buprenorphine dosing

Buprenorphine Post
Posts: 1404

Postby drpasser » Fri Sep 04, 2015 6:58 am

I am starting a new Vivitrol thread :-)

Posts: 187

Postby Dave » Fri Sep 04, 2015 6:58 am

It looks like rfarmer has disappeared after offering to answer questions!

Posts: 101

Postby edibill » Fri Sep 04, 2015 6:58 am

rfarmer I too have many questions. I'm as_suming you have the patients completely detoxed and give a test dose of naloxone. Are your patients coming to you out of an inpatient treatment program or off the street and if they're off the street how are you getting them completely detoxed? What is your compliance rate with that step alone? How about 3 months after starting Vivitrol injections, what percentage are still coming in for their injections?

Posts: 187

Postby Dave » Fri Sep 04, 2015 6:58 am

rfarmer, I have many questions. How many patients have you treated with Vivitrol? How many have serious withdrawal reactions? How many discontinue Vivitrol?

drpasser, Thank you for your supporting information re my previous comments about methadone and bupe.

m kaylor, drpasser and I have answered your question about how I arrived at my conclusion that methadone is like heroin and bupe is like feeling normal.

Posts: 1404

Postby drpasser » Fri Sep 04, 2015 6:58 am

Rfarmer- maybe you should start a new thread, so we can learn about and benefit from your experience with Vivitrol.?


Posts: 38

Postby rfarmer » Fri Sep 04, 2015 6:58 am

Why take chances with either of these. I use Vivitrol in all cases of heroin and heavy oxy use with excellent results. If the family has health insurance, it pays$7000.00 and the manufacturer issues a $500.00 credit, covering the entire cost. I spend 45-50 min for therapy and 10 min preparing the injection and giving it IM in the gluteus in alternate sides every 3 wks. Questions?

Posts: 1404

Postby drpasser » Fri Sep 04, 2015 6:58 am

Methadone is more euphorigenic than bupe. More 'buzzy' from what pts have said.

Methadone takers will say they can 'feel' the Methadone and can tell they've taken something. Bupe folks will say, they really don't 'feel' the bupe; rather, they say they just feel 'normal' or 'regular.'


Posts: 180

Postby entjwb » Fri Sep 04, 2015 6:58 am

There is a place and need for both programs. I also, believe a place for Vivitrol for unto 6 months. Many court ordered cases and the person is there because they have to be instead of want to be. Would do better with Vivitrol and then switched to Bup. This would give them 6 months of sobriety and that make them want to stay that way and couldn't divert meds and allow them to get a full time or part time job and have more money coming in than going out. Street drugs are expensive.
I don't want to try to argue which program is better because each can fit certain patient needs.

Posts: 571

Postby kcairns » Fri Sep 04, 2015 6:58 am

methadone maintenance long established standard of care, despite which forever multiple efforts to de-legitimize it and shudder to think what it would be like in case such happened

Posts: 22

Postby m_kaylor » Fri Sep 04, 2015 6:58 am

I interpret this as saying that methadone and buprenorphine are equal and that dose matters when it comes to suppressing illicit use of opioids.

Dave you have faulty logic: No one I know likes methadone (this is anecdotal onley) so the "logical" conclusion is that methadone is legal heroin and so people who use methadone just want to get high? I don't understand how you arrived at this conclusion

Your comments demonstrate you have little idea how methadone works and are insulting and offensive to everyone who has worked hard to achieve/maintain sobriety but chose methadone to do so.

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