Many people addicted to opioids go through a revolving door from treatment to relapse and back to treatment, sometimes with a stop in jail along the way. Avoiding that cycle requires selection of the appropriate treatment. Experience has taught me that some people are appropriate candidates for buprenorphine treatment, and some are not. I strongly encourage people seeking treatment to review my criteria carefully and honestly. I do not want to waste your money on ineffective treatment. Below are the criteria for treatment in my program.
- No addictive use of cocaine or methamphetamine in prior 12 months. What’s ‘addictive use’? If you want off opioids so bad that you’ll gladly stop cocaine, then I might be helpful. But if you’re still playing and not ready to stop, I won’t be of help.
- No addictive use of benzodiazepines (e.g. Xanax, Klonopin) unless current prescription.
- No active alcohol problems.
Let me clarify things a bit… I realize that ‘perfect sobriety’ is a goal. Some people would find that their life improves beyond their imagination if they abstained completely from mind-altering substances. There are many programs out there that will immediately discharge you if you test positive, one time, for an illegal substance. I don’t see that as a rational way to help someone who is dependent on opioid agonists.
My goal is to create an open and honest relationship with my patients. If your use of a substance is causing problems, I want you do feel confident that you can discuss it with me WITHOUT being kicked out of treatment. If you are using multiple substances, you’re welcome to schedule an appointment with me — providing that your true, honest GOAL is to stop.
As for THC, I think there are now about 33 states where THC use is legal. Use of THC is your business, unless it is clearly causing problems in your life. After all, diagnosis of any drug use disorder, according to DSM-5, requires that the substance is causing problems in your life.
If you have any questions, send me an email, and be honest! Emails go to me, and only to me. Use a fake gmail account if you’re worried about privacy. The criteria are in place for YOUR benefit, to avoid wasting your time and money- but I don’t want to close the door if I can help.
Jeffrey Junig MD PhD