How am I supposed to find a counselor?
We can provide you with a list of Drug and Alcohol Counselors in the community, and we will ask you to set up an initial appointment with them, and begin counseling. Once you have established care with this counselor, we will ask you to sign a release of information verifying that you have started counseling and so we can coordinate care with your counselor and verify that you are engaging in counseling.
I already was seeing a counselor prior to coming to the AIR Program. Can I just continue to see them to fulfill my two hour a month counseling requirement?
Yes! If you are already receiving counseling prior to starting at AIR, we will simply ask you to sign a release of information which allows us to verify with your counselor that you are in fact participating in counseling.
What can I expect on my first visit?
Your first appointment at our clinic should take between 60 and 90 minutes. Please be sure to fill out your new patient packed prior to coming to your appointment. During this appointment you will meet with a counselor or Medical Assistant who will review the paperwork that you completed in the new patient packet, and also ask you some additional questions related to your substance use. Next, you will meet with a Medical Assistant who will review your medical history, take your vital signs, and ask you to submit a urine sample for a drug test. Finally, you will undergo a history and physical with our Physician. You and the Physician will discuss whether or not Suboxone is an appropriate medication to try, and if so, the Physician will write a prescription for Suboxone. You and your provider will decide when you should be seen back in our office to review your response to the medication.
I don’t have insurance and I don’t know if I will be able to pay for my appointments or my medication, can I still be seen at your clinic?
Yes. If you are uninsured, and Medication eligible, we will assist you in getting signed up for the appropriate coverage. We also offer financial aid to eligible patients, and we can assist you in filling out a financial aid application. If you plan on applying for financial aid please bring in one of the following:
Pay stubs for past 2 months
Bank Statements (checking & savings) for past 2 months
Copy of Federal Income Tax return (most current year)
Copy of notice received from Social Security Administration indicating monthly benefit
Copy of notice received from Bureau of Unemployment for weekly benefit
Copy of any pension payments that are received monthly
Notice of current Medical Assistance denial or approval (if applicable)
How often will I need to see Dr. Kawasaki, and what will I need to bring to each appointment?
You and Dr. Kawasaki will decide how frequently you need to be seen. Every patient is different, therefore one patient might only need to be seen once a month, and another might need to be seen more frequently. At each appointment you must bring in the following in order to obtain a new prescription:
Verification of counseling. We will provide you with a form that your counselor can fill out which asks them to list the days, time and duration of each counseling session that you attended.
Any other prescriptions that you are currently taking. Please bring in the bottles of each prescription so we can note the prescriber, the medication, the date prescribed, and the amount of medication prescribed.
What if I forget my verification of counseling?
We see Buprenorphine as one of many tools necessary to achieve a life of recovery. That is why we see counseling as being so important. If you forget to bring your proof of counseling attendance of counseling in, we will attempt to contact your counselor in our office to verify. If we are unable to reach your counselor, and are unable to verify that you have attended counseling, we might have to withhold your prescription until we receive verification. All situations will be handled on a case by case basis, and will be made by the treatment team.
Will I need to submit a drug test?
Yes. State and Federal Laws require that you submit drug tests while you are being prescribed Buprenorphine. You will be required to submit a urine drug screen as a part of the admissions process into our program. The initial urine drug screen is collected in order for us to see what drugs are in your system before we start prescribing Buprenorphine.
Urine samples are collected and tested to assist in stabilizing you on the proper dosage of methadone or buprenorphine. Drug test results may suggest that your dose needs to be adjusted or that a more intensive level of care is needed. Positive drug tests alone do not confirm that you are not engaged in treatment or are not in compliance. The entire clinical picture must be considered. Drug tests are not used to punish you or as the sole reason to discharge you from treatment. Please be assured that the results are confidential and will be released only with their permission or pursuant to a court order (42 CFR Part 2).
How often will I need to provide a urine drug screen?
Each new patient is asked to provide one random urine sample once per week for the first two months of treatment. After the first two months in treatment urine drug screens will occur randomly at least once monthly, depending on how well the patient is doing in treatment. No patient is monitored less than once a month. Urine samples are collected randomly. A patient is not told when he or she will be asked to provide a urine sample so that a more accurate assessment of drug abuse patterns can be made. A patient might be called back to the office at any point to provide a urine drug screen. In addition to urine drug screening, we will ask you to bring all empty medication wrappers to every office visit. You also might be called to come to the office so we can verify medication count.
