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How you proceed and the impact of management will depend on several factors. If the patient is taking non-prescribed opioids on a regular basis, it would seem likely that full mu use would continue with Belbuca tapering. As such, opioid withdrawal might not be a major factor. If withdrawal emerges, ancillary withdrawal medications such as clonidine could be useful. It would be helpful to understanding factors contributing to the patient's non-prescribed full mu opioid use, such as whether pain was incompletely controlled on Belbuca or whether there might be an underlying an opioid use disorder

Great initiative. I would be happy to be of assistance if need by. I am a PMHNP currently practicing in MD and also license in DC. Just got the MAT waiver few weeks ago. Please let me know how I could be of help. Thanks Martin

My name is Jennifer Hale and I am a provider in a CARF facility. I have worked in healthcare for 35 years but most recently (2 years) became an advanced practitioner. I obtained my X-waiver and I work in a detox unit. I enjoy my work, but sometimes don't feel we are making a difference. I'm hoping to learn from other providers and gain pearls of wisdom.

Welcome! I would refer you to SAMHSA's website with regard to federal regulations regarding MAT: https://www.samhsa.gov/medication-assisted-treatment/statutes-regulations-guidelines For your state specific guidelines I would your State Board of Health.

I reached out to SAMHSA regarding your question and here is their response: The buprenorphine prescriptive authority can only be attached to one DEA number, but you can add multiple locations to your profile, additional DEA number is not required. To add another address: https://buprenorphine.samhsa.gov/forms/update-contact-info-login.php Thanks much and hope this helps!

This is an important topic and I am glad it was brought up, so please allow me to make a comment. There is a broad range of opinions as to what the "harm reduction" in the context of OUD treatment means. Traditionally harm reduction involves a set of outreach activities to people using drugs that occur before the individual enters treatment, done by peers or a non-medical staff. This includes provision of food/shelter, health education on drug effects and risk reduction, drug supply testing, needle exchange and condom distribution but also screening for SUD and other medical/psych disorders, m