Search found 52 matches

by entjwb
Tue Jun 02, 2015 1:04 pm
Forum: Clinical Use of Buprenorphine
Topic: Patient Prefers Subutex
Replies: 53
Views:

Fink elms, I am a Suboxone prescriber who after a year of prescribing deceived to learn more and have taken the needed courses and studying to take the boards in October. I have a patient who came to me who was addicted to hydrocordone and went to a Methadone clinic and they started her on Methadone...
by entjwb
Tue May 26, 2015 11:57 am
Forum: Clinical Use of Buprenorphine
Topic: what is enough "behavioral medicine"
Replies: 20
Views:

In Ohio we have to refer to a certified drug counsellor. If you are a Psychiatrist or board certified addictionologist you can fulfill that role. I prefer to send to a drug counsellor as well as spending some time with the patient. I have a good retention rate and 1-5 people a month completing the p...
by entjwb
Tue May 26, 2015 11:57 am
Forum: Clinical Use of Buprenorphine
Topic: what is enough "behavioral medicine"
Replies: 20
Views:

Degree, if you are board certified in any specialty. The ABAM will allow you to take courses to qualify to take the boards if you have one year equivalent patient care in addiction and get 50 hours CME in addiction. I will try to post here later.
by entjwb
Mon Apr 27, 2015 10:55 pm
Forum: Clinical Use of Buprenorphine
Topic: Induction
Replies: 30
Views:

We see a new patient on the first visit and then in one week or two weeks at the physicians option. This depends on the patients situation. Our patients pay for their visits and for the most part very motivated to reaching recovery. We do have policies in place for discipline non compliance.
by entjwb
Mon Dec 15, 2014 10:22 am
Forum: Clinical Use of Buprenorphine
Topic: question re patient
Replies: 27
Views:

My criteria for continued treatment is to stay free of any opiate or illegal substance. I have a three strike program so I give them ample opportunity to change and continue therapy. If they can't do that them I will replace with a patient who will be serious about getting and staying clean.
by entjwb
Sat Jul 12, 2014 7:03 am
Forum: Clinical Use of Buprenorphine
Topic: Bunavail
Replies: 4
Views:

Actually the delivery system of Bunavail has the advantage of almost or none lost in the saliva. With the sublingual delivery a lot of the medication will be in the saliva and may not be absorbed. The bioavailability varies a lot because can be dependent on the amount of saliva produced to dilute th...
by entjwb
Mon Mar 31, 2014 10:21 pm
Forum: Clinical Use of Buprenorphine
Topic: POC testing
Replies: 16
Views:

We buy our cups from a vendor through the lab. Can the lab negotiate a price for their customers based on the normal volume rate? To me this is no different than an HMO negotiating with a pharmaceutical company for a better price and making it a preferred drug with less copayment.
by entjwb
Mon Mar 31, 2014 10:21 pm
Forum: Clinical Use of Buprenorphine
Topic: POC testing
Replies: 16
Views:

For Ohio physicians if you see CareSource patients, they may be contracting with only 2 labs for toxicology.
by entjwb
Tue Mar 18, 2014 4:34 am
Forum: Clinical Use of Buprenorphine
Topic: Question about an inpatient on narcotics
Replies: 6
Views:

First anyone on that daily dose for that long is addicted. The addiction is a physical property of opiates. To me it is malpractice to not give them opiates. I might suspect her symptoms might be withdrawal as a possibility. I would talk with them about decreasing dosages but realize you probably wo...
by entjwb
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

My opinion about this issue is there are not any way we can have a length of time for treatment. That will depend on the progress of each patient. I have found successful therapy and weaning off can depend on the attitude of the physician. I usually ask for the patient to tell me when they think the...

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