There are more than 100 Suboxone providers in Dallas Fort Worth area.

Outpatient Suboxone prescription is only available through a limited number of medical providers. In the past only medical doctors who had obtained the necessary waiver certificates from the DEA were permitted to prescribe Buprenorphine containing products for the outpatient treatment of opioid dependence/addiction.

Now Nurse practitioners and physician assistants are also permitted to apply for a waiver certificate and prescribe these medications.

Drug Addiction and Treatment Act of 2000 (DATA) made it possible for doctors to prescribe medications to treat addiction from their offices, made it easier for patients to seek treatment within their community, and made it possible for patients to obtain this medication from a pharmacy.

 

When searching for providers note that some providers only practice out of a residential treatment facility / reahab hospitals, and some providers have reached their limit of one hundred patients.

It is important that you do the necessary research before enrolling in an outpatient program.

• Does the doctor / program prescribe Suboxone?
• How frequently do you have to see the doctor? once a week, biweekly, or once a month?
• What is the doctors fee for the first visit, for induction, and for follow up visits.
• What are the costs associated with treatment?
• Is counseling included in the fee, or do you have to see a counselor separately.
• What is the cost of urine drug screens?
• Are there any additional costs?
• What is the duration of the program?
• Is there a dose tapering schedule?

Recovery from addiction is not a quick-fix, it is not a sprint, it is a marathon, the better prepared you are … the better the chances of success.

If you have insurance then call your insurance first to find out about your coverage and treatment options.

You can search for a provider in your city from the Substance Abuse and Mental Health Services Administration (SAMHSA) site

https://www.samhsa.gov/

Naabt has a confidential way of finding a provider in your area. You can enter information in a form, with your particular situation and needs. A physician that matches the need may reply.

https://naabt.org

You can also find a physician in your area from the following manufacturers of Buprenorphine preparations. These manufacturers also offer discount coupons through their website.

 

 

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If my practice does not meet your needs then you should look at some of the other doctors in this area that prescribe Suboxone. There are more than 100 Suboxone providers in Dallas Fort Worth Metroplex area. Some of these physicians are listed below.

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Treatment facilities:

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What is an addiction specialist?

Medical doctors that have done a fellowship, usually one year devoted to treating addiction, are called Addiction specialists, and are usually psychiatrists. Rarely an internist, neurologist, pain management specialist, or a family practitioner may do a fellowship in addiction medicine, and be certified as an addiction specialist.

Now American Board of Preventive Medicine administers the program for specialty certification of Addiction Medicine

There are some psychologists and counselors who call themselves addiction specialists, however they can not prescribe any medications.

Should you go to an addiction specialist?

Not necessarily. Addiction specialists are few and getting an appointment may be difficult.

Treatment of addiction takes a priority and getting treatment through any provider is better than waiting for a specialist. So, start with a doctor who has an appointment available. It really does not matter all that much. The doctor’s role is very limited in your recovery. The doctor prescribes the medication that stops your withdrawal, and any doctor will do.

In fact nurse practitioners and physician assistants can obtain a waiver from DEA that allows them to prescribe these approved medications.

These medications are safe when used appropriately and any provider that prescribes these medications has done additional training before they are granted the waiver by DEA.

It is up to you to taper your dose progressively and make a complete recovery.

Otherwise go to an addiction specialist, … if an appointment is readily available, and the practice is otherwise easily accessible and convenient to you. Addiction specialists tend to provide counseling too or have counselors in there office. They also tend to be more relapse friendly … so there is less interruption in your treatment. They are also more likely to be acceptable to your insurance provider.

Always ask if that doctor prescribes Suboxone, and whether they are accepting new patients.

You should look at your own needs. Do you have ongoing psychiatric problems then chose a Suboxone doctor who is also a psychiatrist.

If you have additional medical problems then chose a Suboxone doctor who is an internist or family practitioner.

If you are an injecting drugs, then you may have to seek an addiction specialist who is also an internist to treat the infectious diseases commonly associated with intravenous drug use.

If you are pregnant then you should seek treatment through a high risk pregnancy unit, usually associated with major hospitals.

If you have had several relapses then go with a Suboxone doctor who is a psychiatrist, they tend to be more relapse friendly.

A good counselor that you respect and are willing to listen to … is far more important. You should meet at least three counselors before you settle on one. And if you are not making progress try a different counselor.

