Medication Management

Medication Management - The Bergand GroupThe Bergand Group has a drug free/abstinence philosophy as the foundation to addiction treatment. However, The Bergand Group also recognizes evidence-based and appropriate use of medications and dietary supplements to assist with addiction treatment and co-occuring disorders. This knowledge goes into our medication management systems.

When patients come to The Bergand Group, they are first evaluated to assess the severity of their addiction. Together with an addiction treatment physician, patients and therapists decide which combinations of treatment methods will work best for them. Our physicians are experienced and trained in the use of a spectrum of medication usage including Suboxone, an opioid pharmacological intervention that is used for detoxification and short term stabilization purposes, and Vivitrol, a once-monthly medication that helps reduce opioid and alcohol dependence and cravings. Our physicians are both American Board of Addiction Medicine and Suboxone certified.

Medication management is always used in conjunction with other programs such as group, individual, and family therapy and counseling. The physical withdrawal symptoms from certain substances such as opioids and alcohol can be especially strong, making it difficult for the patient to concentrate on other aspects of recovery. Medication management treatment is used to treat the physical withdrawal symptoms of addiction to allow the patient to move forward with other facets of the recovery process.

The Bergand Group Offers Two Medication Management Treatment Options at Their Offices in Baltimore and Harford County:


What is Suboxone?

Suboxone - The Bergand Group

Suboxone, also known as buprenorphine, is used for the treatment of opioid addiction. Not only does it reduce withdrawal symptoms and cravings, it also prevents the patient from feeling the effects of opioids if he or she were to introduce them into their body. It does not produce a high or feeling of euphoria in patients with opioid addiction.

How Does Suboxone Work?

Suboxone uses two medications: buprenorphine, and naloxone.

Buprenorphine is a partial opioid agonist. Full opioid agonists include drugs such as heroin, morphine, and oxycodone. When a partial opioid agonist attaches to opioid receptors in the brain, it does not produce the same euphoric effect as a full opioid agonist would in an opioid addict. The brain, however, perceives it as a full opioid agonist, which in turn reduces withdrawal symptoms and cravings. Buprenorphine remains in the brain’s opioid receptors for 24-hours. It reduces withdrawal symptoms and cravings during this time, and also prevents full opioid agonists from occupying the receptors. This means that if a patient were to use a drug such as oxycodone or heroin within 24 hours after having taken Suboxone, he or she would not feel its effects. Patients cannot achieve a euphoric effect with Suboxone by taking more than the prescribed dose.

Naloxone is an opioid agonist which is not absorbed by the bloodstream in any meaningful quantity when taken as directed. However, if Suboxone is taken incorrectly, for example by injection or snorting, the naloxone travels to opioid receptors and removes the opioids that are there, causing a sudden and severe withdrawal. Because of this property, Naloxone is included in Suboxone to encourage its proper administration.


What is Vivitrol?

Vivitrol - The Bergand Group

Vivitrol is a once-monthly medication that helps in treating alcohol and opioid dependence. Those suffering from an alcohol or opioid dependence must stop using before starting Vivitrol. Vivitrol is not a replacement for alcohol and drug recovery programs, rather it works in conjunction with treatment such as therapy and Intensive Outpatient Programs.

How Does Vivitrol Work?

When coupled with counseling, Vivitrol becomes part of a comprehensive treatment plan for addiction. Vivitrol targets the limbic region of the brain, which is associated with “basic drives or urges, rewards and pleasure,” and therapy targets the cortex, associated with “decision-making, thinking, reasoning, learning, and willpower.”

Vivitrol is a once-monthly drug administered by your addiction treatment physician. This treatment option is an extended-release “injectable formulation of naltrexone,” which works as a blocker for opioid receptors. This means that if a patient is to take opioids their effect will not be felt by the user. When taken for alcohol dependence, Vivitrol reduces the pleasurable feelings achieved from drinking which, in turn, reduces the desire to drink.

This drug will not “prolong your dependence on opioids or alcohol” and does not produce withdrawal when stopping the medication. Vivitrol helps those with a drug or alcohol dependence to prevent relapse, stay sober, and minimize cravings. Vivitrol is nonaddictive and nonnarcotic.

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