My son is opiate dependent. He has been through several detox programs and long term inpatient rehabilitation programs over the years. In recent years he has done well, overall, but he has had an occasional brief relapse. On his last most recent relapse, he caught himself promptly but was not in a position (due to lack of healthcare insurance) to get into a detox program.
His only other option at that time was to get on Suboxone. He started out working with a private physician who prescribed Suboxone, but his charges for visits were truly excessive, and paying for a required monthly visit in addition to the out of pocket cost for the medication, he was unable to afford even that.
He ended up finding a source to buy the Suboxone on the street. This is far from ideal, but it allowed him to stay clean and to work on getting his life in order. He had a reaonable job and was trying to develop a life as a responsible citizen.
Although buying the Suboxone on the street curiously and ironically proved to be more affordable than buying it with the assistance of a doctor, it was still excessive relative to his earnings, and once his mother (my ex-wife) and I came to recognize that he was without healthcare insurance, we got him back on her insurance program (I am disabled and on Medicare, but we share the premiumrs in paying for his insurance on her plan).
Once he had insurance, he looked for options to assist him in getting off the Suboxone, so he would be free of the opiates altogether. He found the Florida House online and was surprised to find that they were very near his residentail address. He was also surprised to find that their website described inpatient detox from Suboxone that sounded like it should work.
Their site stated clearly that they offer detox from Suboxone. They state equally clearly that the detox will be conducted in coordinated, ongoing assessment of the patient's progress. They also state that they offer and recommend prolonged inpatient rehabilitation but that they are aware that it will not fit in the life of all patients and purported to work with patients on finding a plan of rehab that fit their life needs at the time.
Our son was excited to find that there was a program that purported to provide inpatient Suboxone detox that was truly adjusted in accordance with the patient's response and that they would have some leniency regarding the issue of ongoing rehabilitation, as he had been free of abusive behavior for quite some time and was in a position of being financially responsible for himself and two other people, so he could not afford to take off a prolonged period from work to get into inpatient rehab. He did not believe he needed it after the prior experience and the course his life was taking.
Unable to reach me by phone on that particular day, he contacted his mother, and she paid the $3,000 deductible for hospital addmission associated with her insurance plan (not that it is important to the overall report, but I shared that expense with her after the fact). I have no idea what the total bill for the hospitalization was.
We had prior experience with Suboxone detox, because our son had been using physician-prescribed Suboxone when he decided to get into one prolonged outpatient rehabilitation program previously, and of course, he had to be opiate-free before he got in the program. We had been able to find one clinic associated indirectly with the rehab center at that time that offered accelerated Suboxone detox, which would enable our son to get into the rehab program reasonably promptly. Even in that accelerated program, he was kept and treated for ten days, and he felt incompletely detoxed and somewhat sick for the first week that he was in the rehab program. It was difficult but tolerable.
I understand that there are programs of accelerated detox from Suboxone that utilize complete general anesthesia to keep the patients from experiencing the severe withdrawal reactions that would be associated with such a rapid withdrawal. In fact, outpatient Suboxone withdrawal is typically done over the course of at least four months, and it is not usual for patients to be without symptoms when they come off their last tiny dose after several months of downward titration.
There is no place for the basically 5 day (that is a liberal description) detox program from Suboxone that was provided to him by the Florida House in exchange for at least our $3000 deductible, and it did not work. This would more typically have potential for successful use in the case of an individual who had been recently detoxed from heroin using Suboxone and then found they needed to be detoxed from the Suboxone after that shortterm use, not in the case of a patient who had been using Suboxone for a prolonged period of time.
Our son had been using Suboxone for about ten months, so it would have been natural to predict a somewhat prolonged detox in this program that purported to adjust treatment in accordance with a patient's progress. He had been using 4 mg tablets, generally taking one twice daily and occasionally adding a third. He explained it to them plainly in those terms. The typical expectation would be that they'd start him at a dose near what he had been taking and then drop it from there in somewhat gradual titration. Instead our son experienced the following:
They admitted him on the evening of August 5, 2015 at 8 pm and gave him a single dose of 16 mg of Suboxone. On August 6, they gave him an 8 mg dose twice daily. On August 7, they gave him a 6 mg dose, again twice daily. On August 8, they gave him a 4 mg dose twice daily. On August 9, they gave him a 2 mg dose twice daily. Then on August 10, they gave him a single 2 mg dose before discharging him.
He was frightened and dumbfounded to learn that they meant to discharge him already and asked to speak to the doctor in charge of his care, but he was issued out the door without being offered that opportunity. In fact, the only doctor he was aware of having seen during the brief addmission appeared to be interested only in the fact that my son has asthma. This point is only incidental to the major issue of this report, but the physician prescribed an appropriate inhaler for treatment of that. Then, unlike any other hospital I've ever seen (I am myself a physician), they discharged him without even allowing him to take what was left of the inhaler that had been ordered for him!
