Iatrogenic opiate dependence in a pain pt

Buprenorphine Post
Posts: 22

Postby m_kaylor » Thu Aug 13, 2015 6:34 am

You could make some****umptions and generalizations (take with a grain of salt):

Iatrogenic: Pros: familiar with medical system, likely to have some form of insurance which indicates some stability. Possibly less legal issues, less likely to have used IV and less likely to have polysubstance abuse (maybe).
Cons: you will likely have to deal with some chronic pain issues, may be less likely to feel that they have a problem with addiction and may be seeing you only because they have been cut off by physicians and may not want to completly move off of opiates.

"street addict": Pros: if they are seeing you they are likely motivated to discontinue drug use unless they were coerced to see you by family or the legal system
Cons: less qualms about breaking the law, more likely to have used IV or inhalation of narcotics (possibly), more likely to have polysubstance abuse. Likely has a social network that encourages or at least provides access to illicit drugs and may impede sobriety. Possibly less resources/stability in life.

Both groups have their challenges

Posts: 267

Postby peterorrin » Thu Aug 13, 2015 6:34 am

Pain doctors necessarily cause, from time to time, opioid dependence in some patients. These doctors are often adept at weaning them off opioids; the buprenorphine doctor never sees them.
Pain doctors also identify opioid dependant patients who lose control of their use. They finish Rx.s early, family members complain, etc. Those patients are referred to a buprenorphine provider.

So, not all [[iatrogenic] opioid-dependant patients have opioid-use-disorders. Or, not all dependant patients have brain disease.

Posts: 571

Postby kcairns » Thu Aug 13, 2015 6:34 am

no --the mu receptors recognize no difference....( and individual other-than-opioid variations are limitless.)...why no difference? the poppy gives and takes away indiscriminately

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