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Substance Use Program

Intensive Outpatient Program

Opiate dependence has reached pandemic proportions leaving many people, young and old, dead from overdose from heroin. At Charak, we provide comprehensive, outpatient treatment services to include, but not limited to: diagnostic assessments from a psychotherapist and a psychiatric provider to assess the patient’s individual needs, psychotropic medication management from a psychiatric provider, group psychotherapy for addictions, individual psychotherapy for underlying mental health symptoms, such as anxiety, depression, PTSD, bipolar, and personality disorders, and case management services to address and solve any potential barriers to treatment. With over 100 years of collective addictions experience that includes Board Certified Addictionologists and psychiatrists, licensed psychologists and social workers, licensed professional counselors, chemical dependency counselors, and case managers, our staff is dedicated to providing the best intensive outpatient services to our patients.

Charak offers a pharmacological treatment protocol that includes Suboxone and Vivitrol to assist opiate dependent men and women with their recovery. Once a patient has signed a contract and they have completed both diagnostic assessments, they proceed to the induction phase of treatment. During the 5 consecutive days of treatment in the induction phase, patients are medicated and observed for tolerance of the suboxone. Upon completion of this phase, patients attend an intensive outpatient programs (IOP), which involve group therapy, three times a week, three hours per group, and individual psychotherapy.

Charak offers morning and afternoon IOP groups in the Medina, Garfield, Mentor and Elyria offices 5 days per week. Because addiction is a chronic illness that impacts not only the person abusing the substances but also the family members and loved ones, Charak offers Family Night Groups during the IOP phase. Patients also participate in Aftercare groups, 2 times a week for 2 hours each group, for 10 weeks, then Aftercare groups once a week for 10 weeks, and then maintenance therapy (psychotropic medication management and individual psychotherapy) once a month for a minimum of 20 weeks until treatment is completed. Patients are also required to submit scheduled and random urine screens, participate in group and individual sessions, and attend all scheduled appointments throughout the course of treatment.  

Medication Assisted Treatment

What is Suboxone?

Most people who are dependent on pain killers, heroin, or other opiates cannot quit “cold turkey” due to severe withdrawal symptoms that include nausea, vomiting and severe fatigue, and because they can experience triggers and cravings months after discontinuation. Research has shown that the majority people who quit “cold turkey” do not remain abstinent after one year. When a person is dependent on opiates, he/she needs to satisfy cravings and avoid withdrawal symptoms. Consequently, medication- assisted treatment, counseling, and behavior modification are necessary for sustained recovery.

In 2002, Suboxone was approved for the treatment of opioid addiction in The United States. Suboxone suppresses withdrawal symptoms and cravings, does not cause euphoria, and blocks the effects of other problematic opioids for at least 24 hours. Suboxone film contains buprenorphine (partial opioid agonist) and naloxone (opioid antagonist). After taken, Buprenorphine will remain in the brain’s opiate receptors for 24 hours. During this time period, Suboxone prevents opioids, such as Oxycodone or heroin, to allow the person to get high. There is also a “ceiling effect” to where a patient will not be able to achieve a high by taking more than the required dosage of Suboxone. Because a patient cannot get high off misuse of Suboxone or by using other opioids after taking Suboxone, Suboxone is preferred by providers over previously used medications like Methadone. With Methadone, using more than the recommended dosage could lead to a high. That being said, Suboxone must be taken exactly as prescribed by your provider.

While Suboxone is an opioid that can cause physical dependence with chronic use, dependence is not the same as addiction and Suboxone can be monitored effectively by your prescribing provider. It should be noted, however, that Suboxone can cause serious life-threatening breathing problems when taken with benzodiazepines, sedatives, tranquilizers, and alcohol. Suboxone must be kept out of reach from children as it can also cause serious breathing problems and death if taken by children. If you are pregnant, or plan on becoming pregnant, you must consult with your prescribing provider about the use of suboxone. The decision to stop taking suboxone after an extended period of maintenance should be made by a comprehensive treatment team that includes your prescribing provider. 

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