How to Prevent Opioid Relapse After Detox or Rehab
No opioid-free waiting window before starting treatment at DeBinge When travelling to DeBinge in The Bahamas for OLANI treatment, there is no requirement to complete a separate opioid-free waiting window before arrival. DeBinge uses a medically supervised 4-to-5-day buprenorphine transition. Buprenorphine is introduced to bridge the patient away from full-agonist opioids, stabilised and tapered over the first several days, and the O’Neil Long-Acting Naltrexone Implant is typically inserted around day 4 or 5 while buprenorphine is still being tapered. The planned overlap continues as buprenorphine clears and the implant gradually releases naltrexone. This pathway is clinician-supervised because mistimed naltrexone exposure can precipitate withdrawal.
Based on DeBinge’s clinical experience in The Bahamas since 2018, the implant typically provides its strongest craving and relapse-prevention support on average 9 months, while clinically meaningful opioid-receptor blockade may persist for longer, in some patients up to about 15 months. This longer blockade may continue to reduce opioid effects and overdose risk.
Ongoing recovery: The implant is not a cure. The DeBinge programme includes a full year of professional counselling after implantation to address the behavioural and psychological side of addiction.
Finishing opioid detox or leaving rehab can be an important turning point, but it does not mean that opioid use disorder has disappeared. Cravings, triggers, stress, untreated mental-health problems, exposure to opioids and changes in tolerance can continue to create risk after the initial treatment period.
The strongest relapse-prevention strategy usually combines several layers of protection rather than relying on willpower or one intervention. These may include continued treatment after detox, an appropriate medication for opioid use disorder, management of cravings and triggers, counselling or behavioural support, treatment of co-existing mental-health problems, changes to the recovery environment, family or social support, overdose planning, access to naloxone and rapid clinical intervention when warning signs appear.
There is no single treatment that guarantees a person will never return to opioid use. The objective is to reduce risk, make recovery more sustainable and create a clear response plan before a high-risk situation develops.
Preventing Relapse Starts Before a Craving Becomes a Crisis
A relapse-prevention plan should not begin at the moment someone is already holding an opioid. It should be built in advance, while the person is stable enough to identify risks, choose treatment, organise support and decide what will happen if cravings or substance use return.
Opioid use disorder is a medical condition that can involve changes in reward, motivation, stress responses, habits and decision-making. Completing withdrawal management removes opioids from the body, but detoxification by itself does not necessarily treat the processes that contributed to repeated opioid use.
This is why the period immediately after detox or residential treatment deserves careful planning. A person may feel physically better while still being vulnerable to cravings, old routines, emotional triggers or sudden opportunities to use.
In This Guide
- Why relapse can happen after detox
- Why detox alone is not enough
- Reduced tolerance and overdose risk
- Understanding opioid cravings
- Common opioid relapse triggers
- What to do during an opioid craving
- Medications for opioid use disorder
- How naltrexone differs
- Oral vs extended-release naltrexone
- Long-acting naltrexone implants
- Counselling and behavioural recovery
- Mental-health treatment
- Changing the recovery environment
- Family involvement
- Naloxone and overdose planning
- What to do if opioid use happens again
- Building a relapse-prevention plan
Why Does Opioid Relapse Happen After Detox or Rehab?
A person can sincerely want recovery and still experience strong pressure to return to opioid use. That pressure can come from several directions at the same time.
Cravings
Cravings may be triggered by stress, memories, people, places, pain, withdrawal-related discomfort or exposure to drug-related cues. Their intensity can change over time rather than disappearing in a straight line.
Conditioned Triggers
The brain can associate opioid use with particular environments, relationships, routines or emotional states. Returning to those cues can reactivate learned patterns even after a period of abstinence.
Stress and Emotional Distress
Conflict, loneliness, anxiety, depression, grief, financial pressure or other difficult experiences can increase vulnerability when opioids were previously used as a way of coping.
Returning to the Same Environment
Someone may complete treatment and then return to the same dealers, substance-using social circle, unstable housing, relationship conflict or other circumstances that existed before treatment.
Treatment Ending Too Early
A short period of detoxification may address withdrawal without providing enough time to establish ongoing medication treatment, counselling, structured routines and relapse-response planning.
