Search found 52 matches

by entjwb
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

I discuss the goal of weaning off the Bup on the first visit. I don't believe a trade one drug for another drug, even if a lot safe, should be the goal of a treatment program like this. I just talked with a patient yesterday who has been weaned off for Three months and still doing fine no cravings o...
by entjwb
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

Crack, I understand where you are coming from. But as others have said not every patient is going to be the same. I have found with working on each aspect that needs to be addressed with each individual patient it increases the chance of being able to wean off Bup and be fine. I have found, in my pr...
by entjwb
Mon Mar 17, 2014 11:24 am
Forum: Clinical Use of Buprenorphine
Topic: duration of treatment with buprenorphine
Replies: 72
Views:

Gordon, when that comes up I usually asked how much a day they spent on street drugs. Then calculate to how much a month. Most of the time the monthly cost of my office visit is 2-7 days of street drug use. I had one patient with no insurance. He paid the office visits and for the medication and tol...
by entjwb
Tue Feb 18, 2014 11:48 am
Forum: Clinical Use of Buprenorphine
Topic: DEA inspection.
Replies: 16
Views:

Need to check with State Board. Each state might be different. We have asked that same question because the computer keeps a record of the Rx which is what is required.
by entjwb
Mon May 20, 2013 7:57 am
Forum: Clinical Use of Buprenorphine
Topic: Do you have a max dose of methadone?
Replies: 9
Views: 3830

I just had a patient who wanted desperately to get off the Methadone and on Suboxone. He was on 70mg per day. He stopped and then 10 days later called me to start him on Suboxone. I went to the office and evaluated he was in 80-85% withdrawal and urine screen only positive for methadone. I started o...
by entjwb
Mon May 20, 2013 7:57 am
Forum: Clinical Use of Buprenorphine
Topic: Do you have a max dose of methadone?
Replies: 9
Views: 3830

I usually have them get Rx for 6 films and bring back to office for induction. Check and document the COWS.
by entjwb
Fri Feb 08, 2013 10:22 am
Forum: Clinical Use of Buprenorphine
Topic: Value of pill/strip counts
Replies: 23
Views: 10629

Steve, I would have first done weekly UDS and if noncompliance is shown. I have no problem dismissing the patient. My patients are told on first visit. I will totally trust them until they prove to me to be untrustworthy. What you described has proved that. We have an obligation to treat patients wh...
by entjwb
Mon Feb 06, 2012 7:27 am
Forum: Clinical Use of Buprenorphine
Topic: cocktail for transition from bup to naltrexone...
Replies: 43
Views: 14900

We are just now deciding to start a Vivatrol program. The Medicaid in Ohio do cover. We are looking into using a local Compounding Pharmacy to supply. We are asking them to deliver the injections to the office and we will administer. This same pharmacy will deliver Suboxone for office inductions of ...
by entjwb
Mon Feb 06, 2012 7:27 am
Forum: Clinical Use of Buprenorphine
Topic: cocktail for transition from bup to naltrexone...
Replies: 43
Views: 14900

DR Passer, I prefer Diclofenac 75 mg to ibuprofen for pain. Also, doesn't have the GI side effects like Ibuprofen.
by entjwb
Mon Feb 06, 2012 7:27 am
Forum: Clinical Use of Buprenorphine
Topic: cocktail for transition from bup to naltrexone...
Replies: 43
Views: 14900

I have not used any Meds after Suboxone therapy completed except for Diclofenac and Tramadol for limited time. They are told if they have any cravings they are to call the office, immediately. They are also encouraged to continue one on one counseling for at least 3 months and group for one year. So...

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