Online Telemedicine treatment of opioid use disorder (OUD) using direct telemedicine detox and maintenance treatment (MAT) via DEA approved protocol with primary care providers in every city in the United States and advertising BRIXADI and SUBOXONE. Current similar competitor "Bicycle Health."
Opioid Use Disorder (OUD) is at epidemic levels in the United states and the World. At the Pain & Addiction Integrated Network, Inc. also known as the P.A.I.N. Institute, we have developed a unique program to help individuals who suffer with Opioid Use Disorder. HOW DOES OPIOID USE DISORDER DEVELOP? Opioid drugs are prescribed to alleviate pain. In the United States, 100 million or 1 in 5 individuals suffer with chronic pain. Last year, approximately 142 million opioid prescriptions or 43 OPIOID scripts per 100 persons were written, which is down 40% from 2018 and considered the lowest number in 10 years yet, inexplicably, the overdose death rate increased by >40% resulting in 110,000 or 320 people dying each and every day as a result of drug overdose. We know that 3.8 % of American Adults abuse opioid drugs every year or approximately 11.4 million Americans, but officially, it is estimated that only 2.7 million individuals suffer with Opioid Use Disorder (OUD). 72%-80% of overdose deaths involve Opioid drugs and 20% of OD deaths involve illicit Fentanyl (100 times more potent than Morphine). Opioids and opiates used to treat pain also produce a sense of euphoria in some people. This, combined with tolerance, results in the opioid dependent individual progressively needing more and more to produce the same effects and, this can result in Opioid Use Disorder. Opioids profoundly affect brain chemistry and OUD develops when genetics and biology is triggered by access and exposure to opioids and are often exacerbated by medical conditions involving mental health, medical conditions and memories of traumatic & adverse childhood experiences.
The United States is facing an epidemic due to massive amounts of FENTANYL and OPIOID drugs flooding American communities at unprecedented quantities. Once the unsuspecting individual's brain receptors are captured by Opioid drugs, in effect the brain's pain and pleasure center MU receptors being hijacked, no amount of willpower can stop the despiration and psychologic inprisonment due to constant, 24/7, craving for more opioid drugs! Drug rehabilitation treatment costs the United States over 42 billion dollars per year and the rate of success in treating Opioid Use Disorder is only 10-20%. However, Opioid Use Disorder can be successfully treated using MAT (Medication Assisted Therapy) with 90% via telemedicine.
We, at the Pain & Addiction Integrated Network, Inc. have treated thousands of individuals for Opioid Use Disorder over the last 20 years yet, our nation does not have enough specialists to address the millions of Americans who suffer from Opioid Use Disorder, drug dependency, and other Addictive Maladies. We are the first Telehealth Opioid Use Disorder internet treatment program designed by an Addiction Physician who has experience treating thousands of opioid dependent individuals. Dr. Chavez has developed a therapeutic protocol that can rapidly identify, assist, and begin treatment of drug dependent individuals while initiating treatment out of the comfort of their homes.
1) 100% Initial Online Consultation, recommendations, & options regarding the treatment of Opioid Use Disorder (OUD) and/or other Addictive Conditions.
2) Consultative analysis by a Board Certified / Addiction Specialist to determine the best options available to you and your family regarding the treatment of Opioid Use Disorder and/or other Addictive disorders.
3) Depending on your current clinical and family situation, our certified providers will make realistic recommendations regarding the initial Detoxification and therapeutic management of Opioid Use Disorder (OUD) & other Addictive maladies over the internet via TeleMedicine.
4) Under DEA proposed rules: Telemedicine consultations that recommend DETOX therapy and the prescribing of a schedule III-V medications to treat Opioid Use Disorder may be arranged by the certified provider via Tele-Medicine in the comfort of your home, directly managed and supervised by our certified clinical providers.
5) Our staff will determine if you or your family member is a candidate for the initial TeleMedicine Detox protocol plus 30 days of maintenance BUPRENORPHINE therapy followed a call to either your current primary care provider or another clinician in your home community who is contracted with the P.A.I.N. Institute, to continue maintenance therapy as part of management of your Opioid Use Disorder (OUD).
6) Currently, we have providers available in the Los Angeles, Orange, San Bernadino, Kern, and Ventura County Areas.
7) We are looking for collaborating providers in communities and states across our great nation who will be seeing patients in their communities. MAT treatment is extremely effective in treating OUD (other protocols for other disorders like tobacco use disorder, alcohol use disorder, benzodiazepine disorder, stimulant use disorder) and 90% of disorders can be started via Tele-Medicine initially supervised by certified providers, however, all individuals who successfully are managed initially using MAT are required to follow up with their primary care providers or a P.A.I.N. Institute Collaborating Provider (M.D.s and N.P.s) who has established an association with our Tele- Medicine program, whose practice is in your specific community.
