Jump to content
EllieGraber

Substance Use Disorder Treatment Survey for PAs and PA students

Recommended Posts

Hello!  I am a PA seeking PA and PA student's opinions regarding substance use disorder treatment. Please watch this very short video of patient's experiences and then answer a 3-question multiple choice survey. This survey is completely anonymous and feedback will impact dissemination practices of evidence-based treatment practices going forward. 

Survey: https://ellieg225172.typeform.com/to/fF1r3T

 

Share this post


Link to post
Share on other sites

Not likely to change, across the board: not because I don't care, but because I already do care, am quite conscientious in my opioid prescribing--I ask history of addictions before a codeine cough syrup rx, and doing the 32-hour waiver course was already on my to-do list and has been for months.

  • Like 1

Share this post


Link to post
Share on other sites

Having worked in ED's in several different locations where substance abuse was prevalent influenced my answers:

  1. Already have substance abuse conversations as a regular part of my practice.
  2. Not going to change my controlled substance prescribing patterns because I already respect patient wishes and prescribe only short courses of them based on need: fractures, renal colic, etc.
  3. Having seen patients on suboxone, I don't believe it is the right choice to manage opiate abuse.  I much prefer managing the withdrawal period and then start the patient on vivitrol.  Suboxone is abused on the street and it is extremely difficult to wean.
  • Like 1
  • Upvote 1

Share this post


Link to post
Share on other sites
3 hours ago, ohiovolffemtp said:

Having worked in ED's in several different locations where substance abuse was prevalent influenced my answers:

  1. Having seen patients on suboxone, I don't believe it is the right choice to manage opiate abuse.  I much prefer managing the withdrawal period and then start the patient on vivitrol.  Suboxone is abused on the street and it is extremely difficult to wean. 

The ASAM training I linked to, above, says don't even try to wean them off. Keep them on Suboxone indefinitely as those patients are the most productive and have the best life successes. The goal of abstinence is unlikely to be successful in the long run.

  • Like 2
  • Upvote 1

Share this post


Link to post
Share on other sites
15 hours ago, MedicinePower said:

The ASAM training I linked to, above, says don't even try to wean them off. Keep them on Suboxone indefinitely as those patients are the most productive and have the best life successes. The goal of abstinence is unlikely to be successful in the long run.

This is a poor message. Don’t even try to wean? If you tell an addict they will never be drug free trust me they never will.

  • Like 1

Share this post


Link to post
Share on other sites
2 hours ago, hrubenstein said:

This is a poor message. Don’t even try to wean? If you tell an addict they will never be drug free trust me they never will.

Of course they have tried to wean but every bit of data shows the patients are far more successful in life when they stay on Suboxone. Have a look at the ASAM's training videos (free, linked above) and you'll see what I'm talking about.

  • Like 1

Share this post


Link to post
Share on other sites

This is what I hate about medicine. Everyone’s not data they are people. They are individuals.

 

i anecdotally know many people that live clean and sober myself included. I was told I’d never be clean but I am over 8 years clean and sober. If I fell into that trap my life wouldn’t be nearly as fulfilling as it is today.

  • Like 1

Share this post


Link to post
Share on other sites

Congratulations on your sobriety. That’s incredible! I completely agree with you. I also know many, many people who have gotten their lives back without the use of medication, it is definitely possible and (I feel) should be the ultimate goal. But I have also come around to the thought that Suboxone and related medications can play a helpful role in the interim, while maybe not ideal. Thanks for your valuable input! 

Share this post


Link to post
Share on other sites

My personal experience is that at least half of the folks I saw at a practice that did vivitrol were able to come off it in 2-3 years and not relapse.  Of the folks I see in the ED who have maintained sobriety after opiate abuse, none used suboxone.  The suboxone patients tend to stay one it.  Clearly, suboxone is one plausible path to treat opiate abuse, but not one I personally prefer.

Separately, in the areas I work: Ohio, Kentucky, Indiana; opiate abuse is way down.  A large part of the reason appears to be cost and supply issues. Meth has largely taken its place.  Meth seems to be much harder to come off of and I don't know of any good medical therapies to help.

Also, I know of several programs where addicts/patients are kept incarcerated during their withdrawal period so they can be medically managed then given their 1st dose of vivitrol prior to release.  They then have to continue receiving their monthly testing and injection as a condition of their release on probation/parole.

I think there is a lot of merit in this approach.  Especially when connected to drug courts, this seems like an effective way to help these folks turn their lives around.

Edited by ohiovolffemtp
  • Like 1

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More