addicition medicine/suboxone-vivitrol

[problem child]

anyone out there have experience working in addictions clinics, esp those prescribing suboxone and/or vivitrol?

 

I wonder if you are simply an Rx machine, or if you also actually screen prospective patients with H&Ps, make treatment plans for co-morbidities, etc.

 

I live in MA and the state is suffering an epidemic of prescription opioid addiction, with a subsequent massive spike in fentanyl-laced heroin ODs (drug of choice when Rx addicts get cut off from opioid Rxs).

 

I know addicts can drive you off your nut, but I just wondered if others might have experience in this sort of (rapidly-emerging) practice.

 

thx, pc 

[ohiovolffemtp]

I've done a small amount of  vivitrol work as part of an IM practice.  I did an initial screening which included an H&P, blood work esp LFT's, and Rx for meds to manage withdrawal symptoms.  Monthly visits required an in-house UDS and brief face-to-face assessment.

[PAsoldier]

anyone out there have experience working in addictions clinics, esp those prescribing suboxone and/or vivitrol?

 

I wonder if you are simply an Rx machine, or if you also actually screen prospective patients with H&Ps, make treatment plans for co-morbidities, etc.

 

I live in MA and the state is suffering an epidemic of prescription opioid addiction, with a subsequent massive spike in fentanyl-laced heroin ODs (drug of choice when Rx addicts get cut off from opioid Rxs).

 

I know addicts can drive you off your nut, but I just wondered if others might have experience in this sort of (rapidly-emerging) practice.

 

thx, pc 

 

 

 

I work in an addiction clinic.  The majority of our patients are on Suboxone (or another form of buprenorphine), but we also have many on Vivitrol.  While typically everyone that is a part of our program gets a Rx, there is an extensive screening process that includes H&P, lab work, urinalysis, etc.  We assess for appropriateness of treatment.  Some people don't meet the "addiction" criteria for one reason or another.  Some people require a higher level of care than we ware capable of providing.  Some people have HCV or HIV that requires treatment before they can safely take medication for their addiction.  We are a specialty clinic and don't actively treat the co-morbidities, but we do ensure that they have a PCP and are addressing other issues.  Counseling is also a mandatory part of the treatment plan.  Addiction is a complicated brain disease and it can't be treated by simply throwing medication at it.  I believe that MAT (Medication Assisted Therapy) is a vital, life-saving, adjunct to a well-rounded, comprehensive addiction treatment plan that is tailored to the specific patient.  We operate on a BioPsychoSocial model and try to address all aspects of a patients life.  We assist them with obtaining transportation, housing, education, child care, etc.  

 

I actually really enjoy working with these patients and find the work extremely satisfying.  It's a great thing to help someone go from daily IV heroin use to Recovery.