8) After the initial Tele-Medicine Consultation, if you understand and have agreed to beginning the MAT protocol we can arrange treatment via Tele-Medicine in the comfort of your home. Once successfully instituted, treatment is straightforward, and we are there with you 24/7 and will contact your primary care physician on your behalf for continuation of outpatient management or refer you to a provider practicing in your community for follow-up. Once you have seen a provider in person after the first 30 days, according to the DEA recommendations, we can continue ordering prescriptions on your behalf as long as the monitoring of your treatment follows protocol.
Treating Opioid Use Disorder (OUD): Evidence-Based Care That Works.
Opioid Use Disorder is not due to “LACK OF INDIVIDUAL WILL-POWER.” Up to 20% or, ONE in FIVE of all Americans, are GENETICALLY PRE-DISPOSED or PRE-PROGRAMMED to develop OUD when their brains are exposed to potent OPIOID drugs through Opioid medications prescriptions or illicit opioid use. OUD is truly a GENETICALLY driven physiologic disorder. At the Pain & Addiction Integrated Network, OUR proven & effective Medication Assisted Treatment (MAT) based on EVIDENCE-BASED SCIENCE using the ONLY medication proven to safely & effectively block the individual’s brain MU receptors, immediately results in reversal and opposition to ALL OPIOID CRAVING, ALL OPIOID DRUG SEEKING, and ALL OPIOID WITHDRAWAL SYMPTOMS RAPIDLY, allowing the OUD suffering individual to re-establish and regain NORMAL PHYSIOLOGIC, AND PSYCHOLOGIC FUNCTION, resulting in a return to WORK, SCHOOL, FAMILY, FRIENDS, and setting the stage for fulfilling CAREERS, STABILIZING RELATIONSHIPS and, ASSURING SUCCESSFUL future outcomes. Relapse rates for traditional INPATIENT & OUTPATIENT drug rehabilitation treatment has an 85-90% FAILURE RATE while, therapy using evidence-based MAT prescribed by CERTIFIED PROVIDERS can be as HIGH A SUCCESS RATE as 85-90% of treated individuals using MAT protocols developed at the P.A.I.N. Institute.
"You're Never Alone – BECAUSE We are HERE for the Journey." We understand how opioid use disorder (OUD) affects not only you, but your WORK, FAMILY, FRIENDS, and LOVED ONES. OPIOID USE DISORDER is present at epidemic proportions in the U.S. today. Our consultants are focused on changing the way that OPIOID USE DISORDER (OUD) is addressed and treated. By utilizing the latest Medically Assisted Therapy (MAT) we are committed to helping you attain the best quality of life attainable as you begin your journey towards a healthier Body, Mind, & Spirit. Opioid Use Disorder is well understood scientifically and can be treated effectively by medication intervention and management. Like all chronic disorders, understanding that OUD is not a matter of “will-power” but rather is because the brain MU receptors require maintenance medication management over many months while the individual normalizes daily activities and lifestyle adjustments AND simultaneously takes medications to effectively block ALL OPIOID CRAVING and DRUG SEEKING. Traditional admission to drug rehabilitation facilities is COSTLY and has an 85-90% failure rate. The United States expends 42 Billion Dollars a year to treat addiction. Individuals who can return to routine activities as soon as possible and get back to normal activities of daily living are more likely to resolve Opioid Use Disorder (OUD) and RE-ESTABLISH their original hopes and dreams.
We are committed to helping those who suffer with OUD successfully transition onto Medically Assisted Therapy (MAT) and to be your “Personal Guide & Advocate as you Journey towards attaining a healthier Body, Mind, & Spirit.” Healthcare and the treatment of OUD is a collaborative and committed partnership between ourselves, you, and your family. We are here . . . . For the Journey!
WHAT IS MEDICALLY ASSISTED THERAPY (MAT)? AND, WHY IS IT CONSIDERED THE BEST APPROACH TO TREATING OUD? Opioid Use Disorder is a COMPLEX disorder and TREATMENT requires the establishment of TRUST between the OPIOID DEPENDENT INDIVIDUAL and the PROVIDER. DR. CHAVEZ has treated OPIOID USE DISORDER for 40 years and has treated thousands of patients. Opioid molecules bind to the MU receptors triggering release of NEUROTRANSMITTERS resulting in ENDORPHIN production. These NEUROTRANSMITTERS result in euphoria and suppression of pain.
MAT treatment requires FIRST, that the clinician understand the clinical history and current medical condition of the individual requesting treatment. The FIRST ISSUE is a determination regarding the type of OPIOID drug that the individual is dependent on and having determined the quantity, dosing intervals, and the length of time of opioid utilization. Understanding that the shorter acting the OPIOID identified, the easier MAT induction will be. SECOND: Stop all OPIOID drugs at 5 P.M. the day before anticipated induction is to begin and wait 12 to 14 hours. THIRD: During this time medications to treat early withdrawal symptoms of anxiety, intestinal spasm, muscle spasms, aches & pain, sweats, nausea, and restlessness.
