As the Richmond office of Coleman Institute for Addiction Medicine has evolved into treating addiction with a wider spectrum of Medication-Assisted Treatment (MAT) options,* I see more people who haven’t exactly hit bottom (whatever that subjective term may mean), but they damn sure don’t want to find that place. [*Since June 2019, we offer treatment using buprenorphine under the AppleGate Recovery brand in Richmond for those patients for whom this is the most appropriate clinical option]. Patients are not only struggling with addiction problems—the wanting, the craving, the never-quite-getting enough, the lying, the spending, sickness of withdrawal—or fear of the sickness of withdrawal—but also with the terror of admitting this problem. Many of these patients are holding down jobs, have relationships and responsibilities, and no legal issues…but they are consumed with keeping the lid on the box of their secret addiction. One of the questions that most interests me is Why have you allowed yourself to suffer so much in this pattern of using/stopping/using when the high was no longer the point, and treatment is so readily available? Fear of the perceived ramifications of coming forward is the most common answer. As people find themselves trapped in the ever-deepening holes they have dug for themselves and just can’t climb out, their imaginations about the future can be immobilizing. Visions of lost jobs, reputations, insurance, judgments, jail time, custody issues, humiliation, and financial ruin are swirling around in their minds like a pit full of poisonous vipers. Taking the first step to seek help can be terrifying. Below are a few important things to know that may mitigate the fear of initiating treatment for a Substance Use Disorder (SUD):   1. First of all, when you go through any of our treatment options in Richmond, Virginia, you will receive medications to help you:  
  • If it’s a Suboxone® (buprenorphine/naloxone) induction under our AppleGate Recovery brand, you will receive Suboxone® on the first day.
  • If it’s a rapid opioid detox using the Coleman Method, you will get the first dose of comfort medications in the office and take home medicine that your support person will distribute throughout the treatment duration. So take the fear of physical discomfort off the table.
UNDERSTANDING ACCELERATED OPIOID DETOX     2. Second, your confidentiality is guarded like HIPAA on steroids. Many people are unaware of the heightened discretion in record keeping and sharing that comes along with substance use treatment. The layers of regulations that sheath the treatment of substance abuse are almost impenetrable.   Good old 42 CFR Part 2, affectionately known as Part 2, covers almost any concern one might have about the confidentiality of seeking medical treatment for substance abuse treatment.   3. Without a special court order, treatment programs are prevented from releasing patients’ Substance Use Disorder info to law enforcement authorities.     4. There is good insurance coverage for both Suboxone® and Vivitrol®, and growing coverage for the actual Coleman Method for accelerated outpatient opioid detox.     5. Seeking help for a Substance Use Disorder does not necessarily mean giving up your ability to parent your child. Again, patient privacy and confidentiality are closely protected even in the parenting realm.   If you know you are ready to stop letting opioids control your life, I hope you will not be thwarted by the fear of confidentiality issues. Patients seeking our assistance have a chance to stop this train before it devastates their employment and their relationships and find they are able to do this without opening a can of worms they can’t put the lid back on. The bottom line is: This extra layer of protection allows people who need help to get off drugs to do so, with the freedom of knowing this information will not impact their jobs, their insurance, or their ability to parent their child. The Coleman Institute treats patients 365 days a year, comfortably, competently, and confidentially. Please call us or request a callback to learn more about your choices. Joan R. Shepherd, FNP  

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