Untreated Co-existing Problems
Chronic pain, trauma, sleep problems, depression, anxiety or another substance-use disorder can continue to influence opioid use unless they are recognised and treated appropriately.
Why Detox Alone Does Not Treat Opioid Use Disorder
Detoxification and withdrawal management can be medically important, particularly when a person needs to stop or transition away from opioids safely. However, becoming opioid-free is not the same as having a complete relapse-prevention strategy.
U.S. clinical guidance from the Centers for Disease Control and Prevention states that detoxification on its own, without medication treatment for opioid use disorder, is not recommended for OUD because of increased risks of returning to opioid use, overdose and overdose death.
This does not mean every person needs exactly the same medication or treatment pathway. It means that what happens after detox matters.
The better question is not simply, “How do I get through detox?”
It is: “What will protect my recovery during the weeks and months after detox?”
That question should be answered before treatment ends, not after a major craving or return to opioid use.
Why Relapse After Detox Can Carry a Serious Overdose Risk
After a period without opioids, tolerance can decrease. A quantity that a person previously used may therefore have a much stronger effect after abstinence.
This is one reason returning to opioids after detox, residential treatment, incarceration or another period of abstinence can be particularly dangerous. The illicit opioid supply can also be unpredictable in potency and composition.
Reduced tolerance can turn a return to use into a medical emergency.
Someone should not assume that a previously tolerated dose is still safe after a period of abstinence. Overdose can occur unexpectedly.
A relapse-prevention strategy should therefore include overdose education and access to naloxone where opioid exposure is possible.
If someone is unresponsive, cannot be awakened, has very slow or stopped breathing, or an opioid overdose is suspected, administer naloxone if available and contact local emergency services immediately. In the United States, call 911.
How to Understand Opioid Cravings After Detox
Cravings are not always experienced as a simple thought such as “I want an opioid.” They may appear as physical agitation, anxiety, intrusive memories, restlessness, irritability, obsessive thinking, dreams about using, romanticising previous drug use or a sudden urge to contact someone associated with opioids.
Cravings can also appear unexpectedly after a person has felt stable for weeks or months. Their return does not automatically mean treatment has failed. It means the recovery plan needs to contain a response that can be activated quickly.
A craving is a signal to activate the plan, not a command that must be followed.
The objective is to create enough time, distance and support between the craving and access to opioids for the intensity of the urge to change.
Common Opioid Relapse Triggers
Triggers differ between individuals. Effective relapse-prevention planning therefore requires identifying the person’s actual pattern rather than relying on a generic list.
People
Dealers, previous using partners, friends who continue to use substances or relationships associated with previous opioid use.
Places
Neighbourhoods, homes, bars, workplaces, hotels, streets or other locations strongly associated with obtaining or using opioids.
Emotions
Anger, loneliness, shame, boredom, grief, fear, rejection, anxiety and depression can become high-risk states.
Pain and Physical Symptoms
Acute or chronic pain can create particular challenges when opioids were previously used for pain control or emotional relief.
Money and Opportunity
Payday, unstructured cash access, travel, being alone or unexpectedly encountering someone who can provide opioids may create sudden risk.
Overconfidence
Thoughts such as “I can control it now” or “one time will not matter” can appear after a period of stability and should be discussed openly.
Celebration
Relapse risk is not limited to negative emotions. Parties, holidays, reunions and celebrations can also reactivate substance-use patterns.
Loss of Routine
Sleep disruption, unemployment, isolation, missed appointments and stopping counselling can gradually remove protective structure.
What Should You Do During a Strong Opioid Craving?
A strong craving is easier to manage when decisions have already been made in advance. The person should know exactly whom to contact, where to go and what situations to leave.
- Create distance from access. Leave the place, person or situation connected with obtaining opioids.
- Contact someone immediately. Call a counsellor, clinician, recovery contact, family member or another person included in the recovery plan.
- Do not remain isolated with escalating thoughts. Moving into a safe and supportive environment can interrupt the progression from thought to action.
- Delay decisions. A craving can change in intensity. Avoid making permanent decisions during a temporary high-risk state.
- Use the written relapse-prevention plan. High-stress moments are not the best time to invent one.
- Review medication adherence. Missed doses, delayed injections or discontinued treatment should be discussed with the treating clinician.
- Escalate care when necessary. Repeated cravings, imminent access to opioids or an inability to remain safe may require urgent professional assessment.
