Treatment, there is not currently any program in place.
Methadone has been used to treat opioid dependency for many years and has been widely studied. Methadone is a full opioid agonist, which means it binds to the opioid receptors in the brain and alleviates withdrawal symptoms. At a stable, therapeutic dose, opioid dependent patients will have no withdrawal symptoms and no overmedicated symptoms or "feeling high." It will also produce a blockade effect, shielding patients from reinforcing effects of further opioid use. With suboxone, there is a ceiling dose of 32 milligrams, which no one exceeds. It is reportedly a simpler medication to taper off of, and that, combined with the lower dose, makes tapering to zero milligrams a quicker process. Additionally, suboxone is indicated for patients who may have a shorter history of opioid dependence and may not be appropriate for methadone maintenance treatment. Further, many have found that getting stable on Suboxone (especially for those with significant opioid use histories) can be problematic. Many report "just not feeling well." Neither is "better" or "more effective;" simply different patients may do better on a different medication.
Buprenorphine is the generic medication name of one of the two medication in Suboxone, which is a brand name. Suboxone is Buprenorphine and Naloxone combined. As noted above, it is a partial opioid agonist which means that its opioid effects are limited when compared to substances like Oxycontin or heroin, which are full opioid agonists. Buprenorphine binds to opioid receptors allowing opioid dependent individuals to discontinue use of opioids without experiencing withdrawal symptoms. The safety profile of buprenorphine, pharmacologically, makes it an attractive treatment option for patients addicted to opioids.
Naloxone is an opioid antagonist. Naloxone also binds to brain receptors, but instead of activating, they block receptors keeping them from being activated. Naloxone is one of the two medications combined to make Suboxone (again, a brand name). Naloxone is also available as an overdose reversal agent to be deployed in an emergency situation where someone has overdosed on an opioid such as heroin or fentanyl. It is often known as Narcan and is available to all patients in Central Florida Treatment Centers' programs as well as their friends and family members.