Search found 61 matches

by jhartdo
Tue Dec 20, 2016 2:54 am
Forum: Clinical Use of Buprenorphine
Topic: But Discontinuation Syndrome ??? Studies
Replies: 7
Views:

The difficulty in going from 2 mg to zero, is not a matter of milligrams but a matter of receptor numbers. At 2 mg, buprenorphine still has command of a large number of receptors. Compared to 16 mg, the percentage is small but when compared to 0 mg, it is significant. I think of the normal brain as ...
by jhartdo
Fri Oct 23, 2015 5:00 am
Forum: Clinical Use of Buprenorphine
Topic: unusual pregnancy conundrum
Replies: 18
Views:

Like Dr. Passer said, the lowest dose that solves the problem.
by jhartdo
Mon Aug 10, 2015 7:15 am
Forum: Clinical Use of Buprenorphine
Topic: pregnant pt on methadone requesting buprenorphine
Replies: 16
Views:

I only do it with the direct discussion with the OB/Gyn. The OB/Gyn may discuss it with the peds physician. I see it as a group decision.
by jhartdo
Mon May 12, 2014 8:22 pm
Forum: Clinical Use of Buprenorphine
Topic: Selling bup
Replies: 35
Views:

The films do have a market, but the plain bup tables have a hotter market, since it can be used IV. When a person is on subxone and the receptors start to recover, the dose is usually lowered by the physician. Many patient will say they continue to say they need 2 or 3 films, when their actual requi...
by jhartdo
Mon May 12, 2014 8:22 pm
Forum: Clinical Use of Buprenorphine
Topic: Selling bup
Replies: 35
Views:

Naloxone is a deterrent, as was noted in the Australian study. However, It is not a complete deterrent, as the combination drug has been used IV. Probably two very human factors come into play, availability and desperation. The European experience, with France and Iceland leading the way, showed how...
by jhartdo
Wed Jan 15, 2014 1:42 pm
Forum: Clinical Use of Buprenorphine
Topic: Zubsolv
Replies: 58
Views:

Cutting the film is much easier and slow reduction is a major part of treatment. I consider this to be important.
by jhartdo
Thu Aug 15, 2013 2:24 pm
Forum: Clinical Use of Buprenorphine
Topic: What? NO one can help w/this detox?
Replies: 9
Views:

I agree. I am a pain physician. We rarely go over 16 mg and then for only a few months. What is the cause of the pain? That is the primary question. That level of subx requires blood dripping on the floor and then, subx is the wrong treatment. N&V, weight loss and anorexia does not come from pain; i...
by jhartdo
Thu Aug 15, 2013 2:24 pm
Forum: Clinical Use of Buprenorphine
Topic: What? NO one can help w/this detox?
Replies: 9
Views:

Our instructions are, under the tongue, hang your head down and look at the floor for five minutes. Don't look up, don't talk. We want all of the Suboxone to stay in the front of your mouth for five minutes. That's where the absorption takes place. Dr. Passer's comment is right on. It's interesting ...
by jhartdo
Tue Sep 25, 2012 7:08 am
Forum: Clinical Use of Buprenorphine
Topic: subtexting
Replies: 1
Views: 143

She requires a higher level of care then OBT and this simply just may not be her time, as she wishes "partial" recovery on her terms. Time to refer and quit.
These are always tough for me.

John
by jhartdo
Mon Jun 18, 2012 7:18 pm
Forum: Clinical Use of Buprenorphine
Topic: Butrans for final step of taper
Replies: 20
Views: 863

jritvo, Thank you for keeping us up dated on your patient. I will be trying this in the future. It would be good to hear of successes or failures as we learn to deal with the tribulations of coming off of suboxone. Dr Ballester, very interesting link. I will look at it this next week as I haven't sp...

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