A person should not abruptly start, stop or change opioid-use-disorder medication because a craving has appeared. Medication decisions should be made with the treating clinician.
Medication Can Be an Important Part of Opioid Relapse Prevention
The U.S. Food and Drug Administration recognises three medications for the treatment of opioid use disorder: buprenorphine, methadone and naltrexone.
These medications work differently. Choosing between them should be based on individual medical circumstances, previous treatment, current opioid use, treatment goals, access, preferences and clinical assessment.
Buprenorphine
Buprenorphine is a partial opioid agonist. It can reduce withdrawal symptoms and opioid cravings while helping stabilise opioid use disorder.
Several formulations are available, including sublingual and extended-release options.
Methadone
Methadone is a full opioid agonist used in structured treatment for opioid use disorder. It can reduce withdrawal symptoms and cravings and help stabilise ongoing opioid use.
Access and dispensing requirements vary by jurisdiction.
Naltrexone
Naltrexone is an opioid receptor antagonist rather than an opioid agonist. It blocks opioid receptors and can reduce or prevent the rewarding effects of opioids while adequate medication levels are present.
A person must be appropriately opioid-free before naltrexone is started because administering it during opioid dependence can precipitate severe withdrawal.
There is no universally “best” medication for every patient.
Buprenorphine, methadone and naltrexone differ substantially in how they work, how treatment is initiated and how treatment is maintained. A qualified clinician should assess which approach is appropriate for the individual.
Where Does Naltrexone Fit Into Opioid Relapse Prevention?
Naltrexone works differently from methadone and buprenorphine. It is an opioid antagonist, which means that it occupies opioid receptors without producing the opioid effect associated with agonist medications.
When sufficient naltrexone levels are present, the medication can block or substantially reduce the effects of opioids. This may reduce the reinforcing effect that can otherwise follow opioid use.
Naltrexone should not be described as making opioid relapse or overdose impossible. A patient can still attempt to use opioids, and trying to overcome opioid receptor blockade by taking large quantities can be dangerous.
Naltrexone initiation also requires a medically appropriate opioid-free interval. Starting naltrexone while opioids remain active in a physically dependent patient may precipitate significant withdrawal.
Naltrexone and naloxone are not the same medication.
Naltrexone is used as part of ongoing treatment for conditions including opioid use disorder. Naloxone is an emergency medication used to reverse an opioid overdose. A person taking naltrexone may still need access to naloxone as part of an overdose-safety plan.
Oral Naltrexone vs Extended-Release Naltrexone
One practical question in naltrexone treatment is adherence. A medication cannot provide its intended pharmacological effect when it is repeatedly missed or discontinued.
| Form | Practical Consideration | Important Limitation |
|---|---|---|
| Oral naltrexone | Does not require an injection or implant procedure and can be appropriate for selected patients. | Requires regular adherence. Missed or discontinued doses can remove medication coverage. |
| Extended-release injectable naltrexone | Provides longer medication exposure without daily tablet-taking. | Requires repeat administration according to the prescribed schedule and appropriate opioid-free preparation before initiation. |
| Sustained-release implant formulations | Designed to provide prolonged naltrexone release without daily medication decisions. | Implant products differ in formulation, duration and evidence, and naltrexone implants are not FDA-approved for routine clinical use in the United States. |
Longer medication duration should not automatically be interpreted as better treatment. Safety, evidence, clinical appropriateness, preparation, patient preference, counselling and follow-up remain important regardless of the delivery system.
What Is the Potential Role of a Long-Acting Naltrexone Implant?
For some patients who have completed appropriate opioid withdrawal and who are considering antagonist treatment, one challenge is maintaining medication coverage over time.
A sustained-release naltrexone implant is designed to release medication gradually after placement beneath the skin. The practical concept is to reduce dependence on remembering or choosing to take a tablet every day.
This does not mean an implant removes the psychological, behavioural or social dimensions of opioid use disorder. It does not eliminate the need for counselling, mental-health care, recovery planning, family support where appropriate or ongoing medical follow-up.
Important information for U.S. patients
Naltrexone implant formulations are not currently FDA-approved for routine clinical use in the United States. FDA-approved naltrexone options for opioid use disorder include appropriate oral naltrexone formulations and extended-release injectable naltrexone.
