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jmosby1469

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jmosby1469 last won the day on March 20 2020

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  1. Motivational Interviewing in Practice: Using Tools Effectively Self-Assessment USING MOTIVATIONAL INTERVIEWING TOOLS EFFECTIVELY 1. OPEN QUESTIONS* 1 When discussing a behavior change, I mostly used closed questions 2 When discussing a behavior change, I occasionally used open questions 3 When discussing a behavior change, I used approximately equal numbers of open and closed questions 4 When discussing a behavior change, the majority of my questions were open. 5 When discussing a behavior change, I used nearly four open questions for every closed question. 2. REFLECTIVE STATEMENTS** 1 The con
  2. This is clear enough. However, my patient is similar, but besides the Suboxone I prescribe, is receiving prescriptions for many MME's worth of an oxycodone product. I believe I understand the use of buprenorpine in divided doses as useful for the pain problem, but am unfamiliar with any value in continuing that therapy in addition to concurrent full agonist.
  3. A recent issue of DOCWIRE details many of the hazards of gabepentinoids, further enhancing my respect for this class of drugs which are often rather liberally prescribed: https://www.docwirenews.com/docwire-pick/rheumatology-picks/fibromyalgia-medication-tied-to-suicidal-behavior-overdoses/?exsource=postup&recipientID=327580&subject= Smartphones and Speakers Detecting Heart Attacks&utm_source=postup&utm_medium=dwemail&utm_campaign=general
  4. I have several patients taking split doses of buprenorphine products for the dual purpose of OUD and pain management. One of these is a patient whom I've cared for for years, has a number of psychiatric comorbidities and seems resistant to resume the addition of psychiatric specialty care to our current treatment plan, for reasons unclear to me. Several months ago is when their pain problems began, based on a number of surgeries. I've had to add tramadol to their 32 mg buprenorphine, but they remain very anxious regarding relief for ongoing wound care procedures and surgeries, calling for earl
  5. Please comment on my projected management of a painful dressing change for my MAT patient using buprenorphine at up to 32 mg to help manage the very painful breast abcess she's developed. Her surgeon refused to give her any other analgesics due to her MAT status the day before her I&D, but afterwards she found some relief with toradol, which I continued. With resolution of the inflammatory process, she has been able to return to her preop doses of BPE at 24 mg, but has been warned that the delay in removal of her packing and dressing change will be an additional pain challenge, for which s
  6. My sense is that you find the use of high doses of this drug to be problematic. I hope responses to your question also touch on the issue of gabapentin misuse. I have a husband and wife opiate use disorder patients who both take 800 mg tid, which I am in process of reducing. I also understand that there is a demand for this drug among our population struggling with substance abuse disorders, so that diversion in my high dose patients may be a feature of their misuse, as well.
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