Search found 9 matches

by tdbailey
Thu Apr 28, 2016 5:44 am
Forum: Clinical Use of Buprenorphine
Topic: PPI's and false + THC
Replies: 3
Views:

I don't recall seeing THC positives before with PPI's. It's good to know it is possible though. We have had instances in our patients of PPI's causing false positives for Amphetamines and Opiates, often both on the same screen. Not just the dip either but also on the send off. A GCMS is negative onc...
by tdbailey
Wed Apr 27, 2016 1:01 pm
Forum: Clinical Use of Buprenorphine
Topic: Vivitrol Question
Replies: 4
Views:

I'm not sure how long the Vivitrol 'stays good' once reconstituted but would have tried to get a 50mg PO Naltrexone to try with the patient first. If he did fine with this I would have been fine with the injection. If he did have withdrawal with the tablet at least it would have 'worn off' relativel...
by tdbailey
Fri Aug 14, 2015 4:48 am
Forum: Clinical Use of Buprenorphine
Topic: Butrans to Suboxone
Replies: 0
Views:

The strongest Butrans patch, I believe, is similar in terms of daily bio-availability to a 2mg Suboxone. So to have the pt take the patch off the end of one day and start 2mg Suboxone the next would seem to be a wash. (Butrans and Suboxone equivalency were discussed in this thread, I did not redo th...
by tdbailey
Mon Aug 10, 2015 7:15 am
Forum: Clinical Use of Buprenorphine
Topic: pregnant pt on methadone requesting buprenorphine
Replies: 16
Views:

Methadone does remain the gold standard of MAT in pregnancy. Also as you point out, to transition she will have to have some withdrawal. Our procedure is the pt doses down to 30mg and remains at that dose for a week, then misses 1-2 days, then starts on Bup. (This is not specific to pregnant pts but...
by tdbailey
Tue Jul 28, 2015 10:28 am
Forum: Clinical Use of Buprenorphine
Topic: Salary Advice? - We All Have to Make a Living
Replies: 15
Views:

I don't seem to have the option to email you. Maybe is is how you have your settings. I think you should be able to email me though and if you do I can give you some specific numbers.
by tdbailey
Fri Jul 17, 2015 7:26 am
Forum: Clinical Use of Buprenorphine
Topic: re-examing diversion
Replies: 23
Views:

A counselor at one of the clinics in which I work recently served on grand jury duty. Of the 47 people they indicted, 42 were related to Suboxone-either selling or illegal possesion. This was startling to me. It's no wonder law enforcement-and the public at large-seems so often to have a prejudice a...
by tdbailey
Fri Jul 17, 2015 7:26 am
Forum: Clinical Use of Buprenorphine
Topic: re-examing diversion
Replies: 23
Views:

It seems to me if we take some of the above positions to the reductio ad absurdum then we should prescribe 100 Suboxone strips to every patient we see and with a wink ask them to pass 'em out. Would we be ok with that? Personally I do feel uncomfortable with a patient who comes to see me with the in...
by tdbailey
Wed Jun 24, 2015 5:32 am
Forum: Clinical Use of Buprenorphine
Topic: Buprenorphine patches for tapering
Replies: 13
Views:

The DEA specifies the DATA waiver is for using forms of bup "approved" to treat addiction. The patch is not. Whether it makes sense is irrelevant, I would be very careful using the patch for addiction.

http://www.deadiversion.usdoj.gov/pubs/docs/dwp_buprenorphine.htm
by tdbailey
Wed Jun 24, 2015 5:32 am
Forum: Clinical Use of Buprenorphine
Topic: Buprenorphine patches for tapering
Replies: 13
Views:

I had two patients recently who left my practice as their PCP offered to use the patch to treat both their pain and addiction, and their insurance would pay for it. One was an epic fail as he was on 14mg Suboxone at the time and was back to see me right away. (He was wearing all 4 of the patches whe...

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