Notes:

• Only a physician with DEA waiver can prescribe Suboxone for outpatient use. Each Suboxone provider is allowed to enroll up to 100 active patients. This limit is imposed by Federal Law. A provider may not be accepting new patients if they have reached their limit.
• Some providers accept insurance, but most do not accept it, because insurance coverage is patchy, with no clear policy, and is restricted to approved psychiatrists, addiction specialists, or addiction programs. The majority of Suboxone prescribers are not psychiatrists or addiction specialists, … most of them are internists, family practice doctors, or pain clinics.
• Methadone cannot be prescribed by physicians for addiction treatment. It can only be obtained through approved Methadone clinics.
• Many Methdone clinics also prescribe Suboxone.

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Emergency Detox in a hospital.
It is covered by most insurances including Medicare … but you can not do it again and again. Doctors in a hospital do not require DEA waiver certificate as they are not prescribing it for outpatient use … it is only for administration while in the hospital, and is limited to short duration, generally one to three days. This is not a good method … after detox and discharge from hospital you will be back in withdrawal … and at risk for relapse.

You can not get Suboxone from Emergency Room.

Your best source of information will be your insurance plan, as each policy plan is different in its coverage. Preauthorization is almost always required.
Ask them for:

• a list of contracted addiction treatment providers in your network
• duration of treatment coverage
• medication coverage duration and quantity limits
• contracted providers are usually full … so expect to be placed on a waiting list

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Substance abuse treatment facility locator:

https://findtreatment.samhsa.gov/
This site will help you locate facilities nearby based on state, city, or zip code.
These facilities are more likely to accept insurance.

If you can not afford doctors fees and cost of Suboxone, then there are other alternatives available for treatment of addiction. In fact you should try these first.

1. Methadone Clinics: Methadone clinics prescribe Methadone and may also prescribe Suboxone/Subutex. These clinics are very few, located only in bigger cities, and require daily visit when you begin treatment. Methadone can not be prescribed by physicians outside these programs for addiction treatment.

2. Residential programs: There are several residential programs, that can range from a week to several months of treatment. These programs have a very fast taper, if any, and rely on denial of access to drugs, and behavioral changes rather than medications.

Many of these programs receive state funding. The cost is usually based on a sliding scale, related to income. These are comprehensive programs, which may also provide job training, and being residential include food and lodging during treatment etc. Some also accept single parents, including their children, … if there is no one else to take care of them. Most state funded programs will not accept a patient who has already used up the benefit once.

Charity run programs are more likely to accept a patient even if they have had a relapse and need treatment again.

Even if the program claims that the treatment is free … there may be application fees and other costs involved.

Even if you can not find a physician in your insurance network, you may be able to submit your physician’s bill/CMS 1500, and seek reimbursement from your insurance carrier, … call them and ask for the procedure. Most of them will find some excuse to decline it.

Some insurance plans contract out this coverage to companies like Magellan and ValueOptions. These companies generally do not cover for services provided by physicians who are not psychiatrists, or addiction specialists, and, or restrict coverage to approved Addiction treatment providers/facilities.

Call your insurance carrier and obtain a list of approved providers. If it is provided under your policy, and they can not provide you with the necessary treatment, then lodge a complaint, and demand that they reimburse your out-of pocket costs.

You can ask your insurance carrier to clarify their policy regarding Suboxone coverage, and enroll additional providers.

Coverage Notes:
Most insurances, including Medicare and Tricare do not cover outpatient opioid addiction treatment.

• They only cover inpatient opioid addiction or detox treatment, generally limited to 3 days.
• Addiction treatment falls under behavioral health … see if your policy has such coverage. If it does then your insurance will cover it only if you go through their approved providers. They may cover inpatient residential rehab or outpatient treatment programs.
• Addiction treatment facilities and Addiction specialists are more likely to accept insurance.
• Doctors who accept insurance are also more likely to be full to their capacity.
• Some insurances including Medicare/Medicaid will cover your doctor visits if it is for a purpose other than addiction treatment. That is you have a dual diagnosis thus allowing the psychiatrist to bill for a different diagnosis.
• Your prescriptions are covered by your prescription plan which is different from your insurance plan. So sometimes your doctor visits are not covered but your prescription is covered.
• Most Suboxone providers are not addiction specialists, that is they do not have Fellowship training or Board certification in addiction medicine.
• Drug addiction treatment act does not require a doctor to be an addiction specialist.

Many PCP’s will accept insurance for other services but not for Suboxone because of re-imbursement problems. It is still worth while to obtain Suboxone from such providers as any associated problems, blood tests, etc, may be covered by your insurance.

Your prescriptions may be covered by your prescription plan … which may be different from your insurance plan. Ask them if Suboxone prescriptions are covered, which brand is covered, whether pre-authorization is required, quantity and duration limits if any, and the co-pay. These prescription plans typically cover either the generic Suboxone tablet or one of the brands Suboxone, Bunavail, Zubsolv. Get the information before you go to the doctor.