The setting
- Where exactly will I be sedated? A hospital ICU, a hospital bed, a surgery center, a licensed clinic or an office. The programs on this site span all of these. Ask for the name and address of the facility, then check it on the facility's own website.
- If something goes wrong during sedation, what happens? Is there an ICU in the building, or is the plan a transfer by ambulance to another hospital? How far?
- Is the facility accredited, and by whom? Joint Commission accreditation applies to hospitals and some surgery centers. LegitScript and NAATP certify the program; they do not accredit the facility. A state license number can be checked with the state.
The people
- Who gives the sedation, and what are they board-certified in? Ask for the physician's full name and look up the license on the state medical board website.
- Who stays with me while I am sedated, and for how long after? Anesthesiologist, critical care physician, ICU nurse, RN, paramedic. The answers differ by program.
The procedure
- Is it general anesthesia or sedation, and how long? Programs describe anything from several hours under anesthesia to about 24 hours of sedation.
- What drugs are used to reverse the opioids, and what is given for symptoms afterwards?
- Which opioids are you experienced with? Fentanyl, methadone and buprenorphine behave differently from short-acting opioids. Ask how many patients on your drug the program has treated.
- What medical conditions rule a patient out, and when is that decided? Ask whether the screening happens before or after you pay.
Afterwards
- How many days do I stay, and where? In the facility, in a hotel nearby, or home the next day. Ask whether a companion is required.
- What naltrexone do I leave with? Tablets, a Vivitrol injection or an implant, for how long, and who prescribes the follow-up doses.
- What follow-up is included, for how long, and with whom?
Money
- What is the all-in price, in writing, and what is excluded? Facility, physician, aftercare days, first naltrexone dose, complications. See what each program says it costs.
- What happens to my deposit if the screening rules me out, or if I cancel? Get the refund terms in writing before paying anything.
One more thing to check
Search the program's name together with the words "lawsuit", "death" and "license", and check the state licensing site. The public record page lists what has been documented for US programs.