Search found 113 matches

by sslonim
Wed Jan 25, 2017 11:03 am
Forum: Clinical Use of Buprenorphine
Topic: BORDERLINE PERSONALITY DISORDER IN OPIOID DEPENDEN
Replies: 12
Views:

OK, you got me curious as this didn't sound right. From the CA Medical Board web site - just copying this in... don't know if they follow this or not... http://www.mbc.ca.gov/Enforcement/Complaint_Process.aspx To review these complaints, Board staff will request copies of the patient's medical recor...
by sslonim
Thu Oct 27, 2016 1:08 pm
Forum: Clinical Use of Buprenorphine
Topic: Written documentation of when XR number is needed.
Replies: 7
Views:

Just want to agree with the above responses. I don't know the actual rules/regulations but too often come to conclusion that pharmacists are paranoid (justly or unjustly) - also some work in (large) chains where decisions/rules are made 1000s of miles away from the actual pharmacist and they have to...
by sslonim
Tue Jul 12, 2016 12:25 pm
Forum: Clinical Use of Buprenorphine
Topic: Probuphine
Replies: 13
Views:

2 quick thoughts: 1) one place where I think it clearly would help is patients who will be in jail and not allowed to take Suboxone; 2) cost: if I've got this right its for patients on 8mg/day or less and good for 6 months; so at $4995 for 6 months that is around $830 per month and while Suboxone 8/...
by sslonim
Mon Apr 25, 2016 8:08 am
Forum: Clinical Use of Buprenorphine
Topic: update: the adequate maintenance "blocking dose"
Replies: 8
Views:

Welcome Gordon. I don't think there is a right answer or a only one way to do it answer. Different docs may do it differently based on their experiences. Even the same doc may do it differently with different patients. I prefer to start low and work up. I basically have them use it somewhat PRN the ...
by sslonim
Wed Apr 06, 2016 8:11 am
Forum: Clinical Use of Buprenorphine
Topic: opioids and alcohol
Replies: 10
Views:

For clarification are you saying they stop drinking when they start using opioids ... or when they have their opioid dependence treated? My experience is a few patients who tell me they lost their desire to drink when we started Suboxone.
by sslonim
Thu Mar 10, 2016 8:13 am
Forum: Clinical Use of Buprenorphine
Topic: liver disease
Replies: 2
Views:

Maybe some one can provide guidelines based on lab results ... but I think there is still place for old fashioned clinical judgment where the doc uses his/her knowledge, experience, knows the patient and their various circumstances/factors. I think you did the right thing - you tried a low dose on e...
by sslonim
Tue Jan 26, 2016 9:02 am
Forum: Clinical Use of Buprenorphine
Topic: what doses are being used?
Replies: 11
Views:

No I didn't write for 12mg. That patient has been on 8/2 for years - I just changed from 2/day to 1 1/2 per day. My understanding (I haven't checked recently) is that the 8/2mg film is the best ... well, least expensive price per mg. I only use 8 or 2mg sizes (for Suboxone). Of course, insurances ma...
by sslonim
Tue Jan 26, 2016 9:02 am
Forum: Clinical Use of Buprenorphine
Topic: what doses are being used?
Replies: 11
Views:

MChaplin - thanks, my experience/thoughts are the same (I have patients long term on 24mg down to one patient who a 2mg film lasts 8 days now but can't get off it) As for insurers putting limits on medicines saying its for patient safety ... I better not write what I think. Somewhat bizarre thing ha...
by sslonim
Wed Oct 14, 2015 5:53 am
Forum: Clinical Use of Buprenorphine
Topic: Medicaid and Cash only clinics
Replies: 10
Views:

I think so but don't quote me ... possibly may vary by state. Here's an example I've seen (I live in Washington state). The Medicaid insurer I use requires pre-auth for Suboxone. So say a patient is out, I give them an Rx they take to pharmacy. Pharmacy lets us know a pre-auth is required before ins...
by sslonim
Mon Oct 12, 2015 1:37 pm
Forum: Clinical Use of Buprenorphine
Topic: cutting films in half
Replies: 9
Views:

Dave has a good idea. Maybe as an alternative all of us who have patients cut the film up could make a brief comment here and maybe print out this topic to show how common it is -- possibly that might help. Put me down as having many patients who cut up the films, using portions and I don't remember...

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