Addiction Medicine

Our Addiction Medicine program is designed to help patients tackle various forms of substance abuse.

Abuse of opioids is a national problem of unprecedented proportions that can ultimately be traced back to the rising abuse of prescription medications and the easy availability of drugs. Addiction can manifest as compulsion and cravings and gives individuals the inability to stop using substances.

Based on the statistics provided by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control (CDC):

  • On average, 130 Americans die every day from an opioid overdose
  • 11.4 million Americans misused an opioid of some type
  • Almost one million Americans used heroin at least once
  • 67% of drug overdose deaths involved an opioid

Substance abuse includes tobacco, alcohol, opioid, pain killers, heroin, and prescription drugs such as pain medications, sleeping pills, anti-anxiety medication, marijuana, cocaine, inhalants, and so many other substances. Addiction to these aforementioned substances, in general, cause different symptoms in different people; thus, treatment options will differ for each person.

Advance Preventive Medicine and Urgent Care (APMUC) specializes in treating and recovering all substance abuse medications. Certified by the American Academy of Addiction Psychiatry and Substance Abuse and Mental Health Services Administration, We find the best type of program for each patient based on their specific addiction and their individual lifestyle.

Recognizing Addiction

Signs of addiction include the following:

  • Taking a substance more often and in a higher dose than expected
  • A willingness to reduce use without any permanent success
  • Long-term use and probably repeated attempts to stop
  • Feelings of increased cravings for the substance
  • Performance reduction at work, family, friends, society, school
  • Relationship issues with friends, family, and social circle due to constant use
  • Engaging in non-acceptable behavior that puts someone in danger
  • Engagement with illegal or criminal activities
  • Developing tolerance and requiring a greater dose to achieve the same results
  • Off and on experiencing withdrawal symptoms if enough dose isn’t used

Multiple Addictions

APMUC Can Help patients with multiple addictions to find appropriate continuity of care with the appropriate specialist to treat the other addictions and be part of the full treatment program. It is critical to understand addiction is no longer a voluntary reaction but is a chronic brain disease that has changed the structure of the nervous system and affects the brain.

Opioid Addictions

Opioid addiction may affect the parts of the brain that control impulses, judgment, and decision-making capacity. For some people with opioid addiction, choosing whether to take opioids or not can be out of their control. Opioid addiction is a chronic disease, so while there is no cure, it can be treated and managed. Please tell your health care provider about all your medicine, including prescriptions and over-the-counter medications.

Eligibility

  1. Eligibility Criteria: Patients 18 years or older have a co-occurring severe mental illness and Opioid Dependence.
  2. Exclusionary Criteria: Patients who have serious, uncontrolled medical conditions in which the use of buprenorphine/Suboxone® would be contraindicated.
  3. Factors to be considered and addressed before starting buprenorphine/Suboxone® treatment: Alcohol or benzodiazepine dependence, pain syndrome requiring opioid analgesics, homelessness, coexisting stimulant abuse/dependence, and/or lack of a support network.
  4. Program Requirements: A minimum of monthly random urine toxicology screening and monthly visits with the prescribing physician. Additionally, every six months, behavioral counseling for opioid dependency and remission.

Program Process

  1. Patients can call (407) 845-8623 to schedule an appointment or walk-in (1400 East Robinson St Orlando, FL 32801)
  2. Our certified team will provide patients with an assessment to develop a treatment plan.
  3. Clinical teams and prescribers will identify those patients who could benefit from buprenorphine/Suboxone® treatment and who can comply with the program requirements.
  4. We provide our own referral to a trusted behavioral counselor.
  5. The Pharmacy – Ongoing prescriptions for buprenorphine/Suboxone® will be provided through the pharmacy of the patient’s choice.
  6. Record Keeping – Our office will be maintained on a secure database to ensure an accurate count and meet regulatory requirements. Prescribers will enter information into the secure database.
  7. Discharge – while treatment retention is a primary goal, the discharge shall be initiated when the patient has gone thirty (30) days without buprenorphine/Suboxone® or a continuance of failing a drug test. Reasons for discharge shall include voluntary discontinuation of care, including a pattern of no-shows, relocation, failure to comply with office policies, and referral to a higher level of care and/or diversion.

Program Policies

  1. All patients will be educated about buprenorphine/Suboxone® and the clinic requirements and will sign informed consent to treatment and any necessary information releases.
  2. All treatment and associated testing will be provided by a medical doctor certified in buprenorphine/Suboxone® and/or trained direct care nurses.
  3. Urine toxicology screens will be collected at baseline and a minimum of monthly thereafter.
  4. Standardized tests for opiates (morphine, codeine, hydrocodone, hydromorphone), cocaine metabolites, amphetamines, benzodiazepines, and methadone/methadone metabolites will be utilized as indicated.
  5. The originating clinical team will continue to work with the patient and carry the patient on their caseload for therapy and treatment planning.

Getting Help

Substance abuse affects personal judgment, decision making, reactions to stress, memory, and the ability to learn. Individuals seeking help should have the support, patience, and understanding of those who care for them and should be encouraged to seek help from a specialist. Dr.Shemiranei is certified by the American Academy of Addiction Psychiatry and Substance Abuse and Mental Health Services Administration as a provider of Suboxone therapy. If you would like more information or have any questions or concerns please contact our hotline at (407) 845-8623.