Implant formulations can differ in dose, materials, release characteristics, duration and evidence. Findings involving one implant formulation should not automatically be assumed to apply to every other implant.
DeBinge is located in Nassau, The Bahamas. Patients considering treatment there require individual assessment, including evaluation of their opioid history, current medications, physical dependence, previous treatment, medical history and suitability for naltrexone.
Learn more about the treatment model in our Long-Acting Naltrexone Implant Guide and review the wider Naltrexone Implant Knowledge Library.
Medication Does Not Replace Counselling and Recovery Work
Medication can create biological protection or stability, but recovery still takes place in everyday life.
Counselling can help a person recognise patterns that repeatedly precede opioid use and build alternative ways of responding to them. Treatment may address relationships, stress, trauma, impulsive behaviour, self-esteem, anger, grief, motivation, employment, family conflict and the practical task of rebuilding daily life.
For some people, structured behavioural therapy is useful. Others benefit from individual counselling, peer support, recovery coaching, mutual-aid groups or combinations of several approaches.
The important point is that relapse prevention should continue beyond the period of acute withdrawal.
Mental Health Should Be Part of the Relapse-Prevention Plan
Depression, anxiety, trauma-related symptoms, sleep disturbance and other psychiatric problems can coexist with opioid use disorder. They may have existed before opioid use began, developed during the period of substance use or become more visible after opioids are stopped.
Ignoring these problems can leave an important relapse driver untreated.
A comprehensive plan therefore includes appropriate mental-health assessment and treatment rather than assuming that every emotional problem will disappear once opioid use stops.
Treat the whole pattern, not only the substance.
Recovery can become more sustainable when the medical, psychological, behavioural and environmental reasons connected with opioid use are addressed together.
Change the Environment That Previously Supported Opioid Use
A person can complete excellent treatment and still struggle if they immediately return to an environment saturated with the same cues and opportunities to use.
Environmental relapse prevention may include:
- Ending or limiting contact with people directly connected with obtaining opioids.
- Blocking dealer phone numbers and removing relevant contacts.
- Avoiding high-risk locations where possible.
- Planning where to live after treatment if the previous environment is unsafe.
- Reducing long periods of isolation.
- Creating a structured weekly routine.
- Planning employment, education, exercise and meaningful daily activity.
- Agreeing in advance how money or other high-risk situations will be handled.
- Keeping appointments with clinicians, counsellors and recovery supports.
These measures are not about controlling a person. They are about reducing unnecessary exposure while new recovery habits are being established.
How Can Family Help Prevent Opioid Relapse?
Family members often want to help but may not know whether they should monitor, challenge, protect, provide money, remove money, ask questions or stay silent.
Where the patient agrees, family involvement can be built into the treatment plan in a more structured way.
Helpful roles can include recognising agreed warning signs, supporting treatment attendance, keeping naloxone available, providing transportation to appointments, maintaining boundaries and knowing whom to contact if risk escalates.
Family members should not be expected to replace clinicians or provide emergency medical care. They may also benefit from their own support and education because opioid addiction can affect the entire household.
Naloxone Should Be Part of Overdose Planning Where Opioid Exposure Is Possible
Naloxone can reverse an opioid overdose when administered in time. People with opioid use disorder, their families and others who may be present during an overdose should know where naloxone is kept and how to use it.
Having naloxone available does not mean that relapse is expected. It means that the recovery plan recognises that overdose is a potentially fatal emergency and prepares for it accordingly.
If an overdose is suspected
Administer naloxone if available, contact emergency services, follow the product instructions and remain with the person until professional help arrives. Additional naloxone doses may be necessary depending on the situation and product instructions.
What Should Happen If Someone Uses Opioids Again?
A return to opioid use should trigger action quickly. Waiting for a single episode to develop into several days or weeks of repeated use can allow risk to escalate.
The response should focus on safety and treatment rather than shame.
Assess immediate overdose risk
Determine whether opioids have already been taken, whether other sedating substances are involved and whether emergency medical care is required.
Use naloxone when overdose is suspected
Naloxone is an emergency response medication. Call emergency services when an opioid overdose is suspected.
Contact the treatment team
The clinician or treatment service should understand what happened and whether medication, monitoring or the level of care needs to be reassessed.
Identify what changed before the return to use
Look at cravings, medication adherence, contact with previous suppliers, emotional distress, pain, isolation, conflict, alcohol or other substance use and changes in routine.
