Search found 73 matches

by rickbennettmd
Fri May 13, 2016 9:05 am
Forum: Clinical Use of Buprenorphine
Topic: Are initial LFTs, etc. still necessary
Replies: 4
Views:

The Kentucky Medical Board now mandates annual HIV and hepatitis screens as well as a Comprehensive Metabolic Panel.

Fortunately we are often able to simply acquire these lab test results from the patients' other care providers.

Rick
by rickbennettmd
Mon May 09, 2016 9:12 am
Forum: Clinical Use of Buprenorphine
Topic: Managing Constipation; Relistor
Replies: 15
Views:

re opiates and constipation: Mattkeene's post regarding local drug interaction with gut opiate receptors is interesting. I will note that opiates exert a very strong constipating effect SYSTEMICALLY, as well, of course. Parenteral narcotics constipate also. I have studied the constipation issue to a...
by rickbennettmd
Tue May 03, 2016 9:24 am
Forum: Clinical Use of Buprenorphine
Topic: brain zaps
Replies: 5
Views:

I'm afraid the term "brain zaps" is new to me.

How exactly do you two define it?

Dr. Passer -- NTI is an abbreviation used by psychiatrists for nortriptyline?

Richard Bennett
by rickbennettmd
Mon Apr 25, 2016 8:08 am
Forum: Clinical Use of Buprenorphine
Topic: update: the adequate maintenance "blocking dose"
Replies: 8
Views:

"I start on 16mg a day to insure no physical need for other opiates. I then have the patient decrease the dose to establish the maintainance dose. I have a very good retention rate when compared to others. I have found my patients are maintained on 8-16mg. I have found almost zero people come in wit...
by rickbennettmd
Mon Apr 11, 2016 10:02 am
Forum: Clinical Use of Buprenorphine
Topic: Tramadol has unique properties in buprenorphine to
Replies: 9
Views:

I agree with the above comments. My standard advice to patients with acute pain of moderate intensity is also to increase their Suboxone dosage by 4mg. Also, of course, NSAIDS are always recommended in these circumstances. A good friend of mine is a hospie director. I was surprised to learn from him ...
by rickbennettmd
Wed Apr 06, 2016 8:11 am
Forum: Clinical Use of Buprenorphine
Topic: opioids and alcohol
Replies: 10
Views:


Yes, I see this as well.

In fact I don't think I've identify ANY patients who admit to me that they have a current alcohol problem.

Very, very counterintuitive, and difficult to accept as valid.

I hope a lot of posters will share their experince on this issue.
by rickbennettmd
Wed Apr 06, 2016 8:11 am
Forum: Clinical Use of Buprenorphine
Topic: opioids and alcohol
Replies: 10
Views:

mattkeene http://www.ncbi.nlm.nih.gov/pubmed/16533497 Biol Psychiatry. 2007 Jan 1;61(1):4-12. Epub 2006 Mar 14. Buprenorphine reduces alcohol drinking through activation of the nociceptin/orphanin FQ-NOP receptor Thank you for this at least partially explanatory study reference Richard Bennett
by rickbennettmd
Thu Mar 31, 2016 9:28 am
Forum: Clinical Use of Buprenorphine
Topic: Benzodiazepine OD's a major problem
Replies: 1
Views:

My opinion, on the other hand, is that benzos are the sine qua non of anxiety symptom treatment efficacy. Unfortunately we have seen their attendant problems become apparent. They are indispensable anesthetic meds, by the way (I am an anesthesiologist.) Versed is the primary sedative used for medica...
by rickbennettmd
Wed Mar 30, 2016 5:50 am
Forum: Clinical Use of Buprenorphine
Topic: buprenorphine levels
Replies: 23
Views:

Dr. Colleen I have the answer to your inquiry, and it is a surprising and a discouraging one. THERE ARE NO STANDARDS, GUIDELINES, OR EVEN RESEARCH regarding correlation of patient buprenorphine and norbuprenorphine quantitative levels with dose. I researched this exhaustively a couple of years ago a...
by rickbennettmd
Wed Mar 30, 2016 5:50 am
Forum: Clinical Use of Buprenorphine
Topic: buprenorphine levels
Replies: 23
Views:

Bruni My posts concerning the information I gathered on buprenorphine serum concentrations was in the thread "Selling bup" in late June 2014 I've confirmed this with labs. That is, there is no data correlating serum concentrations of bup/norbup in the literature. None. Two tiny lousy studies done ye...

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