Suboxone Clinic at Murfreesboro, Tennessee

Outpatient Clinic treating Opioid and Alcohol Addictions
Serving Murfreesboro and nearby areas
Accepting self-pay patients
Next new patient enrollment will be August 12 and 13
No referral required

Text : 615-968-7727

Suboxone and Naltrexone for opioid use disorder
Naltrexone for alcohol use disorder
Naltrexone for weight loss

Shyam A. Jha
Shyam A. Jha, MD

Shyam A. Jha, MD

I offer outpatient treatment for opioid and alcohol addiction from my office at Murfreesboro, Tennessee.

Outpatient treatment means that you do not have to be admitted to a facility to receive treatment. This eliminates all the costs and disruptions that are associated with getting admitted to a hospital or rehab facility for treatment.

I have offered this treatment in Murfreesboro for more than ten years.

I do not require prior medical records or referral from PCP. Anyone can seek treatment on their own.

It is a self-pay program. I do not need preauthorizations and do not bill your insurance ... that means patients can quickly start treatment.

Initial visit is $278 to $328 and follow up visits are $98 to $148 ... once a month.

Whether I can enroll you in my program or not is determined after a phone interview. The phone interview takes about 5 to 10 minutes, and is offered the same day that the patient makes initial contact.

Appointments are currently being offered once every three months.

Enrollment in the program requires an office visit where patients complete consent forms, provide a medical history and have a physical examination. This is followed by a discussion of the treatment plan and then the prescription is transmitted to a pharmacy chosen by the patient.

This process takes one to one and half hours.

Each prescription is for 30 days and follow up visits are once a month. Follow up visits take fifteen to thirty minutes. Any issues in the interval are handled via text, phone call, or video meeting.

If you do have other significant medical issues then I can evaluate your situation during the phone interview and give you an answer then and there ... as to whether I can see you. I may still be able to see you ... provided you are currently being treated for those conditions by another medical provider.

I am not a primary care provider, I do not diagnose and treat other medical conditions, and do not prescribe other medications.

Patients have to be seen in the office for enrollment. Most follow up visits are done over telemedicine; however, patients do have to be seen in the office at regular intervals.

Currently I offer treatment with the following medications:

  • Suboxone tablets or films or similar medication for opioid use disorder.
  • Naltrexone tablets for Opioid and alcohol use disorder.
  • Naltrexone and Acamprosate tablets for alcohol use disorder.
  • Naltrexone and Bupropion tablets for weight loss.

I do not offer any injections or implants of Buprenorphine or Vivitrol.

Services Offered

These services are offered from my office at Murfreesboro, Tennessee. This is an outpatient clinic.

Currently I offer treatment for opioid use disorder and alcohol use disorder.

Opioid use diorder:

Also known as opioid dependence and opioid addiction.

It is a condition where patients have been using opioids with or without a prescription or using street drugs such as Heroin and Kratom. Opioid medications commonly used or misused are Lortab, Percocet, Oxycontin, Oxycodone, Morphine, Dilaudid, Fentanyl, Tramadol, etc.

People use these drugs for pain management, antianxiety, and euphoric effects. Prolonged use of these drugs induces biochemical changes in the brain which manifests as dependence and tolerance. Brain adapts to these drugs ... and over time it takes more and more drugs to get the same effect.

If the person wishes to stop using these drugs or is unable to get these drugs ... then they experience unpleasant withdrawal symptoms within 12 to 24 hours ... anxiety, irritability, shivering, sweating, cold chills, runny nose, tearing, nausea, vomiting, ... which progressively become more severe ... leading to ... abdominal cramps, diarrhoea, inability to eat, rest, or sleep, ... making it impossible for the person to rest, sleep, work, or attend school.

These symptoms can only be relieved by taking the opioids that the person was using. No matter how strong their desire to stop using ... these symptoms drive patients back to using these drugs again to get some relief.

Treatment invloves prescribing Buprenorphine that substitutes for the opioids that the patient was using ... and then slowly taper the dose as tolerated to have mild withdrawal that is acceptable to the patient. The brain is slowly forced to adapt to lower and lower dose of opioids till no more opioid is needed. This process is within the control of the patient, ... some can do it in months ... but most would take years.

