Search found 609 matches

by docm2
Mon Jan 25, 2021 8:31 am
Forum: Buprenorphine Dosing Discussion
Topic: How much needed for chronic pain?
Replies: 2
Views: 100

Re: How much needed for chronic pain?

Sorry you have not gotten any responses. I am not a pain clinician and do not feel qualified to chime in. Around here Buprenorphine SL is not used for pain because it is very difficult to get prior approval from the insurance companies.
by docm2
Mon Jan 25, 2021 8:28 am
Forum: Buprenorphine Q and A
Topic: Re-induction help needed
Replies: 1
Views: 68

Re: Re-induction help needed

If I read correctly you have been off Suboxone and on a full agonist for 7 days. That is long enough to require re-induction. Use the COWS or SOWS to ensure you are in moderate withdrawal then restart. An alternative, if you are not sure if you are ready is to take a very small dose, 1/2 mg. If no w...
by docm2
Tue Jan 19, 2021 9:05 pm
Forum: Buprenorphine Q and A
Topic: Can I go from Buprenorphine to Opiate
Replies: 2
Views: 175

Re: Can I go from Buprenorphine to Opiate

There is no risk of precipitated withdrawal switching from Buprenorphine to a full agonist such as Norco. The problem you might experience is your tolerance is now much higher on 1 1/2 mg of Buprenorphine a day than you had with your dose of Norco, 15 mg every other day. You might experience withdra...
by docm2
Fri Dec 18, 2020 10:23 am
Forum: Buprenorphine Dosing Discussion
Topic: Buvidal Injections are Working Great!
Replies: 4
Views: 1313

Re: Buvidal Injections are Working Great!

Pharmacologically the Mu receptors remain saturated. Some perspective, once at steady state (3 or more injections) there will be BUP present for up to 6 months. I think you are correct in thinking there is a behavioral component to what you are experiencing. One of the down sides of dosing once or t...
by docm2
Thu Nov 26, 2020 12:49 pm
Forum: Stopping Suboxone
Topic: Kratom to ween off of 1mg habit
Replies: 10
Views: 1977

Re: Kratom to ween off of 1mg habit

Kratom was a topic at a recent weekly conference call. We all struggle with how to treat it. Even though it has MU receptor activity we are getting mixed results when trying to detox/treat with buprenorphine. Clonidine doesn't seem to be as helpful either. It is a growing problem in our area. RDPhis...
by docm2
Thu Nov 26, 2020 11:33 am
Forum: Introductions
Topic: Straight from the pits of HELL
Replies: 10
Views: 1671

Re: Straight from the pits of HELL

Thanks Lily Val, good post. IV BUP has 100% bioavailability; so much lower doses are usually used, 1-4 mg a day would fully saturate the receptors.
by docm2
Sat Nov 21, 2020 7:52 am
Forum: Introductions
Topic: Straight from the pits of HELL
Replies: 10
Views: 1671

Re: Straight from the pits of HELL

I have conducted enough research and spoken to enough providers that work in the field to now understand that suboxone is a gift from Satan straight from the hands of BIG pharma! Step forward and show us your research, with citations of peer reviewed articles. Stephen Scanlan, M.D. a long time advo...
by docm2
Wed Oct 28, 2020 11:03 pm
Forum: General Comments from Subox Doc
Topic: Taking new patients
Replies: 3
Views: 1101

Re: Taking new patients

Cool, glad you are back.
by docm2
Tue Oct 20, 2020 8:36 am
Forum: Introductions
Topic: New here and pregnant
Replies: 3
Views: 839

Re: New here and pregnant

There is really no difference whether you take the strips vs plain buprenorphine during pregnancy. Hopefully your prescriber is familiar enough with them to guide you on your decision. I've had women request to stay on the films as they feel stable and don't want to 'mess' with their recovery. Somet...
by docm2
Fri Sep 11, 2020 1:27 pm
Forum: Misc. Suboxone Issues
Topic: Is this website legitimate for buying Suboxone online?
Replies: 4
Views: 901

Re: Is this website legitimate for buying Suboxone online?