FOURTH: Based on the clinician’s observations via Tele-Medicine, the individual is instructed to begin Sublingual BUPRENORPHINE once determined to be safely in early withdrawal (SCORE >12-16) off of all opioid drugs. Over the next 24 hours, the individual is instructed to take varying doses of SL BUPRENORPHINE, often 2-4 mg SUBLINGUAL every 2-4 hours. Symptoms of withdrawal generally stop and once the individual is on 16-24 mg total daily of SUBLINGUAL BUPRENORPHINE, the individual’s symptoms slowly begin to resolve.
Difficulty and complications during INDUCTION may complicate therapy if the patient was on high dose FENTANYL, which often is difficult because FENTANYL saturates the body’s fatty tissue and prolongs the opioid’s exit. In addition, METHADONE and Extended-Release Opioids will prolong and complicate treatment because of “PRECIPITATED WITHDRAWAL” that may occur.
Finally, Braeburn Pharmaceuticals has recently released injectable BRIXADI, a prescription medicine used to treat adults with moderate to severe Opioid Use Disorder.
BRIXADI is part of a complete treatment plan that should include counseling and behavioral therapy. Brixadi is approved in both weekly and monthly subcutaneous injectable formulations at varying doses, including lower doses that may be appropriate for those who do not tolerate higher doses of extended-release buprenorphine that are currently available. The weekly doses are 8 milligrams (mg), 16 mg, 24 mg, 32 mg; and the monthly doses are 64 mg, 96 mg, 128 mg.
INNOVATIVE MEDICALLY ASSISTED THERAPY.
Once MAT Treatment has been instituted on sublingual MAT, a new and innovative maintenance therapy created by BRAEBURN PHARMACEUTICALS can be used to receive the same dosages of Buprenorphine injected once monthly.
BRIXADI: BRIXADI is designed w Patient Care in Mind with our collaborating providers we can assist maintenance therapy in your community in the future:
1) Brixadi is designed w patient care in mind as the only injectable BUPRENORPHINE offering weekly injections and when stabilized, once monthly INJECTION options
2) Upon injection of subcutaneous BRIXADI the drug transforms into a low viscous solution liquid crystalline gel that releases bup at a steady rate over 28 days
3) BRIXADI can be prescribed in 4 weekly injection doses and/or 3 monthly injections doses.
4) BRIXADI allows for individualized doses for both weekly and monthly formulations based on tolerability and efficacy to an equivalent daily dose between 8 to 32 mg equivalence.
Brixadi demonstrated complete blockade of drug craving effects for OPIOIDS.
1) BRIXADI demonstrated complete blockade of drug craving effects
2) BRIXADI met the primary endpoint for the maximum rating on visual analog scale (VAS)
3) Whether weekly 24 mg or 32 mg Brixadi, resulted suppression of Hydromorphone.
4) This demonstrated complete blockade throughout dosing intervals.
5) BRIXADI is for SQ administration by healthcare professionals, and that is why BRIXADI is only available through the BRIXADI REMS program
6) BRIXADI WEEKLY ADMINISTERED AT 7 DAY INTERVALS
7) BRIXADI MONTHLY ADMINISTERED AT 28 DAY INTERVALS.
8) AVOID MISSED DOSES, SO THAT IT CAN be administered 2 days before and after the weekly appointment. The monthly dose can be administered up to 1 week before and after the monthly injection appointment.
9) Use mult SQ INJECTIONS ROTATING SITES buttock, thigh, abdomen, and upper arm. At initiation of therapy there have been observations of up to 10% less serum levels when the upper arm has been the initial injection site. So use the upper arm once a steady state has been reached after 4 consecutive weekly doses.
10) A video on BRIXADI INJECTION administration is available at brixadihcp.com
11) 23 gauge needle <.5 cc length
BRIXADI ONCE WEEKLY OR ONCE MONTHLY INJECTIONS EQUIVALENCE TO 8-32 mg BUPRENORPHINE SL. Covered by insurance.
At the Pain & Addiction Integrated Network, Inc. also known as the P.A.I.N. Institute, we have developed a unique program to help individuals who suffer with Opioid Use Disorder.
WHAT IS OPIOID USE DISORDER? Opioid use disorder (OUD) is a mental health condition in which a problematic pattern of chronic and persistent opioid misuse causes distress and/or impairs your daily life. OUD exists on a spectrum and may be mild, moderate or severe. It typically involves an overpowering drive to use opioids despite adverse health and psychological consequences, progressing to increased opioid tolerance and/or opioid withdrawal symptoms when you stop taking opioids. Opioid Use Disorder (OUD) can become a chronic (lifelong) condition and may result in serious potential consequences, including disability, overdoses, relapses, end-organ damage, and may lead to death.