  1. Suboxone

  2. Most patients prefer to receive Buprenorphine + Naloxone popularly known as Suboxone, Zubsolv, or Bunavail.

    This is a long acting opioid suitable for once a day dose. This medication is taken by placing it under the tongue from where it gets absorbed within 5 to 10 minutes. This medication must not be swallowed as it is not effective that way. This medication prevents withdrawal symptoms, allowing the patients to feel normal and thereby making it possible for them to work or attend school.

    This medication has been available in USA since 2000 as a tablet and film. It is a controlled substance. I have been prescribing this medication since 2010. It has a very good safety profile if used appropriately. It has minimal to no side effects, and 100% prevention of withdrawal symptoms at appropriate doses. While the dose is being adjusted there might be some withdrawal ... but it is minimal.

    This medication is now also available in generic form and costs $2 to $3 per tablet or film of 8mg. In my program patients are started at 12mg/day or lower and are supported through tapering the dose gradulaly till they make full recovery or reach the lowest maintenance dose.

    Recovery requires the patient to gradually reduce the dose and go through the process of controlled withdrawal. The time required to make a complete recovery depends on the patient ... how aggressive and how uncomfortable they can afford to be. It can vary from three months ... to three years ... to never. It depends on factors like the length of opioid use, the dose used, other medications used, underlying medical problems, etc. Patients who also have chronic pain may never be able to come off this medication as this medication also manages their pain.

    Suboxone can not be used while the patient is on opioids ... it will precipitate severe withdrawal. Patient has to be in withdrawal or be opioid free for 1 to 3 days days before this medication can be started. Starting this medication is called induction and there are several protocols to chose from; including in-patient, in-office, and phone supported induction.

    If used appropriately and under the supervision of a physician ... there is hardly any side effect. Patients feel normal and can attend school, work in medical and legal profession, be a commercial driver or work with machinery. If there are unacceptable side effects then the dose is reduced and side effects treated.

    The average dose of Suboxone tablet or film to treat opioid use disorder is 8 to 12mg per day. It is rare to use more than 16mg/day. The dose is slowly tapered to the lowest dose that prevents withdrawal.

    The discounted cost of generic Buprenorphine+Naloxone (8mg+2mg) per  is $2 to $3 per tablet or film ... which means depending on your dose ... $60 to $180 for one months supply

    This medication is also available as an extended release once a month injection and a six month, under the skin implant. They are expensive and I do not prescribe or administer those forms of Buprenorphine.

  3. Naltrexone

  4. Naltrexone is not an opioid ... it is an opioid receptor blocker and does not prevent withdrawal symptoms.

    However, once patients have gone through the opioid withdrawal then this medication can be used. Patients report that they do not have craving for opioids when they are on this medication, thereby reducing the risk of relapse.

    This is available as once a day tablet, and once a month injection (brand name Vivitrol). I do not offer the injection.

    Naltrexone is not Naloxone. Naloxone is a reversal agent that is used to reverse the effects of opioids and save patients from overdose. Naltrexone can not be used for the treatment of overdose.

    Naltrexone can not be used while the patient is on opioids ... it will precipitate severe withdrawal. Patient has to be opioid free for 3 to 7 days before this medication can be started.

    I have had very few patients chose this medication. Most patients dropped out of the program and a few relapsed.

    This is an alternative for those patients who can not take Buprenorphine for some reason. The advantages are ... this is not a controlled substance, has a good safety profile, low incidence of side effects, and has been around for many years. It has primarily been used to treat Alcohol addiction.

    There is no risk of drowsiness or mental clouding from Naltrexone ... so patients working with heavy machinery or driving will not risk being questioned.

    Disadvantages are ... it does not stop opioid withdrawal and can not be prescribed to patients who need opioid pain medications.

    An important drawback is ... there is increased risk of overdose for a patient who relapses after being on Naltrexone. If there is a possibility of relapse and the patient can take Buprenorphine ... then the patient should not take Naltrexone.

    The average dose of Naltrexone tablet to treat opioid use disorder is 50mg once a day.

    The discounted cost of Naltrexone 50mg tablet per  is $1 to $2 per tablet or or about $30 to $60 for one month supply.

    I do not have any addiction counselors or behavioral therapists in my practice. You are free to go to a counselor/therapist of your choice. I do not require counseling as a condition for offering medications ... because medications by themselves are the most important factor in preventing relapse and overdose.

    I do not do any lab tests in my office. These tests are to be done through your PCP and are covered by your insurance. These tests can also be done directly through the lab.

