Medication First

You receive buprenorphine medication as quickly as possible, prior to lengthy assessments or treatment planning sessions.

Buprenorphine medication management is delivered without arbitrary tapering or time limits.

Psychosocial services are continually offered but not required as a condition of buprenorphine medication management.

Buprenorphine is discontinued only if it is worsening your condition.

Our Medication Firstapproach provides an important stabilizing resource, FDA-approved and evidence-based  Buprenorphine, without conditioning the receipt of medication on other service requirements. 

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 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. 

We DO NOT initiate a taper or discontinue buprenorphine in response to 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. 

Adapted from MissouriOpioidSTR.org/treatment