Considering that he had been using a total 8 mg dose daily before addmission, in fact, including the dose at addmission and the dosing for the first three full days of the addmission, he received a dose in excess of his usual dose on all those days. I do not understand how anyone could pretend that was part of a detox plan. He did not get any sort of a taper, if you can call it that, until the day before he was discharged, at which point his dose was abruptly cut in half. Then on the last day it was quartered! That pattern bears no relationship whatsoever to a well thought out detox. It's just absurd.
To my disappointment and consternation, my son called me the evening of the day he was discharged, entirely confused as to what he was supposed to do. He wondered if he should try to "tough it out", but withdrawal from Suboxone is so prolonged that there is no "toughing it out". I could tell he was already in withdrawal, and as much as I hated to do it, especially with awareness that I had just shared a cost of $3000 with my ex that was totally wasted, I sent him enough cash to get Suboxone on the street to carry him until he could get an appointment with a doctor who could prescribe it, now that he had insurance to cover the med for a copay and had become aware of a private doctor who was prescribing Suboxone at a more reasonable and typical charge for visits.
Beyond the issue of inadequate treatment, my son was further troubled, because although the information they offered stated in no unclear terms that they understood some patients would be unable to undertake their prolonged inpatient rehab program, rather than the promised daily evaluation of his progress, the primary interaction with staff was to get a brow-beating as to how they thought he absolutely needed to be in their prolonged inpatient rehabilitation program. Although this can only be seen as a guess, he came away suspecting strongly that they discharged him after entirely inadequate care because he would not agree to that rehab program and that the offer of detox was a come-on to get people into the presumably more highly revenue generating prolonged rehab program.
I have no other experience of this detox hospital. For all I know they do a perfectly adequate job of detoxing people from some other substances, but this approach to Suboxone is inane, and to discharge someone abruptly without any attention to their clinical status is criminal. We paid a $3000 deductible and got absolutely nothing out of it. This was not a typical case of an opiate addict getting out of a program that they didn't want to be in in the first place and promptly getting back on their drug of choice. My son was anxious and excited about the opportunity to get the need for Suboxone out of his system, and instead he was discharged on a low enough dose, after no true detox, that he would end up in flagrant withdrawal just a few hours later. I think it is a crime.
The Florida House Reviews
My son is opiate dependent. He has been through several detox programs and long term inpatient rehabilitation programs over the years. In recent years he has done well, overall, but he has had an occasional brief relapse. On his last most recent relapse, he caught himself promptly but was not in a position (due to lack of healthcare insurance) to get into a detox program.
His only other option at that time was to get on Suboxone. He started out working with a private physician who prescribed Suboxone, but his charges for visits were truly excessive, and paying for a required monthly visit in addition to the out of pocket cost for the medication, he was unable to afford even that.
He ended up finding a source to buy the Suboxone on the street. This is far from ideal, but it allowed him to stay clean and to work on getting his life in order. He had a reaonable job and was trying to develop a life as a responsible citizen.
Although buying the Suboxone on the street curiously and ironically proved to be more affordable than buying it with the assistance of a doctor, it was still excessive relative to his earnings, and once his mother (my ex-wife) and I came to recognize that he was without healthcare insurance, we got him back on her insurance program (I am disabled and on Medicare, but we share the premiumrs in paying for his insurance on her plan).
Once he had insurance, he looked for options to assist him in getting off the Suboxone, so he would be free of the opiates altogether. He found the Florida House online and was surprised to find that they were very near his residentail address. He was also surprised to find that their website described inpatient detox from Suboxone that sounded like it should work.
Their site stated clearly that they offer detox from Suboxone. They state equally clearly that the detox will be conducted in coordinated, ongoing assessment of the patient's progress. They also state that they offer and recommend prolonged inpatient rehabilitation but that they are aware that it will not fit in the life of all patients and purported to work with patients on finding a plan of rehab that fit their life needs at the time.
Our son was excited to find that there was a program that purported to provide inpatient Suboxone detox that was truly adjusted in accordance with the patient's response and that they would have some leniency regarding the issue of ongoing rehabilitation, as he had been free of abusive behavior for quite some time and was in a position of being financially responsible for himself and two other people, so he could not afford to take off a prolonged period from work to get into inpatient rehab. He did not believe he needed it after the prior experience and the course his life was taking.
Unable to reach me by phone on that particular day, he contacted his mother, and she paid the $3,000 deductible for hospital addmission associated with her insurance plan (not that it is important to the overall report, but I shared that expense with her after the fact). I have no idea what the total bill for the hospitalization was.