Alcohol use disorder

  1. Naltrexone

  2. Naltrexone is an opioid receptor blocker and reduces the desire to drink by reducing the pleasure one derives from drinking ... by blocking opioid receptors and certain mediators in the brain. Patients who drink after taking this medication notice that they are drinking less than what they used to.

    The biggest advantage of this medication is that it avoids hospitalizing the patient for detox ... because no detox is required before starting this medication.

    Patient does not have to stop drinking and can start the treatment while at home. Had the patient been required to stop drinking ... patient would need to be hospitalized for the fear of developing the alcohol withdrawal state ... delirium and seizures.

    This medication does not interact with alcohol and thus does not cause any unpleasant symptoms. Success comes slowly ... over time patients spontaneously reduce drinking. For patients that are well motivated, success comes quickly ... within one to three months patients can give up drinking. For severe alcoholics success is not that dramatic and treatment will be much longer, however, there is always some sucess.

    This is available as once a day tablet, and once a month injection (brand name Vivitrol). I do not offer the injection.

    Naltrexone can not be used while the patient is on opioids ... it will precipitate severe withdrawal. Patient has to be opioid free for three to seven days before this medication can be started.

    Patients also need Benzodiazepines to reduce the risk of withdrawal delirium and multivitamins as part of the treatment.

    I have had quite a few patients chose this medication. It is the drug of choice for the treatment of alcohol addiction, has a good success record, a good safety profile, low incidence of side effects, and has been around for many years. It has to be used with caution in patients with significant liver damage.

    There is no risk of drowsiness or mental clouding from Naltrexone ... so patients working with heavy machinery or driving will not risk being questioned.

    The average dose of Naltrexone tablet to treat alcohol use disorder is 50 to 150mg once a day.

    The discounted cost of Naltrexone 50mg tablet per  is $1 to $2 per tablet or about $30 to $90 for one month supply.

  3. Acamprosate (Campral)

  4. Acamprosate is available as generic tablets and under the brand name Campral. Its mechanism of action is not clearly known but is thought to restore balance in cerebral chemicals that has been disrupted from prolonged alcohol use.

    This medication works best when a patient has already stopped drinking. It helps in maintaining abstinence.

    The advantage of this medication over Naltrexone is that it can be given to patients who have evidence of liver injury as this is not metabolized by the liver. This medication does not interact with alcohol and thus does not cause any unpleasant symptoms as compared to Antabuse (Disulfiram). This medication does not cause dependence or tolerance and can be stopped when patient feels that they have made the necessary changes in their habits to not drink.

    This tablet has to be taken as two tablets three times a day and so is more cumbersome to use.

    This drug is eliminated through kidneys and has to be used with caution in patients with renal failure.

    I have had only one patient ask for this medication. He had previously been prescribed this medication at a rehab and wanted to continue. Compliance is difficult as patients have to take two tablets three times a day.

    There is no risk of drowsiness or mental clouding from Acamprosate ... so patients working with heavy machinery or driving will not risk being questioned.

    The dose of Acamprosate tablet to treat alcohol use disorder is 333 mg tablets, two tablets three times a day.

    The discounted cost of Acamprosate 333mg (180 tablets) per  is $75 to $150 for one month supply.

  5. Disulfiram (Antabuse)

  6. I no longer recommend this medication and have prescribed it to only two patients in the last ten years ... these patients insisted on it, claiming that this is the only way they will stop. Both dropped out of the program. It is difficult to have the self discipline to take it every day and easy to beat the deterrent effect of the medication ... by simply not taking it.

    Disulfiram (Antabuse) works by preventing the body's ability to process alcohol, by blocking acetaldehyde dehydrogenase, ... in the process creating an accumulation of acetaldehyde in the blood, which produces extremely unpleasant symptoms. Within 5 to 15 minutes of consuming alcohol patient will experience skin flushing, sweating, throbbing headache, anxiety, breathing difficulty, rapid heart rate, nausea and vomiting. In severe cases it may progress to chest pain, low blood pressure, irregular heart beat, loss of consciousness, convulsions, circulatory collapse, and even death.

    The fear of the unpleasant symptoms is what deters patients from using alcohol. The fear of a mistake on the part of the patient is what deters doctors from prescribing it.

    Another problem is that this medication can not be used in a patient who has evidence of liver injury due to alcoholism.