Strengthen the plan immediately
A return to use can reveal where protection was insufficient. The response may involve more intensive treatment, medication reassessment, additional counselling or environmental changes.
A return to opioid use does not need to become a reason to abandon treatment. It should become a reason to reassess risk and strengthen treatment.
A Practical Opioid Relapse-Prevention Plan
A useful relapse-prevention plan should be specific enough that the person knows exactly what to do when circumstances change.
Identify your five highest-risk triggers
Name specific people, places, emotions, events or physical symptoms that have previously preceded opioid use.
Decide what you will do when each trigger appears
“Avoid stress” is too vague. A stronger plan specifies who you will call, where you will go and what situation you will leave.
Choose an evidence-based treatment pathway
Discuss buprenorphine, methadone, naltrexone and other appropriate treatment considerations with a qualified clinician rather than relying on detoxification alone.
Protect medication adherence
If medication is part of treatment, create a plan for appointments, prescriptions, administration schedules and what happens if treatment is interrupted.
Build a support contact list
Include the treatment provider, counsellor, trusted family member, recovery contact and emergency numbers.
Remove unnecessary access to opioids
Remove contacts, routes and opportunities that previously made obtaining opioids easy wherever reasonably possible.
Treat mental-health problems
Anxiety, depression, trauma, insomnia and other psychiatric symptoms should be assessed rather than left to become unmanaged relapse drivers.
Plan for pain before it happens
Tell relevant clinicians about opioid use disorder and current treatment. Patients using opioid antagonists such as naltrexone need individual medical planning for pain management and procedures.
Keep naloxone accessible
Make sure the patient and people around them understand where naloxone is kept and how to respond to an opioid overdose.
Decide what happens after one use
Write the response before it is needed: who is contacted, how safety is assessed and where the person will receive rapid clinical support.
Warning Signs That a Relapse-Prevention Plan May Be Weakening
Relapse sometimes appears sudden, but changes can occur earlier. Possible warning signs include:
- Missing counselling or medical appointments.
- Stopping medication without discussing it with the treating clinician.
- Increasing isolation.
- Reconnecting with people strongly associated with previous opioid use.
- Returning to high-risk locations.
- Romanticising previous drug use.
- Increasing secrecy.
- Persistent insomnia, anxiety or low mood.
- Increasing alcohol or other substance use.
- Repeated thoughts that treatment is no longer necessary.
- Strong cravings that are becoming more frequent or harder to interrupt.
- Trying to obtain opioids or contacting previous suppliers.
These signs are reasons for earlier support, not reasons to wait until opioid use resumes.
Relapse Prevention Is Stronger When Several Layers Work Together
No single layer should carry the entire burden of recovery.
Medical
Assessment, medication where appropriate, withdrawal planning, physical-health monitoring and ongoing clinical review.
Psychological
Counselling, treatment of co-existing psychiatric problems, coping strategies and work on patterns connected with substance use.
Behavioural
New routines, recognition of warning signs, structured responses to cravings and gradual rebuilding of everyday life.
Environmental
Reducing access to opioids, changing high-risk relationships and creating a safer recovery environment.
Social
Family involvement where appropriate, recovery contacts, peer support and meaningful relationships that reinforce recovery.
Emergency Safety
Naloxone, overdose education, emergency contacts and a rapid response if opioid use returns.
Considering Long-Term Relapse Prevention After Opioid Detox?
DeBinge provides addiction treatment in Nassau, The Bahamas, including assessment for long-acting naltrexone treatment and ongoing recovery support. Treatment suitability cannot be determined from a website and requires individual medical assessment.
A consultation can help you explain your opioid history, previous detox or rehab experience, current medications and concerns about relapse so that the next appropriate steps can be discussed.
Continue Reading
Opioid & Heroin Addiction Treatment
Learn more about opioid use disorder and the wider DeBinge treatment pathway.
Long-Acting Naltrexone Implant
Review how sustained-release naltrexone works, its limitations, safety considerations and regulatory status.
The DeBinge Clinic
Learn about the treatment environment, assessment, preparation, procedure and recovery support in Nassau.
Naltrexone Research Library
Review research and educational resources covering naltrexone and sustained-release formulations.
