At RTB, treatment is available for abuse of any drugs and/or alcohol but we specialize in treating and managing opiate addiction. Some common opiates that you may have heard of include Oxycodone, Hydrocodone, Vicodin, OxyContin, Darvocet, Percocet, Morphine, and Heroin.
What is the criteria for admission to treatment?
Raise the Bottom is a voluntary treatment program. Anyone over 18 who is seeking freedom from active addiction is welcome here.
What is the admission process?
The first step towards recovery is contacting us! For this reason, we are available by phone or email and our office is open seven days a week. We take appointments and in most cases, can accommodate admission walk-ins Monday – Friday. Your initial appointment may take up to 2 hours and will consist of an orientation to the facility, patient handbook and review of policies and procedures, a blood draw, a urinalysis, a full physical and a complete bio-psychosocial assessment. If you are seeking treatment for an opiate addiction and are admitted to our program, you will receive your first dose of medication at this appointment.
How long will I need to be in treatment?
Unlike physical dependence, addiction is a disease. Addiction is a condition that manifests itself as uncontrollable cravings, the inability to control or manage your use, an obsessive and/or compulsive desire to use, and continuing to use despite doing harm to yourself or others. Uncontrollable cravings prompt the destructive behaviors of addiction. These cravings are rooted in the altered brain biology of those who suffer from Substance Use Disorders. Recovery is the process of reversing, to the extent possible, these brain changes. This is accomplished through therapy and replacing the addictive behaviors with healthy alternative behaviors. Treatment and recovery is a very personal experience and length will vary by the individual.
What is opioid dependence?
Opioids, to include prescription pain medications and heroin, attach to the opioid receptors in the brain, which stimulate the release of dopamine and produce pleasurable feelings. When the opioid eventually detaches from the receptors, people experience withdrawal and cravings and have a strong desire to repeat the experience. The need to satisfy cravings or avoid withdrawal can be so intense that people who want to stop taking opioids find it difficult to do so. Those who have opioid dependence may find themselves doing things they would not ordinarily do in order to obtain more of the drug they crave. For this reason, even though opioid dependence is a medical condition and not a moral failing, it can drive behavior. Drug use often begins as a choice, but frequent use can cause the brain cells to change the way they are supposed to work, resulting in physical dependence. Because the brain and thus the body become physically dependent on the drug, each time the opioid begins to wear off, the person will have withdrawal symptoms to include nausea, vomiting, diarrhea, sweating, chills, cravings, agitation, anxiety, etc. For these reasons, the brain and body become dependent on opioids not to produce pleasurable feelings, but rather, to not feel sick. Researchers have discovered that many drugs, including opioids, cause long-term changes in the brain. These changes can cause people to have cravings years after they stop taking drugs. Research has shown that addiction is a chronic, relapsing brain disease, but treatment with medication and counseling can help achieve recovery.
How does Medication Assisted Treatment (MAT) work?
Evidence-based addiction treatment is aimed at correcting and reversing the changes in brain cells associated with addiction. Medication Assisted Treatment works by stabilizing the patient on medication to suppress their symptoms and cravings while allowing them to focus on and make behavioral changes that will rewire the brain and reverse cell changes caused by addiction. Once the patient is stabilized on medication (Methadone, Suboxone, Vivitrol, etc.), they can start the real work of overcoming their addiction by engaging in counseling and making the necessary behavioral changes to re-engage in a substance free lifestyle. Eventually, patients will begin a taper (slow weaning off) of medication to remove any remaining physical dependency.
Is treatment confidential?
Yes. Information regarding your health care, including payment for health care, is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the Confidentiality Law, 42, U.S.C. Under these laws, Raise the Bottom may not disclose to others that you attend the program, disclose any information identifying you as an alcohol or drug abuser, or disclose any other protected information except as permitted by federal law. Raise the Bottom must obtain your written consent before it can disclose information about you for payment purposes. Generally, you must also sign a written consent before RTB can share information for treatment purposes or for health care operations. You may revoke any such written consent either verbally or in writing. Under certain circumstances, federal law permits Raise the Bottom to disclose information without your written permission:
Pursuant to an agreement with a qualified service organization / business associate; For research, audit or evaluations;
To report a crime committed on Raise The Bottom premises or against Raise the Bottom personnel;
To medical personnel in a medical emergency;
To appropriate authorities to report suspected child abuse or neglect; Within RTB, certain staff members will have access to your confidential health-related information on a need to know basis. This information is shared to provide you with the best substance abuse treatment, medical care, and referral and support services. If you have any questions about any of these rights or about your treatment, please contact your counselor.
What are the signs and symptoms of an overdose?
Methadone and Suboxone can cause death if too much is taken or if it is taken with alcohol, Benzodiazepines, and/or some other medications. Methadone and Suboxone are central nervous system depressants, and due to them being long acting medications, complications may occur long after ingestion. Symptoms of an overdose include:
Slow, difficult or absent breathing
Closing / swelling of throat
Bluish skin or fingernails and/or lips
Weak, slow or absent pulse
Won’t respond to voice or touch
Swelling of lips or tongue
GIVE NARCAN IF AVAILABLE - CONTACT 911 IMMEDIATELY
Narcan and Overdoses
The majority of Opioid overdose-related deaths occur outside of the medical setting. Narcan nasal spray requires no specialized training and can be administered by anyone. Narcan Nasal Spray is the first and only FDA- approved intranasal Naloxone for emergency treatment of opioid overdose. During an overdose, opiates overwhelm certain receptors in the brain, interrupting a key part of the body’s impulse to breathe. Breathing slows dangerously or stops. Reversing this process quickly is crucial because without breathing and oxygen, brain damage or death can occur. Quickly recognizing the signs of opioid overdose and acting appropriately could make all the difference.
