What happens when the treatment with Buprenorphine doesn’t work?

Buprenorphine treatment may be discontinued for several reasons. Here are some examples:

• Buprenorphine controls withdrawal symptoms and is an excellent maintenance treatment for many patients, but some patients may need a stronger maintenance medication. If you are unable to control your heroin abuse, or if you continue to feel like using, even at the top doses of Buprenorphine, then the doctor may advise you to transfer to methadone or LAAN at a clinic licensed to give those treatments.
• There are certain rules and patient agreements that are part of Buprenorphine treatment, which are signed by all patients on admission. If you do not keep these agreements, you may be discharged from Buprenorphine treatment.
• Prompt payment of clinic fees is part of Buprenorphine treatment. If you cannot pay your fees, please discuss arranging a payment plan. If you still cannot pay, you will be discharged from Buprenorphine.
• Dangerous or inappropriate behavior that is disruptive to the clinic or to other patients will result in discharge from Buprenorphine treatment. This includes patients who come to the clinic intoxicated or loaded.
• Obviously, in the rare case of allergic reaction to the medication, it has to be discontinued.

The usual method of ending treatment is a taper, which means a decreasing dose of Buprenorphine over a two-week period. After this time, you would no longer be enrolled in the Buprenorphine program, and your treatment slot would be used for another patient. In some cases, a direct transfer to another kind of maintenance treatment can be made, such as to Methadone maintenance at a clinic with a special license to use Methadone to treat addition.

In the case of dangerous behavior, there will be no two-week taper, and the patient will be summarily discharged and asked not to return.