Search found 110 matches

by fishdoc
Mon Feb 13, 2017 10:01 am
Forum: Clinical Use of Buprenorphine
Topic: Revisiting generics
Replies: 6
Views:

Ohio Medicaid CareSource has done the same thing. In those patients I have had on generic tablets at a methadone clinic, none were happy with it. Each new batch was an adventure as the dosage could vary from 80 to 125% blood levels compared to name brand. Patients did exhibit both withdrawal and fee...
by fishdoc
Fri Dec 02, 2016 5:15 am
Forum: Clinical Use of Buprenorphine
Topic: Was there a data dump?
Replies: 4
Views:

It seems like they save the posts for 6-8 weeks and then release them in a batch. Not really helpful as when the do release them, it appears as if there is new post in every topic.

Yes it is very frustrating.

What "new web board"?
by fishdoc
Thu Oct 27, 2016 1:08 pm
Forum: Clinical Use of Buprenorphine
Topic: Written documentation of when XR number is needed.
Replies: 7
Views:

At my last DEA inspection one of the agents asked me if I knew that Suboxone could be prescribed "off label" for pain. He continued on to say that the prescription must NOT have the X number on it and must have, "FOR PAIN" written on the prescription. He said the prescription written in such manner ...
by fishdoc
Fri Oct 14, 2016 9:14 am
Forum: Clinical Use of Buprenorphine
Topic: Increase to 275
Replies: 6
Views:

ASAM stopped certification when ABAM was created about 9 years ago and began certification. Now that ABPM will be the new certifier, there will be no new ABAM certifications either.
by fishdoc
Fri Oct 14, 2016 9:14 am
Forum: Clinical Use of Buprenorphine
Topic: Increase to 275
Replies: 6
Views:

The application must be accepted or denied within 45 days.

My application was accepted within 25 days as confirmed by a phone call, but nothing in writing until new DEA cards arrived.
by fishdoc
Fri Oct 14, 2016 8:44 am
Forum: Clinical Use of Buprenorphine
Topic: 'online' counseling
Replies: 7
Views:

Many of my patients will supplement local 12 step programs with online meetings. We have found no problems with these meetings, but we have no experience with counseling as you describe. Some of my colleagues are experimenting with telemedicine for well established patients.
by fishdoc
Fri Oct 14, 2016 8:44 am
Forum: Clinical Use of Buprenorphine
Topic: 'online' counseling
Replies: 7
Views:

Be careful with Skype and other such services as they may not be HiPPA compliant. There are free HIPPA compliant video chat services available, though.
by fishdoc
Fri Oct 14, 2016 8:11 am
Forum: Clinical Use of Buprenorphine
Topic: Max Dose Suboxone
Replies: 9
Views:

I have never had a patient on more than 24 mg buprenorphine/naloxone. The one patient on that dose is a cancer patient who takes it for pain, but considers himself an addict. He refuses take more than 24 mg and will use no other prescription pain meds except ibuprofen 800mg. 96% of opiate receptor s...
by fishdoc
Fri Oct 14, 2016 7:23 am
Forum: Clinical Use of Buprenorphine
Topic: Poppy Seeds
Replies: 8
Views:

Previously, I had a patient who consumed 5 POUNDS of poppy seeds daily for his addiction. His UDS was positive for morphine and other metabolites of morphine. There was no 6-MAM, nor should there have been. 6-Monoacetylmorphine is one of three active metabolites of heroin, the others being morphine ...
by fishdoc
Wed Aug 31, 2016 6:53 am
Forum: Clinical Use of Buprenorphine
Topic: Zubsolv Induction Dose Question?
Replies: 3
Views:

The original studies compared Zubsolv to Suboxone TABLETS and the 2/0.5 Suboxone tab was found to be equivalent to the Zubsolv 1.4/0.36 tab, although I believe they actually compared 8/2 to 5.7/1.4. The Suboxone film, however is better absorbed than were the old Suboxone tablets, allowing higher blo...

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