Treatment for Opioid Addiction & Chronic Pain

Steps to Deciding and/or Beginning Treatment for Opioid Addiction or Chronic Pain


At Marina Medical in Normandy Park, WA, Michael Brown, MD, Sjardo Steneker, MD and their care team offer outpatient opioid detox, Suboxone induction and ongoing treatment for beginning the recovery process from opioid dependence and addiction and/or relief from chronic pain.  The discussion below outlines the steps through gathering info, pre-induction, detox, induction and ongoing treatment.




Detox: refers in this instance to the process of withdrawing from an opioid.

Induction: refers to starting and stabilizing on Suboxone   (See “The Role of Suboxone” Medications)


1. Please familiarize yourself with information on this website.


Depending on your particular needs, see articles in Featured Services, either “Opioid Addiction” or “Safe and Sane Pain Management”.

2. Call 206-878-8600 to schedule a Meet & Greet appointment.


This visit is for consultation only, and is offered at no cost to you.*  It is an opportunity for you to meet us and for us to learn about your particular situation, to determine how we may all work together for effective treatment. You can expect an attentive and compassionate conversation.


*Under certain circumstances, if you have insurance, we reserve the right to bill your policy for time spent, but there is no out-of-pocket expense for you, regardless of what insurance pays.


3. If you decide to proceed with treatment during or after your Meet & Greet appointment, you can schedule your next appt(s), complete paperwork and pay the Treatment Initiation fee.

         Scheduling: If you prefer, the Pre-Induction physical exam, lab testing, and detox

         instructions can often be conducted the same day as your Meet & Greet visit.   

         Normally, your Induction can be scheduled within 1-4 days following your Meet &

         Greet visit. Your first Post-Induction ‘stabilization’ appointment is usually 3-5 days

         after your induction.


         Paperwork: If you are a new patient at Marina Medical, this is the time to complete   

         your Medical History and other forms. (Established patients will need to complete a

         few additional forms.) This typical paperwork can be done on paper or online; you will

         be given a code to access your private online portal.


         Treatment Initiation Fee:  This fee covers your pre-induction physical exam, lab

         testing, detox guidance, induction with monitoring, and dose-stabilization

         Post-Induction visit(s) (see below). The fee is due when you schedule your induction

         appointment. For more information regarding fees, read Suboxone Treatment

         Program Fees.


4. Pre-Induction procedures include:


         Physical examination – to rule out acute illness or infection.

         Urine or salivary toxicology analysis – to identify any other drugs in your system,

         especially benzodiazepines.


         Blood chemistry analysis* – to rule out liver or kidney impairment

                   * Blood can also be submitted to Quest Diagnostics for Human

                      Immunodeficiency virus (HIV) and Hepatitis C virus (HCV); the patient is

                      Billed separately by the laboratory for these tests (they are not included in the

                      induction fee)


         Individualized instructions regarding your detox process: when and how to begin

         and complete your detox so that you are in appropriate withdrawal for your induction.


5. Detoxification/withdrawal:


At the time specified and according to instructions given at your Pre-Induction appointment, you will begin and complete the process of withdrawing from opioids. The amount of time required for the prescribed withdrawal schedule varies, depending on each individual’s circumstances -- but you will be in full withdrawal for only a short time.

6. Induction appointment:


If you normally drive yourself, we suggest that you arrange for alternative transportation to this appointment.


         Come to the clinic in withdrawal. It is critical that you have been off the opiates for

         at least the minimum amount of time specified by the physician at your Pre-Induction

         appointment; otherwise your induction cannot proceed as scheduled.


         After checking in and confirming that you are in an appropriate state of withdrawal,

         you will be administered medication and monitored for at least 1½ - 2 hours.

         You will leave the clinic feeling better than when you arrived in withdrawal.


         Before leaving the clinic, you will be given additional instructions and will schedule

         your first Post-Induction stabilization visit, which usually occurs within 3-5 days

         after your induction.


7. Post-Induction stabilization visit(s):


Dose-stabilization on Suboxone requires 1-2 visits within 10 days from your Induction appointment. During this visit(s), your reaction to the medication will be discussed with your care team. If necessary, the medication dose will be adjusted and you may again return to the clinic for confirmation that the correct dose has been achieved.


The cost of these initial follow-up visits and any additional qualitative urine toxicology testing during the ten (10) days after induction is included in the Treatment Initiation Fee paid prior to Induction. In the unlikely event you require additional dose-stabilization visits, additional fees will be charged.


8. Ongoing follow-up visits:


Once the appropriate dose of your treatment medication is confirmed and you are feeling stable, you will generally have monthly appointments with the physician and care team. During these visits your recovery progress will be discussed and any related needs will be addressed.


Some of these visits can be Group Appointments with wellness coaches and other patients in the Suboxone program, allowing all to benefit from each other’s shared experience. Special topics regarding recovery and introduction to activities in OWLS (Optimal Wellness and Lifestyle Support) are included.

Ask us!

Feel free to email us regarding any scheduling or general questions!

Hours & Location








19901 First Avenue South Suite 409, Normandy Park, WA 98148

(206) 878-8600

9 am - 6 pm

9 am - 6 pm

9 am - 6 pm

9 am - 6 pm

9 am - 6 pm

9 am - 1 pm


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