    The dose is 250mg to 500mg once a day. People can beat the deterrence by not taking the medication ... and some are reckless enough to consume alcohol while being on this medication ... that invariably requires an emergency room visit. It is for these reasons that I do not recommend it. It was the only medication for alcohol deterrence for a long time, but now we have better medications ... and gentler methods.

  7. Other medications

  8. If a patient can not take these medications then there are other medications that can be used. These medications have not yet been approved by FDA for alcohol use disorder but have been approved for other conditions and their effects and side effects are well known. Their use to treat this condition is considered off lable use ... and they are prescribed because there is some clinical evidence that these medications may be useful in Alcohol use disorder.

    Baclofen, Gabapentin, Topiramate, Varenicline.

    I have not prescribed these medications to any patient as yet. Patients should consult an addiction specialist if they need these medications.

    I will prescribe these medications if the patient has already tried the approved medications first and does not have access to an addiction specialist.

Food Addiction - Obesity / Weight reduction

Obesity mostly results from calorie imbalance. When more calories are consumed than used ... the excess calories are stored as fat in the body. This predisposes the patient to metabolic syndrome increasing the risk of early onset heart disease, stroke, diabetes ... hampering daily activities and decreasing the life span. The excess weight also causes increased wear and tear of the joints causing knee, hip, and back pain.

There have been many medications over the years to reduce weight ... none of them are satisfactory in keeping the weight off in the long term. The most important thing to do is to make life style changes about eating that are permanent. One needs to do a lot of physical activities to burn accumulated calories to have a significant weight loss ... and that is very difficult to do ... and very difficult to sustain.

A combination of dieting, increased physical activity, and medications gives a more demonstrable weight loss.

The most effective medications for weight loss are those that suppress appetite/cause early satiety ... thus reducing the total calories consumed.

The new GLP-1 agonists Ozempic, Wegovy, Saxenda are very effective ... but are very expensive and difficult to afford in the long run. Discontnuing the medication will result in regaining that lost weight ... unless life style changes are made permamnent. There are other drugs which also suppress appetite ... though their effect is not as dramatic ... and weight loss not that significant ... but they are inexpensive and can be used for a longer time.

  1. Naltrexone and Bupropion

  2. Naltrexone is an opioid blocker that reduces dopamine release follwing eating and drinking, thus reducing the pleasure that people feel from food and alcoholic drinks leading to quantitatively less eating and drinking.

    Naltrexone has not been approved by FDA for this purpose so this is considered off label use. However, Naltrexone is approved for this purpose in combination with Bupropion as a component of Contrave, a weight loss medication.

    Contrave is a fixed dose combination of Naltrexone (8mg) and Bupropion (90mg). Both medications have been shown to help in reducing weight by different mechanisms ... so by combining them together would give better results.

    I prefer to prescribe Naltrexone by itself in a higher dose as it has less side effects than Bupropion and then add Bupropion down the road if the patient desires. Both medications are available in generic form and if prescribed individually costs less than the combination product.

    Naltrexone can not be prescribed to a patient taking opioid pain medication.

    Bupropion is an antidepressant commonly known as Welbutrin. It has been around for a long time and its side effects and safety profile is well established. It can not be prescribed to patients who have seizures (epilepsy) or have suicidal ideation.

    I have prescribed Naltrexone for this purpose in a dose of 25 to 50mg per day. As yet I have not had to add Bupropion. Very few patients have sought this treatment. All of them reported early satiety and reduced eating and drinking.

    Naltrexone is not a controlled substance. It is available as tablets of 50mg. The cost is $1 to $2 per tablet. Monthly prescription cost is $30 to $60 according to


My practice caters to self-pay patients only and my fee structure is such that patients know the cost of treatment in advance, ... it is predictable and fixed so that they can budget for it.

How much are you spending on drugs?

  • If you are spending $10 per day on drugs ... then you are spending $300 per month and $3600 per year.
  • If you are spending $20 per day on drugs ... then you are spending $600 per month and $7200 per year.
  • If you are spending $30 per day on drugs ... then you are spending $900 per month and $10800 per year.
  • If you are spending $50 per day on drugs ... then you are spending $1500 per month and $18000 per year.
  • If you are spending $100 per day on drugs ... then you are spending $3000 per month and $36000 per year.

People who have a drinking problem ... if you are drinking wine then you are spending $10 to $20 per day. People who are drinking beer are drinking a six pack or more per day ... that is $10 to $20 per day.

