How do I start medications for OUD through Confidant?

At Confidant, we are committed to delivering person-centered, evidence-based care. This means providing you with the best care to meet your specific needs. In order to ensure you’re a good candidate for medications for opioid use disorder, the first step is a virtual visit with our Psychiatric Mental Health Nurse Practitioners. These providers are trained in addiction and licensed to prescribe or administer these medications and manage your treatment over time.

Step 1: Virtual Visit with a Nurse Practitioner

During this appointment, a Nurse Practitioner will talk to you about your goals and will conduct an evaluation. The evaluation includes questions about your drug use, psychiatric and physical health history, social situation and living environment. During this visit, the Nurse Practitioner will review your options for opioid use disorder (OUD) treatment medications. It’s okay if you don’t know about these medications in advance of the visit. Your provider will help educate you on the options and what is best for you. Depending on whether you have used medications for opioid use disorder previously and whether you are currently on opioids the Nurse Practitioner may be able to begin prescribing medication to be filled at your pharmacy, or the next step may be home induction. If it is determined that you will use an injectable medication your provider will prescribe an oral dose of the medication first in order to determine the appropriate dose and your reaction to the medication.

Optional Step 2: Either Home Induction OR Office Visit

Based on the determination of which medication to use and your current substance use, the next step may be either a home induction or an office visit. Regardless of the setting, you can expect that your provider will take the following steps during this visit:

• Take additional history.
• Review or order lab work.
• They may take a saliva test or a breathalyzer.
• Provide instructions and expectations for virtual follow-up appointments, utilization of Confidant app, and counseling or psychotherapy via Confidant or elsewhere.
• Provide you with instructions on Naloxone and training on how to use it.
• They will provide you with education about your medication and managing withdrawal symptoms.
• They will answer any questions you may have.

Home Visit: Oral Formulation

If it is determined that you will start treatment on an oral formulation of buprenorphine, such as Suboxone, and are still using opioids then you will have a home visit.  During the home visit, two Confidant Health providers will come to your home. Following completion of your visit, they will send a prescription for your medication to your preferred pharmacy (the providers do not carry any medication). The cost of medication will depend on your insurance.

Office Visit: Injection (Sublocade or Vivitrol)

If it is determined that you will start treatment with an injection, either Sublocade or Vivitrol, then your next visit will be conducted in a medical office. During the visit the provider will administer the injection of either Sublocade or Vivitrol. The cost of medication will depend on your insurance.

Step 3: Virtual Follow-Up

Your provider will work with you to set a schedule for virtual follow-up. If you receive an injection, you will also work with your provider to schedule your next appointment. In addition to your follow up with the provider that prescribed or administered your medication, your treatment plan may also include working with other Confidant providers such as therapists and coaches or joining support groups.