Suboxone maintenance alone helps many patients to remain abstinent from all other narcotics. Relapse is quite high during tapering off Suboxone and thereafter for the first few weeks and months if no additional cognitive behavioral therapy is done, especially if the patient’s psychosocial environment is unstable. Cognitive behavioral therapy includes individual psychotherapy, substance abuse counseling, rehabilitation programs, active involvement in church, and/or 12 step attendance in collaboration with a sponsor.
Opiate addiction does not require a patient to have a primary psychiatric condition. However, quite frequently patient had a co-occurring or perhaps a pre-existing condition that added to their biological vulnerability to developing an addiction. The majority of my patients are discovered to have an additional condition during their initial assessment or sometime after they have become stabilized from narcotic withdrawal. Quite often patients were treating their psychiatric symptoms with a narcotic. I frequently find depression, anxiety disorders, ADHD, and/or a bipolar disorder variant. When these are successfully treated with medication and/or therapy, many patients feel better and function better than any time in their lives.