We had prior experience with Suboxone detox, because our son had been using physician-prescribed Suboxone when he decided to get into one prolonged outpatient rehabilitation program previously, and of course, he had to be opiate-free before he got in the program. We had been able to find one clinic associated indirectly with the rehab center at that time that offered accelerated Suboxone detox, which would enable our son to get into the rehab program reasonably promptly. Even in that accelerated program, he was kept and treated for ten days, and he felt incompletely detoxed and somewhat sick for the first week that he was in the rehab program. It was difficult but tolerable.
I understand that there are programs of accelerated detox from Suboxone that utilize complete general anesthesia to keep the patients from experiencing the severe withdrawal reactions that would be associated with such a rapid withdrawal. In fact, outpatient Suboxone withdrawal is typically done over the course of at least four months, and it is not usual for patients to be without symptoms when they come off their last tiny dose after several months of downward titration.
There is no place for the basically 5 day (that is a liberal description) detox program from Suboxone that was provided to him by the Florida House in exchange for at least our $3000 deductible, and it did not work. This would more typically have potential for successful use in the case of an individual who had been recently detoxed from heroin using Suboxone and then found they needed to be detoxed from the Suboxone after that shortterm use, not in the case of a patient who had been using Suboxone for a prolonged period of time.
Our son had been using Suboxone for about ten months, so it would have been natural to predict a somewhat prolonged detox in this program that purported to adjust treatment in accordance with a patient's progress. He had been using 4 mg tablets, generally taking one twice daily and occasionally adding a third. He explained it to them plainly in those terms. The typical expectation would be that they'd start him at a dose near what he had been taking and then drop it from there in somewhat gradual titration. Instead our son experienced the following:
They admitted him on the evening of August 5, 2015 at 8 pm and gave him a single dose of 16 mg of Suboxone. On August 6, they gave him an 8 mg dose twice daily. On August 7, they gave him a 6 mg dose, again twice daily. On August 8, they gave him a 4 mg dose twice daily. On August 9, they gave him a 2 mg dose twice daily. Then on August 10, they gave him a single 2 mg dose before discharging him.
He was frightened and dumbfounded to learn that they meant to discharge him already and asked to speak to the doctor in charge of his care, but he was issued out the door without being offered that opportunity. In fact, the only doctor he was aware of having seen during the brief addmission appeared to be interested only in the fact that my son has asthma. This point is only incidental to the major issue of this report, but the physician prescribed an appropriate inhaler for treatment of that. Then, unlike any other hospital I've ever seen (I am myself a physician), they discharged him without even allowing him to take what was left of the inhaler that had been ordered for him!
Considering that he had been using a total 8 mg dose daily before addmission, in fact, including the dose at addmission and the dosing for the first three full days of the addmission, he received a dose in excess of his usual dose on all those days. I do not understand how anyone could pretend that was part of a detox plan. He did not get any sort of a taper, if you can call it that, until the day before he was discharged, at which point his dose was abruptly cut in half. Then on the last day it was quartered! That pattern bears no relationship whatsoever to a well thought out detox. It's just absurd.
To my disappointment and consternation, my son called me the evening of the day he was discharged, entirely confused as to what he was supposed to do. He wondered if he should try to "tough it out", but withdrawal from Suboxone is so prolonged that there is no "toughing it out". I could tell he was already in withdrawal, and as much as I hated to do it, especially with awareness that I had just shared a cost of $3000 with my ex that was totally wasted, I sent him enough cash to get Suboxone on the street to carry him until he could get an appointment with a doctor who could prescribe it, now that he had insurance to cover the med for a copay and had become aware of a private doctor who was prescribing Suboxone at a more reasonable and typical charge for visits.
Beyond the issue of inadequate treatment, my son was further troubled, because although the information they offered stated in no unclear terms that they understood some patients would be unable to undertake their prolonged inpatient rehab program, rather than the promised daily evaluation of his progress, the primary interaction with staff was to get a brow-beating as to how they thought he absolutely needed to be in their prolonged inpatient rehabilitation program. Although this can only be seen as a guess, he came away suspecting strongly that they discharged him after entirely inadequate care because he would not agree to that rehab program and that the offer of detox was a come-on to get people into the presumably more highly revenue generating prolonged rehab program.
I have no other experience of this detox hospital. For all I know they do a perfectly adequate job of detoxing people from some other substances, but this approach to Suboxone is inane, and to discharge someone abruptly without any attention to their clinical status is criminal. We paid a $3000 deductible and got absolutely nothing out of it. This was not a typical case of an opiate addict getting out of a program that they didn't want to be in in the first place and promptly getting back on their drug of choice. My son was anxious and excited about the opportunity to get the need for Suboxone out of his system, and instead he was discharged on a low enough dose, after no true detox, that he would end up in flagrant withdrawal just a few hours later. I think it is a crime.