Signs of overdose include, but are not limited to:
Will not wake up or respond to your voice or touch
Center part of their eye is very small, sometimes called “pinpoint pupils”
Slow, or absent heartbeat and/or low blood pressure
Breathing is very slow, irregular or has stopped
Fingernails and lips turning blue or purple
Not all of these signs will be present. If you suspect an opioid overdose, get emergency assistance right away. When used as directed, Narcan can reverse the effects of opioids, temporarily restoring breathing and wakefulness until help arrives. Anyone who uses prescribed or illicit opiates to include heroin is at risk for an overdose. Narcan is not only vital to you as a patient, but it could be vital to saving the life of a friend, family member, co-worker or someone you don’t even know. You can obtain Narcan in the following ways: You do NOT need a prescription for Narcan
Medicaid patients: You are eligible to receive Narcan for free from your pharmacy
Insurance patients: Cost varies per individual insurance company
Cash pay patients: Call your local pharmacy for cost related information
Narcan is easy to use: Step 1: PEEL Peel back the package to remove the device. Hold the device with your thumb on the bottom of the plunger and 2 fingers on the nozzle. Step 2: PLACE Place and hold the tip of the nozzle in either nostril until your fingers touch the bottom of the patient’s nose. Step 3: PUSH Press the plunger firmly to release the dose into the patient’s nose.
Addiction is a family disease that can stress a family to its breaking point, affect the stability of the home, the family's unity, mental health, physical health, finances, and overall family dynamics. Living with addiction can put family members under unusual stress. Normal routines are constantly interrupted by unexpected or even frightening kinds of experiences that are part of living with drug use. What is being said often does not match up with what family members sense, feel beneath the surface or see right in front of their eyes. The alcohol or drug user as well as family members may bend, manipulate or deny reality in their attempt to maintain a family order that they experience as gradually slipping away. The entire system becomes absorbed by a problem that is slowly spinning out of control. Without help, active addiction can totally disrupt family life and cause harmful effects that can last a lifetime. Support groups in the community such as Al-Anon and Nar-Anon are available for the friends and family of people suffering from addiction (alcohol and drugs, respectively). While these support services are important for making connections with others who may be trying to navigate day-to-day life with addiction in the family, so is seeking professional therapy. Individual therapy for each family member, not just the person afflicted with a substance use disorder, is important for the mental health of all involved. Meeting with a counselor as a family can help improve communication among family members, rebalance the family dynamic and give family members a safe environment to express their anger, fear and other concerns. Family counseling may also be helpful in preventing the children of those afflicted with a substance use disorder from succumbing to the disease themselves. RTB offers family counseling and strongly recommends that families participate in the recovery process, please discuss your options with your counselor.
How often will I need to come to the clinic for MAT?
Treatment works best when you take your prescribed medication daily. If an emergency occurs and you are unable to come to the clinic, please call and notify staff. If you miss 2 days or more your medication will automatically be reduced to half of your normal dose upon return to ensure your safety. If you do not come to the clinic for 10 days in a row, upon return, you will need to see a provider for an assessment and new medication orders. You will likely have to wait to see the physician or nurse practitioner; do not expect to be seen immediately. If you do not come to the clinic for 30 days, you will be discharged. If you are experiencing problems that are preventing you from regularly attending, please discuss this with your counselor. At some point during your treatment, you may be given take home medication privileges. A number of factors are considered when providing take-home privileges. These factors include, but are not limited to, approval by the physician, amount of time in treatment, compliance with treatment requirements, attendance of group and individual counseling and urinalysis testing showing no illicit or non-prescribed substances.
Commonly prescription opioids
The following are some of the most commonly prescription opiates: Norco, Tramadol, Codeine, Demoral, Dilaudid, Fentanyl/Fentanyl transdermal, Hydrocet, Hydrocodone, Hydromorphone, Lorcet, Lortab, Mepergan, Meperidine, Methadone, Morphine, MS Contin, OxyContin, Oxycodone, Percocet, Percodan, Roxanol, Roxicet, Roxicodone, Tussionex, Tylenol III & IV, Tylox, Vicodin and Vicoprofen.
Requests for vacation or travel medication must be discussed with your counselor and will be considered and evaluated on a case-by-case basis. These requests must be agreed upon by the treatment team, signed off by the Physician and in some cases may need to be approved by the State / Federal governing bodies. If vacation or travel medication is not approved, every effort will be made to assist you in finding a treatment program near your destination of travel. It is your responsibility to find a clinic in or near your travel destination. You can research clinics (by state) at the following address: http://dpt2.samhsa.gov/treatment/directory.aspx. Once you have chosen a clinic, you need to provide the clinic name, address, and phone number to your counselor. All requests for vacation or travel medication need to be requested at least 2 weeks prior to absence to allow the clinic time to request approvals and/or coordinate guest dosing at another clinic. Emergency situations will be addressed on a case-by-case basis.