Questions? Call now! 410.853.7691

The Bergand Group – February 2015 Newsletter

A Discussion on Replacement Medication in Recovery

By our Medical Director, John Steinberg, MD

One of the thorniest issues faced in early recovery from opiate addiction is the decision to use replacement medication or not. If medication is used, then the patient and doctor must decide whether to use this medication as a long term or maintenance regimen, a bridge regimen to achieve a period of stability in early recovery, or, to only use the medication briefly for detoxification. This has become for many patients, unfortunately, a rather contentious issue for those who wish to participate in the 12-Step programs of AA and NA.

The medical community is fairly consistent regarding the use of buprenorphine replacement medication in the treatment of opiate dependency disorders. The medication should be used at a high enough dosage, usually 12 to 16 mg. daily, to both prevent cravings for opiate use and to preclude the ability to get high if the patient uses opiates while on the replacement medication. Long term maintenance is often recommended. The 12-Step community is rather more divided on this issue, despite the 2007 Narcotics Anonymous (approved world service literature) pamphlet on this subject that is actually rather well reasoned and balanced. Should those on replacement medication be considered “clean”? Should these individuals take a role in the groups, speak at the meetings, celebrate anniversaries, etc.? The NA pamphlet defers to the groups to decide these issues on a case-by-case basis. Nothing is forbidden.

At the Bergand Group, we avoid taking any one-size-fits-all dogmatic approaches. We feel that the patient’s care must be individualized in each and every instance and those needs considered within the context of the patient’s values, beliefs, support systems, understanding, and, above all, in carefully considering the best approach that can be taken to avoid disastrous relapses and to maximize patient function and well-being. As our doctors work with each and every IOP patient individually, so, too, we refrain from being driven by either medical or 12-Step program ideology. There are no universal answers for all patients despite contrary claims by many- on both sides of this issue. If a patient seems a reasonable candidate for detoxification only, we will work with those patients to achieve abstinence based recovery. If other courses of therapy are indicated, we are able to provide maintenance therapy of varying durations, from a few months to as long as clinically indicated. Above all, we are flexible: if the first plan does not achieve the desired goal, we are always willing to consider alternatives and we work with the patients so that they are comfortable in understanding the medical management decisions we reach with them. We believe recovery is possible for all addicts and we are willing to work with every patient to ensure that each patient has the best possible chance to find his or her path to long term, stable, and enjoyable recovery.

John R. Steinberg, MD
Medical Director, Co-Founder
The Bergand Group

Share This Post!

Related Posts

alcohol rehabilitation in Baltimore | The Bergand Group

Embracing a Sober Summer

Summer brings with it a sense of freedom and an abundance of social gatherings, outdoor activities, and celebrations that often include alcohol. For those in ...
Read More →
individual therapy in Harford County | The Bergand Group

Nurturing Mental Health in Addiction Recovery: The Key to Lasting Wellness

Addiction recovery is a multi-faceted journey that extends beyond physical detoxification. It encompasses the healing of the mind, body, and spirit, with mental health playing ...
Read More →
drug treatment in Baltimore | The Bergand Group

Navigating the Challenges of Addiction Recovery in Baltimore, MD

Addiction recovery is a journey that is both profoundly challenging and immensely rewarding. In Baltimore, MD, those in recovery encounter unique challenges that can test ...
Read More →
Scroll to Top

Get Help Now!