MN Society of Addiction Medicine
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Case discussion March 2016

3/2/2016

16 Comments

 
Submitted by Pam Shultz, MD, FASM

A  20 yo male was admitted to his first residential CD treatment for opioid use disorder.  He has a 3yr. hx of opioid use and has been injecting heroin IV daily for the last 6 mos.  He was detoxed with Suboxone and then given gabapentin.  However, after 3 wks. of treatment he has a conflict with a peer.  He decides to leave treatment ASA, and cannot be dissuaded.  He admits that he is having significant cravings for opioids.  He is warned of the risks of opioid overdose due to loss of tolerance, but patient insists that he is not going to go back to using opioids.   He refuses any referrals for outpatient treatment. 
 
Questions:
  1. Would you write this patient a prescription for Naloxone?
  2. Do you prescribe Naloxone for parenteral injection , or intranasal Naloxone?
  3. Do you keep a supply of Naloxone at your clinic  or facility to give to patients such as this?
  4. If so, is this provided  free of charge?
  5. Do you have a “Collaborative Practice Agreement” with a pharmacy to provide Naloxone to your patients?
  6. Have you/do you prescribed Naloxone to families or acquaintances of opioid dependent patients?

To answer these questions and continue the conversation, click on comment (above) or reply (below).
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    MNSAM TEAM

    The MNSAM Board of Directors is interested in open, candid discussion for the purpose of education of our members and others interested in Addiction Medicine.   We welcome all opinions but ask that you confine your comments to the case and questions for the  month.    We welcome all MNSAM members to submit cases and questions for feedback and discussion.  Please  be sure to delete any identifying patient information.  Send your case to Dr. Marc Myer,  at mmyer@hazeldenbettyford.org

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