Search found 74 matches

by MChaplin
Mon Mar 31, 2014 10:21 pm
Forum: Clinical Use of Buprenorphine
Topic: POC testing
Replies: 16
Views:

POC cups are only iffy for klonopin as the test is via immunoa**ay- there are some other quirks- lots of false positives for pcp (including effexor )and seroquel can show up as methadone- all in all though, we find the cups extremely helpful due to immediate turnaround- it is worth getting one that ...
by MChaplin
Mon Mar 31, 2014 10:21 pm
Forum: Clinical Use of Buprenorphine
Topic: POC testing
Replies: 16
Views:

just a heads up- we used to use a lab that supplied us with poc cups until we took a closer look and realized that that probably falls into the area of "kickbacks"- if a lab supplies you with "free" cups that have an established value, and you then send all your labwork to them, then you could be co...
by MChaplin
Mon Mar 31, 2014 10:21 pm
Forum: Clinical Use of Buprenorphine
Topic: POC testing
Replies: 16
Views:

you don't have to decant the pee- most labs will run the test on the urine from the poc cup. and as fas as i know there is no poc test for norbup. so if you don't check, there is a good chance you are being scammed by at least one person- or you will be- i agree with progress not perfection but i st...
by MChaplin
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

http://archinte.jamanetwork.com/article.aspx?articleid=1916910. don't know if folks will be able to access the article BUT it showed clear separation of maintenance treatment (which does work) and taper (which didn't work so well). I think this is a really important addition to the data because i th...
by MChaplin
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

Thanks Kevin- Are you saying you are pretty much not taking new bup patients at this time? do you maintain any kind of wait list in the event that you do have an opening? I think this raises another interesting query- how many of us are now "saturated"? ie can't take any new patients except very spo...
by MChaplin
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

jmosby- but when we cull, even if it for a justifiable reason, is it also "akin to a death sentence" as Dave said in the benzos are bad thread....I have had two patients leave my practice due to my refusal to treat them with benzos who are now dead. I can't help wondering if buprenorphine would have...
by MChaplin
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

I am resurrecting the original topic of how long to treat - i find it telling that the topic moved into how to deal with the 100 patient limit- what does it tell us? that we would not be stopping treatment if we weren't under pressure to treat more than 100 patients!!! But I am resurrecting the topi...
by MChaplin
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

Thanks Ken- you nailed it- it really is too much sometimes and i love your words of wisdom- "it is not about an occassional positive uds...bup is working for the person who is alive and ....capable of doing the work that they have to do in life". You did not flinch from the cold hard reality of doin...
by MChaplin
Fri Feb 08, 2013 10:22 am
Forum: Clinical Use of Buprenorphine
Topic: Value of pill/strip counts
Replies: 23
Views: 10630

i work closely with a team of dual dx (addiction/psych) clinicians- we have people sign an initial treatment contract which is very clear about what is not tolerated- if there is irefutable evidence that they are selling (for example we had a pt asked to return for pill count the very next day who l...
by MChaplin
Mon Feb 06, 2012 7:27 am
Forum: Clinical Use of Buprenorphine
Topic: cocktail for transition from bup to naltrexone...
Replies: 43
Views: 14900

thanks Dr P- i will let you know how it goes....

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