I have only been doing this for a couple of years, but would advise you to keep your pharmacists happy. Many are reluctant to carry buprenorphine at all... (the DEA "visits" them too). It's little enough to ask you to put the numbers on scripts. I would also indicate "Patient is pregnant, or breastf...

What does it take to become certified in addiction medicine? And how much does it cost?

Gordon

I wouldn't hold my breath. It's been 45 years since the War on Drugs was declared... Dismal failure, yet no repeal. What makes you think that a sensible plan to increase patient numbers for MAT would pass?? Also, see "Fentanyl, we have a problem", below. Increased potency of drugs to avoid detection...

A naive question from a newbie (me): Which is best? Start low and work your way up or start high and taper? Right now I start with a higher starting dose to make sure that the patient has relief from his misery right away. Taper later after he/she has realized how much better his life is now compare...

Many thanks for your responses. Sslonim, I would say that my patients have stopped drinking when their opoid addiction started, and continues with bup therapy, that is, no ETOH relapses. It may sound perverse, but in many ways alcohol addiction is worse than opiate addiction, if, for no other reason...

How many hoops would we have to jump through to get approval for clinical trials using bup to treat alcoholism??

It certainly would be a worthwhile study, but I can't see it happening in this political/legal climate..

Gordon

Rick, It is fascinating that you haven't a single patient who has been completely weaned off Bup. I haven't been in this business long enough to confirm your finding, but if those on this forum agree with you, it is possible that "getting off" bup may be an unrealistic goal. (The majority of my pati...

My patients always complain about lack of money, but I try to explain to them that the only shortage they really have is time. Bup buys them the time they have lost being sick, stoned, or in jail, as well as some of the money they spent buying drugs and risking their lives on the street. With their ...

Brand new at this (just over 1 year). I have been suggesting to my highly motivated patients to decrease the dose by 1/4-1/2 film on their own (only on relatively stress-free days), and tell me how they are doing on the next visit. I always prescribe the dose that makes them symptom-free, and let th...