Substance Misuse Management

At Park Avenue Medical, we’re familiar with the frustration experienced by both patients and loved ones due to substance misuse disorder. With our advanced expertise and years of experience, we can minimize the discomfort associated with withdrawal and overcome addiction and dependence of opioids and alcohol. Using medication-assisted therapy and psychotherapy, we’ll help you on your path to a better, addiction-free life. We’ve helped patients from all walks of life defeat addiction and dependence, whether it came from the misuse of prescribed drugs, street drugs, or alcohol. No matter what the situation, know that Park Avenue Medical is here to help you win the battle.

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Buprenorphine-based medications include two classes: drugs that combine buprenorphine and naloxone (Suboxone®/Zubsolv®), and drugs that rely only on buprenorphine (Sublocade®/Subutex®). Suboxone®, Zubsolv®, and Subutex® are all taken sublingually (under the tongue) daily, while Sublocade® is administered monthly by injection. We ask that the patient refrain from using illicit substances for at least 24 hours before their first appointment. Treatment begins with induction, where the patient comes in for 3 consecutive days. If the patient has withdrawal symptoms, we can prescribe Lucemyra® (lofexidine), clonidine, Atarax®/Vistaril® (hydroxyzine), and Zofran® (ondansetron) to ease any difficulties in the transition. On the first day, we talk to the patient and have them retrieve their medication from the pharmacy and bring it to the office. We administer the drug and monitor the patient for stability for at least 30 minutes. After the first day, the patient comes in for two more consecutive days before we switch to a weekly schedule. If the treatment succeeds over the course of a month, we switch to appointments every other week, and we continue to spread appointments out as the patient continues to succeed. We test the urine or saliva of the patient with every visit to ensure that the treatment proceeds as planned.

Naltrexone (Vivitrol®) works for both opioid dependence and alcoholism. We administer naltrexone (Vivitrol®) with an intramuscular injection monthly, and we use the oral form for rare circumstances. Before our patients come in for naltrexone treatment, we ask that they refrain from alcohol for at least 6 hours, short-acting opioids (oxycodone, hydrocodone, or heroin) for at least 24 hours, and long-acting opioids (methadone, buprenorphine, and fentanyl) for at least 1 week. The induction process begins with a patient evaluation, and if the patient is ready, we can administer the injection the same day, and we monitor for stability for at least 30 minutes. For withdrawal symptoms, we can prescribe  Lucemyra® (lofexidine), clonidine, Atarax®/Vistaril® (hydroxyzine), and Zofran® (ondansetron) to ease any difficulties in the transition. Patients come in two weeks later for a check-up, and then monthly after that. We check urine or saliva with each visit to ensure patient success.