Just the cost of alcohol is $300 to $600 per month or more. There will be healthcare costs, DUI costs, legal bills, disrupted family life, disrupted professional life, homelessness ... help is available to avoid all that ... and the treatment will pay for itself within a few months.

Patients who have sought treatment for alcohol dependence or binge drinking have not sought treatment because of the money they were spending ... they sought treatment because of how it was ruining their lives, relationships, professional competence, etc., etc.

Fee Schedule

Initial enrollment / first visit is $278 to $328.

Follow up visits are once a month $98 to $148.

There is no charge for random urine drug screens. Lab tests are to be done thrugh PCP or directly purchased through lab.

Service Fee Notes
Transfer $278 Transfering from another program, has current prescription.
Initiating or restarting treatment $328 Initiating treatment or restarting after relpase.
Follow up $98 Monthly visits, prescriptions given for 30 days.
Follow up $148 Monthly visits, for patients on Suboxone more than 8mg/day, or if more than one controlled substance is prescribed.

Fees for alcohol addiction treatment: First visit $328, then monthly follow up $98.

Fees for Naltrexone for weight management: First visit $328, then follow up $98.

The fees do not include the cost of medications or lab tests. Medications are to be purchased from a pharmacy and lab tests are to be done through your PCP or directly through the lab.


Appointment Process

  1. Please read this website. It provides all essential information that any patient would need before seeking an appointment. If you still have questions then please send a text message.

  2. Do you meet the following conditions?

    • Must be a resident of Murfreesboro or surrounding area (Lives or works within 60 miles of Murfreesboro)
    • Must not have Medicare, Medicaid, Tricare, or other Govt funded insurance plan. It is best to call your insurance plan for a list of providers and seek appointment with them.
    • Must not be pregnant.
    • Must not be allergic to medication being prescribed, that is Buprenorphine, Naloxone, or Naltrxone.
    • Must not need Suboxone more than 12mg/day. I do not prescribe more than that.
    • Must not require Subutex. I do not prescribe Subutex.
    • I only accept uncomplicated cases. Examples of complicated cases are patients with psychiatric disorders, liver or kidney failure, patients on multiple medications, intravenous drug users, etc. Such patients are best served by an addiction specialist. I am not an addiction specialist.
    • Some complicated cases can be accepted if they are currently under the care of a specialist or primary care provider. Please text to discuss.

  3. Send a text message requesting appointment and indicate a good time to call back. Please do not call as I do not answer calls from unfamiliar numbers. I will contact you for a phone interview and discussion. This takes 5 to 10 minutes. Call back is between 11AM and 7PM.

  4. If we agree to make an appointment then I will ask you for a copy of your ID to be sent as image by phone-text, and your email address. Further instructions and invoice is sent by e-mail.

  5. Payment is required before service is provided. You should hold off on the payment till the actual appointment.

  6. Please come to the office at the appointment time. Consent forms, controlled substances agreement, and medical history forms are to be read and completed. This is followed by a problem focussed medical exam which is mostly a neurological exam. You are not required to disrobe. I do not do any genital exam.

    The final step is a discussion of medication and treatment plan. Please allow one to one and half hours for this entire process.

  7. Prescription is sent to a pharmacy of your choice. Follow up appointment is made in three weeks, a week before you will run out of medication. Future follow up appointments are once a month.

  8. After starting the treatment you will be asked follow up questions to ensure that everything is proceeding as discussed and you will be monitored for side effects. Please answer my text message promptly.

  9. Follow up appointments are done through telemedicine via audio and video meeting. You will need a camera enabled phone or a computer with a webcam. Any other support is promptly provided through text message and phone calls. Patients are required to come to clinic once every three months.

Contact us

Best method to contact me for an appointment is through text message. I do not answer phone calls from unfamiliar numbers.

You do not have to complete any forms or submit any information before an appointment is made

After your text message a phone interview is setup at a mutually convenient time

A phone interview is done before an appointment is offered. It is my policy to see the patients in my office before treatment is initiated. Once patients have been seen in the office then follow up visits can be done through a mix of telemedicine and in-person visits.

  • My office is located at Murfreesboro, Tennessee.
  • I only accept patients from Murfreesboro and surrounding areas. (60 miles/within one hour of driving time).
  • I no longer provide one time / emergency prescriptions.
  • I do not provide prescriptions to persons who are not my patient.
  • I have a part time practice, patients are seen only by appointment.