Not an expert, but looks illegal and you might be subject to receiving controlled substances with out an Rx.
A felony in Minnesota.
Coming through the mail might bet the feds involved as well.
by docm2
Wed Sep 09, 2020 3:14 pm
Forum: Buprenorphine Q and A
Topic: Urgent Need Help...I jumped @ 4 mg but
Replies: 4
Views: 1017

Re: Urgent Need Help...I jumped @ 4 mg but

Sorry, misread that you have been taking other opiates up until Sept 6. I retract that you are through the worst of it.
Restarting at a lower dose and slowly tapering would probably be wise.
by docm2
Wed Sep 09, 2020 3:11 pm
Forum: Buprenorphine Q and A
Topic: Urgent Need Help...I jumped @ 4 mg but
Replies: 4
Views: 1017

Re: Urgent Need Help...I jumped @ 4 mg but

If I count correctly you are at 17 days, WOW, I am impressed. Restarting Suboxone would just be postponing and you have already managed to get through the worst of it. The physical aspect is mostly done now, but there will/can be residual withdrawal symptoms characterized as PAWS. There are comfort ...
by docm2
Wed Sep 02, 2020 4:59 pm
Forum: Stopping Suboxone
Topic: Kratom to ween off of 1mg habit
Replies: 10
Views: 1977

Re: Kratom to ween off of 1mg habit

So my plan is to use it for about a week while the sub gets out of my system and to gradually ween from the Kratom - which I’ve done before. My understanding is that in order for it to have any considerable withdrawal effects, it must be used in high doses. So what was your intent with the first po...
by docm2
Tue Sep 01, 2020 4:11 pm
Forum: Stopping Suboxone
Topic: Kratom to ween off of 1mg habit
Replies: 10
Views: 1977

Re: Kratom to ween off of 1mg habit

Kratom has activity at the MU receptor. You are merely postponing the withdrawal. It is tough to taper with Kratom as dose is not dependent on how much product you are using do to variances in growing and production. Kratom has various effects depending on dose, a landmine for folks that are dealing...
by docm2
Tue Aug 18, 2020 3:18 pm
Forum: Induction Discussion
Topic: Questions on switching from Methadone to Suboxone
Replies: 2
Views: 768

Re: Questions on switching from Methadone to Suboxone

My friend stopped taking Methadone and saw my doctor 3 days later. I was shocked that my doctor put her on Oxycodone for a week and then started her on Suboxone after that week was over I'm shocked too. Unless they have a very well documented paper trail of treating her for pain then what they did ...
by docm2
Tue Aug 18, 2020 3:05 pm
Forum: Why the Anger toward Suboxone?
Topic: Why I'm angry towards Suboxone.
Replies: 12
Views: 3657

Re: Why I'm angry towards Suboxone.

B...Li.... a web site for active addiction had detailed instructions on how to inject the films within days of their introduction. Injecting plain buprenorphine is actually probably more dangerous because of the additives in the tabs that can not be filtered out. Causes a crystalline deposit that br...
by docm2
Thu Aug 13, 2020 3:49 pm
Forum: Misc. Suboxone Issues
Topic: Long term side effects of buprenorphine
Replies: 5
Views: 1187

Re: Long term side effects of buprenorphine

The constipation is from the buprenorphine, not the naloxone. Switching will not impact that. Not at all aware that teeth deteriorating is from naloxone either. I'm not sure what you are asking no longer put buprenorphine in my system Subutex (only generic is now made) is buprenorphine. If you misse...
by docm2
Wed Jul 29, 2020 4:52 pm
Forum: Buprenorphine Side Effects
Topic: Need some help please
Replies: 6
Views: 1371

Re: Need some help please

Congrats on getting into a nursing program. Every state is different but I can share what I know from Minnesota. Being on Suboxone does not keep a person out of school or affect their eligibility. When school is completed and it is time to be licensed you would be asked somewhat generic questions ab...
by docm2
Tue Jul 28, 2020 10:00 am
Forum: Misc. Suboxone Issues
Topic: Pink 6 sided pill with 8 imprint
Replies: 2
Views: 804

Re: Pink 6 sided pill with 8 imprint

If you are having problems with multiple oral preparations ask if you can get on the monthly injection (Sublocade).
Your daily dose needs to be in the 12 -20 mg per day range.
If in Kentucky I would be surprised if they would offer plain buprenorphine.
PAX
by docm2
Mon Jun 29, 2020 9:22 am
Forum: Induction Discussion
Topic: Street fentanyl > sub
Replies: 2
Views: 1117

Re: Street fentanyl > sub

I'm confused as to what you are taking. Fentanyl is not taken orally, there are buccal tabs but they are in micrograms. If your tolerance is as high as you profess many will advocate starting with methadone. You avoid the PW that way, stabilize and then later can taper, continue on methadone or tape...