Search found 11 matches

by drcolleen
Wed Mar 30, 2016 5:50 am
Forum: Clinical Use of Buprenorphine
Topic: buprenorphine levels
Replies: 23
Views:

Thanks for the input.
by drcolleen
Mon May 19, 2014 9:07 am
Forum: Clinical Use of Buprenorphine
Topic: constipation
Replies: 1
Views:

We are starting lactulose today. Tried colace. never heard of methylnaltrexone. I'll look it up. Thanks. Will let you know how it turns out.
by drcolleen
Thu Aug 29, 2013 3:05 pm
Forum: Clinical Use of Buprenorphine
Topic: Interesting Psychotherapy Case
Replies: 8
Views:

Difficult situation. If he is not workable, maybe work with her on improving her self esteem and ability to plot her own course in spite of his objections. She needs to develop internal sources of self esteem - not easy in the early stages of recovery. I doubt that he would leave her just because sh...
by drcolleen
Wed Jun 12, 2013 7:16 am
Forum: Clinical Use of Buprenorphine
Topic: suboxone and benzos
Replies: 19
Views: 670

Thanks for the input. I've been away from the forum for awhile. I always find it very helpful though. I did have a discussion with the provider after he returned and I think we came to an understanding. I have found that many suboxone providers don't really understand addiction. They understand subo...
by drcolleen
Mon Apr 01, 2013 7:58 am
Forum: Clinical Use of Buprenorphine
Topic: subutex for detox only
Replies: 8
Views: 268

These are all very helpful viewpoints. I could see the several day detox with subutex if you are going into a residential program. We have some self pay patients who aren't going to be able to afford suboxone outpatient. We try to get them to go to residential but many refuse and there are only so m...
by drcolleen
Mon Apr 01, 2013 7:58 am
Forum: Clinical Use of Buprenorphine
Topic: subutex for detox only
Replies: 8
Views: 268

The clonidine protocol that we use is 0.2 mg. patches, two for patients less than 200 pounds and three for patients over 200 pounds. We also supplement with oral clonidine the first two days if necessary. We instruct them to leave the patches on for 14 days approximately after they leave. My only re...
by drcolleen
Tue Mar 12, 2013 11:27 am
Forum: Clinical Use of Buprenorphine
Topic: opiate and benzo addiction
Replies: 9
Views: 355

Thanks for the input. Since I am inpatient I can get labs and watch LFT's while they are here and I have had to take some patients off tegretol due to dropping wbc. Do you find that 4 days of librium is enough to minimize the benzo withdrawal? Of course here I can't just give them their opiates whil...
by drcolleen
Tue Mar 12, 2013 11:27 am
Forum: Clinical Use of Buprenorphine
Topic: opiate and benzo addiction
Replies: 9
Views: 355

With regard to the question about routinely taking patients off benzos when putting them on suboxone even if the benzo is prescribed. In general, we do take patients off all controlled substances since we are an inpatient detox. There have been some rare occasions when I didn't when the dose was low...
by drcolleen
Wed Feb 27, 2013 11:25 am
Forum: Clinical Use of Buprenorphine
Topic: FDA approves generic bupe/naloxone
Replies: 13
Views: 401

yes I have found that it isn't that much cheaper and I like being able to have patients cut the film for smaller doses. I have never prescribed bupe alone even when money is the issue. I just haven't felt comfortable doing it because of the abuse potential. It does mean that some people can't afford...
by drcolleen
Wed Nov 14, 2012 10:39 am
Forum: Clinical Use of Buprenorphine
Topic: e/m CPT coding for bupe encounters
Replies: 17
Views: 480

I have the same question. What code are most suboxone prescribers using for their office visits? I am finding that many physicians who prescribe suboxone are asking their patients (even those with medicaid or insurance) to pay cash for the office visits. The medicaid people tell us that they will pa...

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