Using Medication to Support Real Healing Suboxone® & Tapering

Suboxone® Role in Recovery

Suboxone® (buprenorphine/naloxone) quiets withdrawal, reduces cravings, and lowers overdose risk so patients can stabilize life and do the deeper work of recovery. It is not a cure-all and it does not “fix” everything on its own; it works best when anxiety, depression, trauma, and insomnia, the drivers that often fuel use, are addressed alongside medical care.

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Suboxone® may be the right choice for people who:

Can not stop using kratom or escalating dosage

Find themselves using “just to feel normal”

Keep cycling through withdrawal when trying to stop

Are exposed to fentanyl/heroin/pressed pills or have overdosed

Want a respectful, non-paternalistic plan that uses medication when it helps and plans for tapering when it’s time

Dr. Felgus’s approach

Stabilize on the lowest effective dose.

The immediate goal is safety and daily function, not maximal dosing.

Treat the person, not only the prescription

Anxiety, depression, trauma, and insomnia receive equal attention.

Expect work beyond medication

Therapy, skills practice, group work, or documented self-help are part of the plan.

Taper gradually—years, not months—when ready.

When timing, readiness, and stability align, he plans careful, individualized step-downs.

No one-size-fits-all

Some remain on MAT longer; others taper off. Both paths can be aligned with healing.
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Getting started

Beginning Suboxone® typically means stopping other opioids long enough to enter mild–moderate withdrawal before the first dose. This timing helps avoid precipitated withdrawal. Dr. Felgus provides clear instructions, dose planning, and close follow-up through the first days so patients can stabilize safely and comfortably.

The first 90 days (a typical arc)

Weeks 1–2

Stabilize.

Find the lowest effective dose; safety planning; immediate supports for sleep, anxiety, and triggers.

7

Weeks 3–6

Build foundations.

Treat the “Big Four” (anxiety, depression, trauma, insomnia); skills for cravings and stress; involve family if helpful.

7

Weeks 7–12

Strengthen & plan

Consolidate routines and supports; review goals. There is no pressure to taper during early stabilization.

When tapering becomes appropriate

Tapering is considered when multiple signs point to readiness, such as:

Steady housing, relationships, and daily structure

Sustained non-use of illicit opioids and other high-risk substances

Reliable supports (therapy/peer/community) and a clear, shared goal to taper

Ability to pause or reverse the taper if life gets bumpy

Tapers are slow, collaborative, and reversible, planned over years, not rushed.

Myths & facts

Myth: “Suboxone® just swaps one addiction for another.”

Fact: Used properly, it treats a medical condition, reduces overdose risk, and helps people stabilize life.

Myth: “Higher doses are always better.”

Fact: Dr. Felgus aims for the lowest effective dose that supports safety and function.

Myth: “If I start Suboxone®, I’ll be on it forever.”

Fact: Many patients taper off, when timing and supports are right. Others benefit from longer-term treatment. Both can be healthy.

Myth: “If I still have cravings, Suboxone® isn’t working.”

Fact: Medication reduces (not eliminates) urges; addressing anxiety, depression, trauma, and insomnia is essential.

Safety & boundaries

N

Suboxone® is prescribed within a comprehensive plan and monitored regularly.

N

Mixing with benzodiazepines, alcohol, or sedatives increases risk and is addressed directly.

N

Urgent concerns are handled promptly; emergencies require 911/ER.

N

Refill, lost/stolen medication, and monitoring policies are reviewed up front.

N

Medication must be stored safely and never shared.

Family involvement & supports

With the patient’s permission, loved ones can be included for education and support. Dr. Felgus encourages skills practice, therapy, and community resources alongside medical care.

FAQs

Will Suboxone® make someone feel “high”?

At therapeutic doses, it should help a person feel normal, not intoxicated.

How long will someone be on it?
It depends. Some remain on MAT longer; others taper over years when life is steady and supports are strong.
Can a taper be done without relapse?
Many do, with readiness, support, and time. Tapers are individualized and can pause if needed.
What about pain treatment or surgery?
We coordinate with other clinicians to manage acute pain safely while on buprenorphine.
Is counseling required?
We expect work beyond medication – therapy, skills, or documented self-help – because medication alone is not enough.
Do patients have to do 12-Step?
No. 12-Step and non-12-Step options are discussed; the plan is tailored to the person.

Ready When You Are

Change is possible with guidance and care.

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