How does the doctor decide what my dose of medication will be?

For methadone this is done by starting with a dose likely considered to be safe in your situation (depending on other medications, medical conditions and other factors). Then we will see you again in 3-4 days and make a determination on whether your dose is good, too high or too low. If it gets raised we will again see you in 3-4 days. We keep doing this until the dose is working well. This is a process called stabilization.

For Suboxone this process is called induction and occurs over the first 24 hours. We start most patients at 9 a.m. with a determination of whether or not they are in withdrawal (see info on Suboxone). If you are determined to be in withdrawal we provide a small test dose and see you again in 45-60 minutes. If you are not feeling worse after this time and are still in withdrawal then we add more Suboxone and again see you in 45-60 minutes. By the third time we see patients most are starting to feel better. If you are still not quite right we may provide another dose and then will ask you to return that afternoon. When we see you in the afternoon it is to make a determination of whether more Suboxone is likely to be necessary so an additional dose may or may not be given at that time. We will then ask you to return again in the morning to see if the dose lasted through the night and will then decide on what your daily dose will be. Most people are then seen a week later just to confirm the dose is working properly.

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