I no longer live in Tennessee. I come to Tennessee for the duration of the clinic. If you are unable to keep appointments then my practice will not be suitable for you.New enrollments are offered only in certain months.

About: Shyam A. Jha, MD

I am a small, one man, part time practice ... I am not an addiction specialist and I am not an approved provider for any insurance network.

The commonest mistake patients make is ... not doing enough research before enrolling in a program. It is important to know what the program does ... and even more important what the program does not do.

To help you decide whether my practice is suitable for you ... here is what I do and what I do not do.

  • I am board certified in anesthesiology, having trained at Vanderbilt University, with a fellowship in pain management from University of Pittsburgh. I no longer practice anesthesia or pain management.

  • Before becoming an anesthesiologist I was a general medicine practitioner for 7 years.

  • I have the necessary training required to prescribe Suboxone and have been prescribing Suboxone for opioid use disorder for more than 12 years at Murfreesboro, Tennessee.

  • I also treat alcohol addiction with Naltrexone and Acamprosate.

  • One does not have to be an addiction specialist to treat opioid or alcohol addiction. One does not have to be an addiction specialist to prescribe Suboxone or Naltrexone.

  • I am a small one man practice with limited resources ... and can not provide the services that a larger practice can provide. Your mileage may vary. My practice has been good enough for most patients. Some patients have been with me for years ... on the other hand some patients do not last even two months.

  • I am not a provider for any insurance plan and do not see Medicare or Medicaid patients or other govt. provided insurance. Un-insured patients or patients with commercial insurance can be seen as self-pay patients.

  • If you want your insurance to cover your treatment ... then it is best to go to a provider within your insurance network. Ask your insurance for a list of contracted addiction treatment providers (addiction is now called "Substance use disorder") and enroll in their program. I do not provide any pre-authorization assistance or claim assistance.

Things that I do not do ...

  • I do not prescribe Subutex (that is Buprenorphine without Naloxone). I do not accept patients who are on Subutex.

  • I no longer provide enrollment via telemedicine. Patients have to be seen in the office to be enrolled in the program.

  • I do not accept patients who are on more than 16mg/day of Suboxone. The maximum dose of Suboxone that I prescribe is 12mg/day, which is reduced to 8mg within one year.

  • I do not offer Buprenorphine extended release injection (Sublocade) or Buprenorphine implants (Probuphine). I do not offer Naltrexone (Vivitrol) injections.

  • I do not provide counseling: There are no counselors or behavioral therapists associated with my practice. You are free to go to a counslor of your choice.

  • I do not insist that patients attend counseling in order to receive medications. Medication by itself is fundamental to preventing relapse and maintaining a withdrawal free state that allows patients to work or attend school. However if the patient has relapse then it means that medication alone is not sufficient and the patient needs to transfer to a more intensive program or attend counseling.

  • I do not prescribe other medications. I am not a PCP and do not diagnose or treat other conditions.

  • I do not dispense any medications. I transmit your prescription electronically to a pharmacy of your choise and you have to pay for and get medications from them. Most prescription plans cover these medications. Some patients find it cheaper to use a discount coupon.

The best information you can get about a program is by talking to one of the patients there. So ask your family and friends about the program and its cost and any problems that they have encountered. Other sources are your PCP, counselors, pharmacists, and people in recovery.

Do not rely on star ratings and google reviews. Happy patients do not write reviews ... when was the last time you wrote a five star review for your doctor? I tell my patients not to write reviews because internet is for ever ... and any information you leave on it can be connected to you and your family.

Unhappy patients anyway write reviews .. it is worth reading them to find out why they were unhappy and see if that applies to you.

I do discharge patients from my practice.

  • The most common reason is inability to keep appointment,
  • second reason is relapse, not disclosing it, and not willing to do anything about it,
  • and the third reason is losing their medications.

There are other reasons ... mostly to do with patient expectations ... people come to my program for being the most affordable and then expect five star services ... I am sorry this is a one star service.

For some patients that is enough and they have been with me for years ... for some that is not enough and they do not last two months. The patients who have stayed in my practice the longest are those that have come from other practices.

Some patients do not wish to come off Suboxone. Many of my patients have made a complete recovery and are no longer taking this medication. Some are unable to come off but they have reached the lowest possible dose ... are stable on it ... and are at low risk for relapse.

There is a difference between Can't do and Won't do ... and only the patient knows that. I am happy to guide those patients who want to taper their dose.