Search found 590 matches

by docm2
Mon Jun 29, 2020 9:22 am
Forum: Induction Discussion
Topic: Street fentanyl > sub
Replies: 2
Views: 429

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...
by docm2
Mon Jun 29, 2020 9:08 am
Forum: Buprenorphine Dosing Discussion
Topic: Buvidal Injections are Working Great!
Replies: 1
Views: 295

Re: Buvidal Injections are Working Great!

Thanks for the update R cubed. Buvidal is not available but Sublocade is getting similar reviews, except the USA cash price is over $1000. I'll save my rant regarding costs for social media. Our practice finally got started a couple of months ago. The red tape was draconian, hoops with the DEA, Indi...
by docm2
Wed Jun 17, 2020 12:18 pm
Forum: Misc. Suboxone Issues
Topic: Hi it's Queenie
Replies: 4
Views: 554

Re: Hi it's Queenie

Hi Queenie, So sorry for your loss. I don't recall if you had mentioned this earlier, was this recent? I have two friends in their sixties that lost children recently and it has been really hard. My sister in law died 20 years ago and sometimes it is as raw as the day we got the call. Mom and Dad st...
by docm2
Sat Jun 13, 2020 11:09 am
Forum: Why the Anger toward Suboxone?
Topic: SUPERMAN I CAN SHOOT MYSELF AND IT WOULDN'T HURT
Replies: 4
Views: 650

Re: SUPERMAN I CAN SHOOT MYSELF AND IT WOULDN'T HURT

Lots of views, but like Rule at a loss for words. I have heard similar tales from patients as well. But, recently, people are reporting getting good care, surgical teams have been willing to call me. I am hopeful that things are changing. I my last 6 OB patients had good deliveries, got good care an...
by docm2
Thu Jun 04, 2020 4:41 pm
Forum: Misc. Suboxone Issues
Topic: Will Buprenorphine/naloxone ever be...
Replies: 1
Views: 311

Re: Will Buprenorphine/naloxone ever be...

In my State, Minnesota, I think the majority of prescriptions are now written by primary care. The number of primary care APP's (N.P. and P.A's) has greatly expanded those able to prescribe. It has pleasantly surprised me how many APP's are getting their waivers since they have a 24 hour course to e...
by docm2
Thu May 21, 2020 10:05 pm
Forum: Opioids and Chronic Pain
Topic: It stopped working!
Replies: 3
Views: 650

Re: It stopped working!

Hello River,
Cymbalta can help if depression or neuropathic pain is part of what you are dealing with.
I don't think you had a specific question but regarding 'stopped working' more information would be helpful. Not working for pain, cravings, blocking withdrawal or something else?
by docm2
Sat May 09, 2020 3:47 pm
Forum: Buprenorphine Side Effects
Topic: Cannot stop itching scrotum..need help
Replies: 14
Views: 15172

Re: Cannot stop itching scrotum..need help

http://www.suboxforum.com/severe-itching-14005

If you look at the bottom of your thread you will find several others of a similar nature.
by docm2
Sat May 09, 2020 3:44 pm
Forum: Buprenorphine Side Effects
Topic: Cannot stop itching scrotum..need help
Replies: 14
Views: 15172

Re: Cannot stop itching scrotum..need help

Opiates can cause itching. Some more profoundly than others for each person. My father itched horribly with morphine, not at all with hydrocodone. I have one patient that is experiencing pruritus (itching) but it is generalized. He is taking 400-600 mg of generic Benadryl a day to suppress it. They ...
by docm2
Wed May 06, 2020 1:12 pm
Forum: Misc. Suboxone Issues
Topic: Compliance while taking Suboxone
Replies: 23
Views: 11304

Re: Compliance while taking Suboxone

It is not the standard of care to be using expensive confirmatory (quantitative) tests. ASAM, American Society of Addiction Medicine, and SAMSHA, (the feds) both recommend simple cup tests that can be processed in an office with rare use of confirmatory tests. I am not aware of any addiction practit...
by docm2
Mon May 04, 2020 10:20 am
Forum: Misc. Suboxone Issues
Topic: Good News Possibly
Replies: 9
Views: 1402

Re: Good News Possibly

Jonathan, that looks like English...
Same problem I have with my daughter that is immersed in a software bootcamp. Can't help with homework anymore :wink:
I'm grateful for folks like you that understand this business.
I do agree with you, the gold of this site is in the archives.
by docm2
Sat Apr 18, 2020 5:07 pm
Forum: International Suboxone Issues
Topic: Moving to Oregon (US)
Replies: 2
Views: 700

Re: Moving to Oregon (US)

Couple thoughts to reinforce what Rule has said and perhaps you are already considering. DIscuss with your current provider how long they are willing to take care of you cross state lines. In the past I have allowed people 6 months to get established with someone new when moving out of state. Consid...
by docm2
Thu Apr 16, 2020 8:47 am
Forum: Misc. Suboxone Issues
Topic: Has anyone ever tried Zentrip or other Sublingual OTC medications?
Replies: 8
Views: 1249

Re: Has anyone ever tried Zentrip or other Sublingual OTC medications?

