Search found 74 matches

by MChaplin
Tue Jul 12, 2016 12:25 pm
Forum: Clinical Use of Buprenorphine
Topic: Probuphine
Replies: 13
Views:

I passed on the training for many of the same reasons outlined by deegee- i don't have all that many patients on 8mg or less and those are not the people that are a big diversion risk- I also worry what happens if I can't locate the patient when it is time to remove the implant- i consider my stable...
by MChaplin
Tue Jul 12, 2016 12:25 pm
Forum: Clinical Use of Buprenorphine
Topic: Probuphine
Replies: 13
Views:

more risks- what happens when a patient abuses benzos or alcohol??? what happens if she becomes pregnant? and as stated above, what happens, if the device proves difficult to remove??? what if the patient relapses and the implant dose no longer "holds" them???
by MChaplin
Tue May 03, 2016 7:12 am
Forum: Clinical Use of Buprenorphine
Topic: Setting to prescribe Suboxone
Replies: 8
Views:

I practice in a cmhc in ct- in order for me to prescribe buprenorphine here for MAT- our agency had to get a substance abuse treatment license from the DPH........I could have prescribed without it but only if I kept my own records and operated outside of the agency umbrella!
by MChaplin
Thu Mar 10, 2016 8:13 am
Forum: Clinical Use of Buprenorphine
Topic: liver disease
Replies: 2
Views:

I ran this by two hepatologists: one said there is no blood test to monitor how well the liver will metabolize a given medication- he said if there is a hx of encephalitis then don't try it- otherwise use caution and clinical judegemnt. the other said plt count and inr are the best measures of liver...
by MChaplin
Fri Feb 19, 2016 6:23 am
Forum: Clinical Use of Buprenorphine
Topic: mid levels without M.D.s
Replies: 5
Views:

no....I have heard a suggestion that waiver's be provided to aprn's in a comprehensive SA treatment facility- possibly with md oversight- but only at the proposal level....
by MChaplin
Fri Feb 19, 2016 5:52 am
Forum: Clinical Use of Buprenorphine
Topic: inducing patient with negative UDS
Replies: 10
Views:

did you check your state's prescription monitoring program to see if he has a hx of obtaining meds from ER? or do you have a reliable family member to corroborate his story? did he in fact appear to be in WDRL with a positive COWS including at least some objective signs (runny nose/tearing, tremblin...
by MChaplin
Sun Jan 31, 2016 4:58 pm
Forum: Clinical Use of Buprenorphine
Topic: QR and barcodes on medications
Replies: 1
Views:

the only way to track them is to have the patient bring in the strips after they receive them, you record all the numbers and then if you do a pill count later, you can compare them....the pharmacies don't track them...
by MChaplin
Sun Jan 31, 2016 4:56 pm
Forum: Clinical Use of Buprenorphine
Topic: Encouraging more docs to manage addiction?
Replies: 4
Views:

well getting rid of the DEA agent visits would help- although they are nothing to be afraid of if you are keeping appropriate records, they are very intimidating to even very good doctors- why do bup prescribers face DEA scrutiny and not oxy prescribers when bup accounts for a tiny fraction of opioi...
by MChaplin
Sun Jan 31, 2016 4:56 pm
Forum: Clinical Use of Buprenorphine
Topic: Encouraging more docs to manage addiction?
Replies: 4
Views:

I agree that the visits are benign enough- BUT they do discourage people and they send a negative message about the process...
by MChaplin
Tue Jan 26, 2016 9:02 am
Forum: Clinical Use of Buprenorphine
Topic: what doses are being used?
Replies: 11
Views:

I think this is a very complicated question- people have all sorts of individual differences and needs and I don't think the chemistry is as well defined as we would like it to be- in my practice, I have multiple patients that struggle with doses less than 24mg- and honestly I am inclined to beleive...

Go to advanced search