However, everyone is offered psychosocial support.
Once stable on medication, one may choose to re-engage in normal life activities rather than invest hours per day or week in group therapy and education.
"Medication First" is consistent with the Substance Abuse and Mental Health Services Administration's (SAMHSA) working definition of recovery which prioritizes this form of self-determination:
Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
MyStreetHealth has "Do's and Don'ts"
We DO NOT initiate a taper or discontinue buprenorphine in response to patient non-adherence (e.g., missing sessions).
We DO NOT mandate participation in individual or group counseling as a requirement for continued buprenorphine medication management.
We DO NOT set a time limit for buprenorphine treatment.
We DO NOT encourage rapid buprenorphine taper protocols with the goal of transitioning to antagonist medications or no medications.
We DO NOT discharge a patient for a positive drug test result.
We DO individualize dose decisions based on individual patient factors, particularly craving intensity and environmental support.
We DO increase client accountability measures (e.g., drug testing, frequency of medication or dosing visits) without discontinuing buprenorphine if adherence to treatment protocols are disrupted by several missed visits or positive urines.
We DO clarify the rationale for recommending psychosocial supports.