Patient cap being lifted?

Buprenorphine Post
kcairns
Posts: 571

Postby kcairns » Mon Sep 21, 2015 9:25 am

I've got your back, NoDrugs4u, and all our backs as no reason to allow Authority to team-split us....note tho no talk of kicking out docs rather about which docs and opioid addicted Americans they will lift arbitrary caps off the backs of (or not) ...when Americans are dying at clip of 2/hr and fruitlessly texting capped out bup-waived docs, "I feel i cant go on any longer and my kids need me" authorities will have hard time explaining how their refusing any docs w good records from helping all those who call upon us in need could possibly do more harm than good, especially when Authority's long capping of care is responsible for the growth of the epidemic ... doesn't there exist somewhere a plain old fashioned common sense guide for them on what to do in an emergency?


NoDrugs4u
Posts: 198

Postby NoDrugs4u » Mon Sep 21, 2015 9:25 am

On the contrary, I don't need to be Board Certified in Cardiology to do an EKG or treat chronic CHF, Board Certified in Nephrology to treat Stage 3 CKD, or Board Certified in Psychiatry to prescribe Paxil for GAD.

If I understand what you are saying, that all doctors should be Board Certified in Addiction Medicine before prescribing buprenorphine? I don't think we are talking about open heart surgery here. But if that is your belief then I can't imagine the shortage of opiate addiction treatment if we Family Practitioners all stopped prescribing buprenorphine!

peterorrin
Posts: 267

Postby peterorrin » Mon Sep 21, 2015 9:25 am

NoDrugs-4u. We primary care docs do not usually provide specialty services such as cardiology, nephrology, psychiatry. Addiction medicine is also a specialty with a known data base, and added credentials are available...thank you ABAM! Not everyone of us is 'certified' but hopefully those of us on this list provide treatment for patients with opioid use disorders try to adhere to NIDA Principles of Effective Treatment. That includes counseling that is of high quality, focused and long.








drpasser
Posts: 1404

Postby drpasser » Mon Sep 21, 2015 9:25 am

Latest article, which says, among other things, that the 100 pt limit is to be looked at.


https://www.washingtonpost.com/politics/white-house-announces-new-steps-to-combat-heroin-prescription-drug-abuse/2015/10/21/e454f8fa-7800-11e5-a958-d889faf561dc_story.html

:-)

MChaplin
Posts: 183

Postby MChaplin » Mon Sep 21, 2015 9:25 am

of course i can't find the reference now- it was on the addiction treatment forum website I think- this is the closest thing i could find http://atforum.com/2014/10/increasing-the-buprenorphine-patient-cap-threat-to-patient-care/ Peter- what is a good time to call? you can reach me at 860 930-1034- best time for me is between 7:45 and 8:30 or so. The idea is that most DATA 2000 docs are not even able to accomadate 100 people so increasing the cap will lead to medication but no treatment- they make a big deal of diversion for the sake of getting high rather than to treat wdrl- but of course there is no data just anecdotes- i would like to see DAWN data-in any case, from a harm reduction standpoint, would rather have people abuse bup than heroin-

NoDrugs4u
Posts: 198

Postby NoDrugs4u » Mon Sep 21, 2015 9:25 am

Raise standards to "certified addiction specialist" to prescribe bup and no primary care doctors would prescribe it. I hope you can carry 10,000 bup patients to make up for that :-)

But, allowing non-physicians to prescribe, that is going overboard and would create a massive pill mill industry as evidenced by their invading other areas of medical practice like a metastasizing tumor.

peterorrin
Posts: 267

Postby peterorrin » Mon Sep 21, 2015 9:25 am

There are pill mills now. There always have been pill mills. If I, and you had 150 bup patients, every patient would still get the best we have to offer. Raise the standards of bup providers to 'certified addiction specialist' and the number of pill mills would decline. Boy, the stories we could relate! Not that we are guaranteed of being cleansed of bad character because of our advanced credentials. Its that the prescribers I know have made career choices to help patients with drug use disorders.

MChaplin. Please reference that editorial for me. Since I think we are practicing in the same state, I give you my cell phone # 203-733-0843. Please call.

Peter
Peter Rostenberg, MD, DFASAM
Office 203-746-3300

drpasser
Posts: 1404

Postby drpasser » Mon Sep 21, 2015 9:25 am

I am not sure which "Authorities" said what.

It is my understanding, there is an ASAM policy which includes support to lift the cap.

I could be wrong.

:-)

kcairns
Posts: 571

Postby kcairns » Mon Sep 21, 2015 9:25 am

MChaplin if those folks or loved ones had deadly sud I guess they would be ok w a doc cowboying up to work a little extra hard to save life but country better off to just get rid of 15000 per year stranger junkies... I guess they have no problems w docs working a little extra hard to get painkillers out to 101 chronic pain pts, kinda glad these folks weren't around fretting over docs overworking ourselves when the first few of us were head over heels at the outset of aids epidemic...I got tshirts for them --shut up --man up

MChaplin
Posts: 183

Postby MChaplin » Mon Sep 21, 2015 9:25 am

I just read an editorial stating that addiction professionals advised against is claiming that it would lead to the development of pill mills because legit suboxone providers couldn't handle more than 100 patients. I am beside myself....that is so not the point!


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