Rojbrown

Thank you Dr Perez for this and other information. I am finding these pearls very helpful in adopting buprenorphine as the go to medication when pts have exhausted other modalities and medications.

Hello and thank you for any feedback/guidance. Over the last several months I have been researching the expanded use of buprenorphine in my pain practice. Transitioning patients who are on low to medium meqs has been variably successful. For example I most recently transitioned an elderly pt who was taking 80meqs morphine to transbuccal buprenorphine 300ugm bid (according to dosing chart) and she is/was miserable in pain and some withdrawl symptoms. While those with higher meqs remain a quandary. The challenges are numerous and to name just a few include limited insurance coverage of the pain

Thank you Seth. I have found some more useful threads under the pain management section. I'll explore some more. I direct several mid-levels and will want to educate them as well. As I encorperate these transitions I may want to work with a mentor. Is there one you would suggest I contact? Thank you

Hello, I'm a PM&R and Pain Medicine physician searching for answers as to how best to convert patients on COMT for pain to buprenorphine. Many of these patients are legacy patients whom remain on high morphine equivalencies despite efforts to slowly wean. Often reaching plateaus in weaning noting a rebound in pain with diminished function. The morphine equivalency is often too high to convert to belbuca or butrans. I have completed the waiver training. I will likely be treating persistent pain rather then OUD although I'm sure OUD exists within my pt population. I will look under the pain