Search found 71 matches

by NoDrugs4u
Wed Apr 27, 2016 1:01 pm
Forum: Clinical Use of Buprenorphine
Topic: Vivitrol Question
Replies: 4
Views:

I would bill the patient for the $1500. Consider it a Stupidity Fee.
by NoDrugs4u
Mon Apr 25, 2016 8:08 am
Forum: Clinical Use of Buprenorphine
Topic: update: the adequate maintenance "blocking dose"
Replies: 8
Views:

I must agree with Dr Passer on the issue of starting dose. As per the information in all of the training courses and the SAMHSA manual, I start induction with a low dose and titrate upwards based on COWS scale and patient subjective evaluation.
by NoDrugs4u
Mon Apr 11, 2016 7:55 am
Forum: Clinical Use of Buprenorphine
Topic: "high" produced in a 2 film patient by 4 films
Replies: 2
Views:

I can't answer your original question about getting high if not opiate naive. But, my first thought was that I would probably dismiss or severely restrict this patient immediately for noncompliance and self-dosing. I am not a believer in patients adjusting their own doses on a whim, especially doubl...
by NoDrugs4u
Wed Apr 06, 2016 8:11 am
Forum: Clinical Use of Buprenorphine
Topic: opioids and alcohol
Replies: 12
Views:

Welcome Gordon (or Clark?) Yes, I have also noticed this. It is simply trading one substance of abuse for another. Also, you will notice that on this board the replies do not get posted immediately. Sometimes it will be weeks before I see my responses posted. Sometimes I will get email notification ...
by NoDrugs4u
Wed Mar 30, 2016 5:50 am
Forum: Clinical Use of Buprenorphine
Topic: buprenorphine levels
Replies: 23
Views:

I've had some patients in the clinic on observed dosing of a 2mg dose that it did not show up in laboratory testing. Higher doses have always showed up where I work. Our lab prints on the results form a scale roughly correlating dose to expected serum levels, but I don't know how accurate that is co...
by NoDrugs4u
Wed Mar 30, 2016 5:50 am
Forum: Clinical Use of Buprenorphine
Topic: buprenorphine levels
Replies: 23
Views:

Related question - is there any way someone on 8mg daily could test negative for buprenorphine in a urine test? I have two patients in that situation that vehemently claim they are taking their medication.
by NoDrugs4u
Wed Mar 30, 2016 5:50 am
Forum: Clinical Use of Buprenorphine
Topic: buprenorphine levels
Replies: 23
Views:

Thank you everyone. Both had laboratory testing and one had a POC test as well. All negative. One of them kept coming up positive for benzos and denying it, so I ordered a confirmatory laboratory test and didn't tell him that I also ordered a buprenorphine level. I suspect that he had someone else t...
by NoDrugs4u
Wed Mar 30, 2016 5:50 am
Forum: Clinical Use of Buprenorphine
Topic: buprenorphine levels
Replies: 23
Views:

This is a clinic and they do quantitatives by policy. Not my choice.

Well, I can answer about one patient. Once she knew we suspected diversion she has disappeared in the wind.
by NoDrugs4u
Fri Feb 19, 2016 8:27 am
Forum: Clinical Use of Buprenorphine
Topic: Bupe and QT changes
Replies: 3
Views:

Good to know. Curious how many here monitor serial EKG's for QT prolongation? I know that I do not.
by NoDrugs4u
Fri Feb 19, 2016 6:23 am
Forum: Clinical Use of Buprenorphine
Topic: mid levels without M.D.s
Replies: 5
Views:

If "midlevels" are permitted to prescribe buprenorphine it will degrade the quality of addiction treatment, just as it has degraded the quality of every medical specialty which they have invaded.

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