Jump to content

Seth Acton

Administrator
  • Content Count

    886
  • Joined

  • Last visited

  • Days Won

    60

Everything posted by Seth Acton

  1. Welcome to the PCSS Discussion Forum. You'll find that the search tab on the upper right is a great tool for finding information on topics that interest you.
  2. Welcome. If you would like to officially request a mentor through the PCSS program please complete this form: https://pcssnow.org/mentoring/request-mentor/ I'd also encourage you to "follow" the various forums so that you get emails when new topics are posted. Here's a thread that shows you how:
  3. Welcome! I recommend follow the individual forums so that you get emails when new questions are posted. Here's a thread that explains how:
  4. The Question: I have an individual on 4mgs-1mg 1 in am and 2mg-0.5mgs pm from August hospitalization to 10/17/2018. He was increased to 4mgs-1mgbid. Now he is experiencing more pain and potentially needs to be increased. He is on Lamotrigine50mgs daily and risperidone 5mg daily ( I do not manage his other meds which is a problem too) . Does it seem reasonable to increase his dose? His BMI is 24, 5 pain scale. Dr. Edwin Salsitz responds: Average Bupe doses are usually in the 8—16mg daily range. So, yes it is reasonable to increase his dose. Buprenorphine, unlike methadone,
  5. Welcome! Be sure to go into each forum (Buprenorphine, Pain Management, etc) and "follow" each forum int he upper right corner. That way you'll get new emails when new topics are posted.
  6. Welcome to the PCSS Discussion Forum! I'd recommend going into each of the topics (Buprenorphine, Office Practices, etc) and "Following" using the button in the upper right corner. That way you'll get emails whenever new topics are posted. The search tool is also valuable for locating threads on topics you are interested in.
  7. Welcome to the Discussion Forum. Be sure to go into each forum (buprenorphine, office practices) and click the "Follow" button in the upper right corner to ensure that you get emails when new threads are posted!
  8. Welcome to the PCSS Discussion Forums! As the first year with your waiver, you can prescribe buprenorphine to up to 30 patients at any one time. Beyond that, as every state has their own specific regulations I would contact the Texas State Department of Health as they will be able to provide you with specific details regarding prescribing buprenorphine in Texas.
  9. Welcome to the PCSS Forums. I can confirm that we received your mentoring application and we're working to match you up with a mentor. Thanks much!
  10. There's a good amount on PCSSNOW about chronic pain and opioids which might be helpful: https://pcssnow.org/?s="chronic+pain"
  11. Welcome! I recommend going into each Forum and "following" in the upper right corner. This will allow you to get emails when new topics are posted.
  12. Dr. Gibbons, please use this link to post in the Introduce Yourself forum: http://pcss.invisionzone.com/forum/15-introduce-yourself/?do=add Thanks!
  13. Welcome! I recommend going into each of the subForums (buprenorphine, office practices, etc) and "Following" them in the upper right corner. Then you'll get emails whenever new topics are posted.
  14. Welcome to the Forum! I encourage you to "follow" every subforum (buprenorphine, office practices, etc) so that you'll get emails when new topics are posted.
  15. Dr. Andrew Saxon provided this response: If OUD is being treated with buprenorphine in the context of chronic pain, the buprenorphine dosage can be optimized to help with the pain. Typically, that would require a dosage of 8 mg tid or qid. For some patients with OUD and chronic pain, methadone maintenance is a better option since methadone is a full agonist. Neither of these medications have serious interactions with lithium In regard to other possibilities, although non-steroidal anti-inflammatory medications do interact with lithium, lithium is not a contraindication to their us
  16. Dr. Andrew Saxon provided this response: One conceivable approach to dealing with elective surgical procedures in patients on buprenorphine is to add on full agonist opioid analgesics during the acute pain which is essentially what you are doing by adding tramadol, though consideration could be given to using a more potent full agonist opioid. There is probably no reason to discontinue buprenorphine during these elective procedures. Certainly, discontinuing it the night before will not result in many more receptors being available but might result in less analgesia from the buprenorphin
  17. Welcome! I would recommend going into each subforum (buprenorphine, office practices, etc) and "following" in the upper right corner. That way you'll get emails when new topics are posted. Regarding your question about getting starting in Oklahoma, I wasn't able to get any specific advice regarding Oklahoma but I reached out to our lead mentor Dr. Anthony Dekker and he provided some general advice on entering this field: Good luck and please take advantage of the many resources on the PCSS Discussion Forum and www.pcssnow.org!
  18. Welcome! I recommend you go into each of the sub-forums (Buprenorphine, Office Practices, etc) and "Follow" them in the upper right corner. That way you'll get an email whenever a new topic is posted in that sub-forum.
  19. Welcome to the Discussion Forum! We do have a Clinical Coaching program on our new website which may be helpful: https://pcssnow.org/clinical-coaching/coaches/?location=texas
  20. This Question was submitted on our Ask an Experts page: My question is about treating coexisting pain and opiate dependence with buprenorphine. The scenario is a patient doing poorly on long-term opiates for chronic pain, doing better with tid-dosed buprenorphine, but requesting low-dose full-agonist on top of the buprenorphine, for "breakthrough pain." Is that an advisable practice? Dr. Erik Gunderson responds: It would be helpful to have more specifics regarding prior treatment and buprenorphine dosing. For example, have non-opioid medication and non-medication related
  21. Welcome! Be sure to go into each of the sub-Forums (buprenorphine, office practices, etc) and "Follow" them in the upper right side of the page so that you get email notifications when new threads are created!
  22. The Question: Recently I have had several patients on rx opioids for chronic pain who are now having aberrant behaviors such as constantly requesting dose escalations, requesting early fills and acting out in clinic (yelling, etc). Unfortunately, several are older and also have mild cognitive impairment. I'm not certain that the behaviors reflect opioid use disorder, or just the effects of the MCI, but in either case, I feel their presently prescribed opioids are not safe (prescribed around 30 MME but taking 90-140MME daily). I'm contemplating buprenorphine patch (no need to remember if y
  23. Welcome! Don't forgot to go into the different sub-Forums (Buprenorphine, Office Practices, etc) and "Follow" them in the upper right in order to get email notifications when new topics are posted!
  24. Welcome to the Forum! Our search page is a great way to locate any previous threads that may be of interest: http://pcss.invisionzone.com/search/ When you post in existing threads they are automatically bumped to the top of their respective sub-Forum. Let me know if you have any questions!
×
×
  • Create New...