OP trolling? Previous banned poster? Math impaired? Here for 13 minutes once and has a really odd rambling post. Meclizine is an older medication used mostly for disorders that cause dizziness. Several better alternatives for opiate withdrawal. "I'm sure anything SL will solve my craving for Suboxon...
by docm2
Thu Apr 09, 2020 8:53 am
Forum: Buprenorphine Dosing Discussion
Topic: Buvidal
Replies: 5
Views: 1040

Re: Buvidal

Buvidal is similar to Sublocade, a long acting injection of buprenorphine. It has not been release in the US yet. Europe has it as well as Australia, I did not know that so thanks Ryan. $30!!! WTF, Sublocade is $1400 per injection in the USA. Indivior can cry me a river in protest about patient supp...
by docm2
Mon Apr 06, 2020 7:52 pm
Forum: Taking New Suboxone Patients?
Topic: Telemedicine Suboxone clinic in Pennsylvania
Replies: 6
Views: 735

Re: Telemedicine Suboxone clinic in Pennsylvania

and recently my physician decided to not renew his license to prescribe this medication. (Have no idea why.) My question is That is odd, there is no renewal for buprenorphine, the waiver is one time. So either your doctor gave up his DEA registration which means they can no longer prescribe any con...
by docm2
Fri Apr 03, 2020 12:15 pm
Forum: Taking New Suboxone Patients?
Topic: Telemedicine Suboxone clinic in Pennsylvania
Replies: 6
Views: 735

Re: Telemedicine Suboxone clinic in Pennsylvania

We have shut down all face to face contact. Appointments are by video chat or telephone. DEA has modified its rules and we can now initiate care via phone call or video chat. Prior there had to be an in person appointment. Drug screens have been shut down as well. 'Sweet' has been the response from ...
by docm2
Thu Apr 02, 2020 8:55 pm
Forum: Misc. Suboxone Issues
Topic: Good News Possibly
Replies: 9
Views: 1402

Re: Good News Possibly

Everybody I see for buprenorphine gets a sheet with three webs sites with a description. I show them on my screen. Several have said they have come here but only 2 have been able to identify me. One registered, with me now about 5 years. A real rock star, has been hosting a SMART meeting for about 5...
by docm2
Tue Mar 31, 2020 8:02 am
Forum: Induction Discussion
Topic: Suboxone shortage COVID 19
Replies: 1
Views: 509

Re: Suboxone shortage COVID 19

DEA and SAMHSA have both come out with statements that they do not anticipate shortages of methadone and buprenorphine products. However, I continue to advise people to stockpile at least a weeks worth and preferably a months. Amazes and befuddles me that someone on 16 mg a day for 4 years and they ...
by docm2
Sat Mar 14, 2020 9:48 pm
Forum: Buprenorphine Dosing Discussion
Topic: Please Help Me!!!!!
Replies: 2
Views: 459

Re: Please Help Me!!!!!

If you usually take two strips a day at the same time, assuming you allowed for the usual 10 minute absorption time, you will be fine. Dose as usual tomorrow. You can skip a film once in a while and not notice any difference; if you can get beyond the mind games. You've got enough to stress with a n...
by docm2
Wed Mar 11, 2020 12:14 pm
Forum: Other Addiction Support Programs
Topic: Kratom Therapy??
Replies: 22
Views: 13846

Re: Kratom Therapy??

My understanding Kratom has to be tested separately. We have ordered a custom cup to include it and Fentanyl since both are of rising concern here. I am not aware that anything would be false + due to Kratom. Since Fentanyl is a synthetic I'm not aware what could be causing it. I have a word doc wit...
by docm2
Sun Mar 08, 2020 9:40 am
Forum: Buprenorphine Dosing Discussion
Topic: Just for cravings?
Replies: 10
Views: 1584

Re: Just for cravings?

There are times when MAT is started when a person has zero tolerance or low tolerances like Mshaff - glad you posted and hope you continue. We are working with corrections to get people started on Suboxone prior to their release. They will be on Buprenorphine for 3-4 weeks and see me their first wee...