Search found 18 matches

by medic2109
Fri Oct 14, 2016 8:11 am
Forum: Clinical Use of Buprenorphine
Topic: Max Dose Suboxone
Replies: 9
Views:

This is a tough question. In my experience there is ceiling effect of the pain control of Bup. I practice Add Med and Pain Med. In the literature at 24 mg 99% of the opiate receptor as coated with the BUP. Now I have had patient that needed more for pain and it has worked. My guess .... purely specu...
by medic2109
Fri Oct 14, 2016 8:06 am
Forum: Clinical Use of Buprenorphine
Topic: Guidelines for Extended Take Home Doses
Replies: 9
Views:

This is a matter of how much you trust your patient and how well their recover is going. I personally give pts the benefit of the doubt in that I induce them then see them back in 2 weeks. I do a UDS and if they have complied with getting a sponsor or have started counseling I will extend it to a mo...
by medic2109
Fri Oct 14, 2016 7:20 am
Forum: Clinical Use of Buprenorphine
Topic: Buprenorphine Induction in Pregnancy
Replies: 4
Views:

Myself, personally, have done them in the office. But I don't wait for a high COWS score. I will accpet a 5-8 if their symptoms they experience are the typical they get when they first start to get dope sick. If you are able to get buprenex in your office, you can give a small IM test dose to see if...
by medic2109
Thu Sep 08, 2016 1:26 pm
Forum: Clinical Use of Buprenorphine
Topic: It happened
Replies: 10
Views:

I got mine on the office treatment center waiver since I cant take and ABMS board and the AOA has not rune its exam yet. Took like 2 weeks to get a reply and new DEA certificate. Easy process.

Scott Spagnolo-Hye, DO
Assist Prof Osteo Med
Addiction Fellowship Trained
RowanSOM
by medic2109
Thu Apr 28, 2016 5:44 am
Forum: Clinical Use of Buprenorphine
Topic: PPI's and false + THC
Replies: 3
Views:

I have seen it personally. My wife was on double doses for respiration / asthma indication and turned positive in a ER screen after a seizure. It is well reported in multiple on line discussion boards and on many of the****ay cup false positive warnings. Ironically, also high dose Motrin /Advil can ...
by medic2109
Mon Nov 16, 2015 11:34 am
Forum: Clinical Use of Buprenorphine
Topic: Tomorrow, I'm doing an induction on an 87yo F.
Replies: 6
Views:

I have a 65 year old who started misusing her opiates for pain control due to some dementia. Induction went great and pain was totally controlled. She is now communicating more and far more interactive when she comes in. I just use the suboxone films. I am curious, how did you get it approved. Did y...
by medic2109
Mon May 19, 2014 7:59 am
Forum: Clinical Use of Buprenorphine
Topic: Ambien
Replies: 24
Views:

I personally feel and have seen sleep being an critical role in early recovery. I have had more people relapse in recovery who were not sleepingI do prescribe Ambien and have NEVER had an abuse / Misuse problem. I do pill counts and blood screens for it I suspect anything but again I have never had ...
by medic2109
Fri Sep 10, 2010 3:13 pm
Forum: Clinical Use of Buprenorphine
Topic: Headaches
Replies: 13
Views: 507

did you induce with just bup or are you using suboxone? There is a small number of patients (I mean less than 5%) that get a headache and of those, most are tolerable, but the narcan may be the culprit. If it is feasible (ie, no history of injection behaviors, extremely low risk for diversion) then ...
by medic2109
Thu Sep 02, 2010 12:21 pm
Forum: Clinical Use of Buprenorphine
Topic: Super high doses of oxycodone
Replies: 5
Views: 168

I do understand the idea of methadone replacement early and then titration however, where I am the closet methadone clinics are at the best 60-90 minutes away. For my patients that is just not ataibale at the cost of fuel and time away from whatever work they can find. Since I am only outpt I dont h...
by medic2109
Thu Sep 02, 2010 11:13 am
Forum: Clinical Use of Buprenorphine
Topic: buprenorphine/naloxone oral film approved
Replies: 19
Views: 601

Here is the offical information from the company, 1) Same dosages 2) Better tasting (I will give first hand account tomorrow as I am meeting with the rep tonight who has non-medication samples 3)More rapid onset of absorption but no satistically significant total absoprtion (in was higher but not en...

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