WHAT IS AN OPIOID? Opiates (Synthetic drugs) and opioids (derived from opium) are narcotics. Narcotics are a class of drugs that are either natural or synthetic. Opioid drugs stimulate the Mu receptors in the brain causing the release of the neurotransmitter DOPAMINE. DOPAMINE reduces pain and results in a sense of general well-being and may result in euphoria in some people. Unfortunately, in some individuals this can lead to uncontrolled physiologic and psychological opioid dependence leading to intense aberrant drug seeking behavior despite the development of drug tolerance and the development of recurrent drug withdrawal symptoms. Approximately 20% of individuals who are exposed to opioid drugs can trigger opioid craving which can result in drug seeking behavior.
WHAT ARE EXAMPLES OF OPIOID & OPIATE DRUGS? Prescription narcotics are meant to treat acute pain, such as recovering from an injury or post-surgery and, can sometimes help with chronic pain. Some examples of prescription opioids and opiates include: Oxycodone, Oxymorphone, Morphine, Codeine, Fentanyl, Hydrocodone, Hydromorphone, Methadone, © Dilaudid, © Norco, © OxyContin, © Opana, © Hysingla, © Lortab, © Lorcet, © Vicoprofen, © Vicodin, and © Oramorph. Heroin is another opiate that is a derivative of morphine. It is exclusively used illicitly.
HOW DOES OPIOID USE DISORDER DEVELOP? Opioid drugs are prescribed to alleviate pain. In the United States, 100 million or 1 in 5 individuals suffer with chronic pain. Last year, approximately 142 million opioid prescriptions or 43 scripts per 100 persons were written, which is down 40% and considered the lowest number in 10 years yet, inexplicably, the overdose death rate increased by 40% resulting in 110,000 or 320 people each and every day dying as a result of drug overdose. We know that 3.8 % of American Adults abuse opioid drugs every year or approximately 11.4 million Americans, but officially, it is estimated that only 2.7 million individuals suffer with Opioid Use Disorder (OUD). 72%-80% of overdose deaths involve Opioid drugs and 20% of OD deaths involve illicit Fentanyl. Opioids and opiates used to treat pain also produce a sense of euphoria in some people. This, combined with tolerance, results in the dependent individual progressively needing more and more to produce the same effects and, this may result in Opioid Use Disorder. Opioids profoundly effect brain chemistry and OUD develops when genetics and biology is triggered by access and exposure to opioids with medical conditions involving mental health and medical conditions and possibly adverse childhood experiences.
OPIOID EFFECTS ON BRAIN CHEMISTRY? The likelihood of developing dependence following opioid use is high compared with most other drugs. Opioids have high addiction potential because they activate powerful reward centers in the your brain. Opioids trigger the release of ENDORPHINS a neurotransmitter that both decreases your perception of pain and creates feelings of euphoria. Once the opioid wears off, so do the sensations and this may trigger a strong desire to continue opioid use which often leads to physical dependence within a short time and people who have used opioids for a long period of time can experience worse chronic pain called opioid induced hyperalgesia.
DO I HAVE OPIOID USE DISORDER (OUD)? What are the signs of Opioid Use Disorder? According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders:
1) Taking larger amounts of opioids or taking them over a longer period than prescribed.
2) Having a strong desire or urge to use opioids.
3) Continuing to use Opioids despite having recurring social or interpersonal issues due to using them.
4) Spending a great deal of time obtaining or using opioids or recovering from their effects.
5) Having issues fulfilling responsibilities at work, school, or home due to opioid use.
6) Giving up, reducing, or cancelling activities because of opioid use.
7) Using opioids in physically hazardous situations.
8) Continuing opioid use despite an ongoing physical or psychological problem that’s likely caused or worsened by opioids.
9) Developing tolerance or the need for increasing quantities in order to get the same effect.
10) Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids ( or a closely related substance) to relieve or avoid withdrawal symptoms.
WHAT ARE SYMPTOMS OF OPIOID WITHDRAWAL?
1) Generalized Bone & Joint Aches
2) Chills, Sweats
3) Diarrhea, Loose Stools
4) Dilated Pupils
5) Restlessness & Agitation
6) Anxiety & Irritability
7) Nausea and/or vomiting
8) Intense Opioid Craving
9) Elevated heart rate and blood pressure
10) Insomnia, uncontrolled frequent yawning
11) Runny nose, congestion
12) Tremor
13) Goosebumps
OUD is a treatable disorder, so seeking medical care as soon as you have signs and symptoms of OUD is essential.