Prepared for Medical Review
Dr Fergus Law, BSc, MBChB, FRCPsych
Consultant Psychiatrist specialising in substance misuse and addiction psychiatry.
This article has been prepared as an educational resource concerning opioid relapse prevention and is awaiting formal clinical approval. Until that review has been completed, it should not be represented as having been medically reviewed.
View Dr Fergus Law’s professional profile
Frequently Asked Questions About Preventing Opioid Relapse
How do you prevent opioid relapse after detox?
Relapse prevention usually requires continued treatment rather than detox alone. A plan may include medication for opioid use disorder, counselling, management of triggers and cravings, treatment of mental-health problems, environmental changes, family or social support, naloxone and rapid intervention when warning signs appear.
Why is relapse dangerous after opioid detox?
Opioid tolerance may decrease during abstinence. Returning to a quantity previously used can therefore increase overdose risk. The unpredictable strength and composition of illicit opioids can add further risk.
Can cravings continue after detox?
Yes. Withdrawal may finish while psychological, environmental and cue-related cravings continue. Cravings can also reappear after a period of stability, which is why a response plan should be prepared in advance.
What medications can be used to prevent opioid relapse?
FDA-approved medications for opioid use disorder include buprenorphine, methadone and naltrexone. They work differently and treatment choice requires individual clinical assessment.
Does naltrexone stop opioid cravings?
Naltrexone’s primary role is opioid-receptor antagonism, which blocks or reduces opioid effects while adequate medication levels are present. Individual experiences of craving vary, so naltrexone should not be described as guaranteeing that cravings disappear.
Does naltrexone make opioid overdose impossible?
No. Patients should not attempt to overcome naltrexone’s opioid blockade by taking larger quantities of opioids. Overdose risk also requires consideration when naltrexone is discontinued or medication levels decline, particularly when opioid tolerance has been reduced.
Is a naltrexone implant FDA-approved in the United States?
No. Naltrexone implant formulations are not currently FDA-approved for routine clinical use in the United States. FDA-approved naltrexone options for opioid use disorder include oral naltrexone and extended-release injectable naltrexone.
What is the difference between naltrexone and naloxone?
Naltrexone is used as an ongoing treatment medication in conditions including opioid use disorder. Naloxone is an emergency medication that can rapidly reverse an opioid overdose when administered in time.
What should I do if I use opioids again after rehab?
Prioritise immediate safety. If overdose is suspected, administer naloxone if available and contact emergency services. The treatment team should then be contacted promptly so relapse risk, medication, counselling, triggers and the current level of care can be reassessed.
Is relapse a reason to stop treatment?
A return to opioid use should usually prompt rapid reassessment rather than abandonment of treatment. It can identify weaknesses in the existing plan that may require stronger medical, psychological or environmental support.
Authoritative Clinical Sources
This educational page is informed by established U.S. guidance concerning opioid use disorder, medications for opioid use disorder, overdose prevention and naloxone.
- Centers for Disease Control and Prevention. Opioid Use Disorder: Treating. View CDC guidance.
- Centers for Disease Control and Prevention. Treatment of Opioid Use Disorder. View CDC treatment information.
- U.S. Food and Drug Administration. Information About Medications for Opioid Use Disorder. View FDA information.
- Substance Abuse and Mental Health Services Administration. TIP 63: Medications for Opioid Use Disorder. View SAMHSA TIP 63.
- Centers for Disease Control and Prevention. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. View the CDC guideline.
Evidence and regulatory information should be periodically rechecked because treatment guidance, approved formulations and regulatory status can change.
Medical Disclaimer
This page provides general educational information and does not diagnose opioid use disorder, determine treatment suitability or provide individual medical advice.
Do not stop opioids, methadone or buprenorphine, start naltrexone, attempt unsupervised detoxification or change prescribed addiction treatment on the basis of this article alone. Medication transitions can involve significant withdrawal and overdose risks and should be managed by an appropriately qualified clinician.
If someone is unconscious, cannot be awakened, has abnormal or stopped breathing, or an opioid overdose is suspected, administer naloxone if available and contact local emergency services immediately.
DeBinge is located in Nassau, The Bahamas. We do not operate a treatment facility in the United States. Naltrexone implant formulations are not FDA-approved for routine clinical use in the United States. Treatment suitability, preparation and follow-up require individual medical assessment.