What if I am unemployed (or employed) and do not have insurance, and cannot afford my medication or my office visits?
We will work with you regardless of your financial situation and ability to pay. At the time of your first visit please bring your insurance card (if you have insurance). If you do not have Insurance, please provide a copy of your most recent pay stub (or we can make a copy for you), or proof that you are receiving unemployment. If you have none of the above documentation, please just let our staff know, and we will discuss ways for you to still access treatment with us. For those who are uninsured, and interested in signing up for Medicaid, we can assist you in this process.
What if I refuse to submit a urine drug screen?
We would like to reiterate that urine drug screens are not collected as a form of punishment. This is a State and Federal requirement, and it really just helps us to understand if the dose that we are prescribing is effectively treating your Opioid Use Disorder. We are here to support you and understand that slips are sometimes a part of the recovery process, so please alert us as soon as possible if you have had a slip and returned to use.
If a patient refuses to submit a urine drug screen, then Dr. Kawasaki will be notified immediately and she, along with other clinical staff will decide the next course of action. All circumstances will be taken into consideration. Please note that refusal to provide a urine drug screen might be ground for termination from our program. We will help you receive placement with another program if you wish.
I slipped and used Heroin or another opioid pain medication, what should I do?
Patients will meet with one of our staff to discuss if your dose needs to be adjusted, or if a higher level of care is needed. We might also ask you to increase the frequency that you are receiving counseling. Please just contact us as soon as possible and ask to speak with a staff member. We will decide the next course of action upon hearing more about your specific situation.
I went to the ER because I broke my arm (or some other medical emergency) and they prescribed me an Opioid Pain Medication? What should I do?
If you are experiencing a medical emergency, please notify your emergency medical provider that you are currently taking Buprenorphine. Upon becoming a patient in our program you will receive a wallet card that states that you are currently taking Buprenorphine for Opioid Use Disorder. This card will also note the dosage of Buprenorphine that you are taking. Please show your emergency medical provider this card, or tell them that you have it in your possession and they can get it for you. ER providers can also look up your dosage of Buprenorphine by looking at the Pennsylvania Prescription Drug Monitoring Portal.
IT IS EXTREMELY IMPORTANT THAT YOU INFORM YOUR EMERGENCY MEDICAL PROVIDER THAT YOU ARE CURRENTLY TAKING BUPRENORPHINE BECAUSE BUPRENORPHINE MAY DECREASE THE EFFECTIVENESS OF OTHER IMPORANT MEDICATIONS, AND WHEN MIXED WITH OTHER MEDICATIONS IT MIGHT BE FATAL.
I went to my psychiatrist and they prescribed me Valium for some panic issues that I am having. Is this okay to take?
Valium, Xanax, Klonopin and Ativan are Benzodiazepines, and taking Buprenorphine and Benzodiazepines at the same time increases your risk for overdose. This is because Buprenorphine and Benzodiazepines are both depressants, and they slow the central nervous system which includes heart rate and breathing. We strongly recommend not taking Benzodiazepines while taking Buprenorphine. In fact, benzodiazepines and opioids are commonly used together for anesthesia in surgery. Dr. Kawasaki will discuss this issue further with you, and might be able to recommend a safer alternative to Benzodiazepines. If you are struggling with anxiety and panic, we also strongly encourage you to talk with your counselor about this, and discuss some effective behavioral techniques that can help anxiety or panic. At your initial appointment with Dr. Kawasaki she will go over medications both over the counter, and prescribed, which will be unsafe to take while also taking Buprenorphine.
What happens if I am experiencing a medical emergency related or non-related to Suboxone?
Please go to your nearest emergency room ASAP or call 911. The staff at the ER can verify your dosage of Buprenorphine by looking at the Pennsylvania Prescription Drug Monitoring Portal. Again, it is very important that you inform medical staff at the ER or Paramedics that you are currently taking Buprenorphine.