Takoring Off Methadone: A Case Study

This writer met with the patient to address the conflicting issue with his medication. According to the patient, his PCP was prescribing him with his benzodiazepine medications; however, the patient says, " I had to seek a psychiatrist because it was only temporary." This explains the conflicting issues with the Rx Scripts on file. The patient started his treatment with his now psychatrist on 6/12/2017 and signed an ROI. Addressing picking up his medication from two different pharmacy, the patient was advise that he needs to be pick up his medication with only one pharmacy as it is required. The patient agreed to the terms and said, " I like CVS better than Walgreens. Sometimes they would my refill to Walgreens or whatever is closer to me,

The purpose of this briefing memo is to provide recommendations to Council of City ABC on certain aspects it may or may not include in its zoning provisions with regard to methadone clinics and dispensaries. In the following sections I will provide my input on the provisions laid out by council.

D-The patient arrived on time for her appointment. Reported stable on her new current dose. Deny craving and withdrawals. According to the patient, her weekend was good and again, happy to have her take home bottles. Then the patient reported, she continues to keep all appointments with her mental health provider and its going very well. This writer then discussed with the patient about the next step to her recovery. The patient reported, she wants to continue with her methadone until she's ready to start tapering off on the methadone. The patient has some fears to tapering off on her methadone because she does not want to experience any craving and have a relapse.

D-The patient reports nothing has changed since his last encounter with this writer. The patient reports he is stable on his current dose, completed his Methadone Stabilization today, and looking forward to his take home bottle, at which is pending for determination by the clinic's TEAM. During the course of the session, this writer discussed topics that was addressed in group and what he have learned.

Met with the patient as directed by the Clinical Director. According to the patient, he requested for a dose decrease of 1mgs per day until he reaches 0mgs. Based on the patient's order, he is indeed decreasing his methadone of 1mgs; however, the order stated that it will stop at 53mgs, not 0mgs. The patient informed this writer about a discussion he had with his assigned counselor Cherron about the importance of this due to the need to get off on the methadone as he wants to obtain his CDL but cannot do so if he is prescribed with methadone. This writer reviewed the patient's record and there are no AMA taper signed and no medical consultation documented. This writer then addresses this matter with the clinic's medical doctor, who was told

There were no Cochrane meta-analyses or systematic reviews for comparing methadone and Suboxone maintenance treatment head-to-head. There were 8 trials that had specific populations or were under-powered that I had difficulty choosing between. Before I tried deciding between these articles, I chose to search Medline for any more leads. After searching Medline, I found a rapid response report by the Canadian Agency for Drugs and Technologies in Health that compared Suboxone and methadone head-to-head. After looking into this review more, many of the trials I was considering choosing from Cochrane were included in the study, such as one by McKeganey, Russell, Cockayne (2013) which compared methadone and Suboxone in context of opioid

The purpose of the Standardized Methadone Wean Protocol for NAS is to initiate a standard treatment protocol for infants admitted to RNICU & CCN with a diagnosis of NAS that require pharmacological management of their symptoms. The process will begin by identifying those infants that require pharmacological management by accessing maternal history and Modified Finnegan Scores. A Modified Finnegan Score (see Appendix F) is a standardized scoring system such as the system developed by Finnegan and later modified by Jansson and others that is used to assess the signs and severity of withdrawal in infants (Finnegan, 2013; Finnegan, & Kaltenbach, 1992; & Jansson, Velez, & Harrow, 2009). RNICU & CNN use a modified version of the Finnegan

Methadone Maintenance Therapy (MMT) is used with opioid dependency and is an opioid replacement therapy. MMT typically replaces heroin with Methadone which is a cleaner substance than heroin, and is used to avoid withdrawal and allow the user to function normally within society. MMT has been around for the last 50 years, and research studies have been conducted to address the benefits and the complications associated with this replacement therapy. This paper will examine some of the advantages and disadvantages associated with MMT and reflect on personal ideals in accordance with MMT.

Methadone is one of the most common medications used to treat opioid addiction. It decreases the symptoms of opioid withdrawal and inhibits the euphoric effects caused by abusing heroin and prescription opioids such as oxycodone. When used as prescribed and under the supervision of a trained physician, methadone is an effective complement to treatment. SAMHSA also recommends patients remain on methadone treatment for at least 12 months. Many people require multiple years of treatment. When discontinuing methadone treatment, patients should slowly taper off of it under doctor supervision. Buprenorphine decreases the potential for opioid abuse, reduces withdrawal symptoms and cravings and decreases the risks of overdose. Because buprenorphine

Besides preventing withdrawal, methadone treats the mom’s opioid addiction. About 70% of pregnant opioid addicts will relapse back to illicit opioid use (heroin or pain pills not prescribed to them) if they are taken off methadone. We also know that women enrolled in a methadone treatment program are much more likely to get prenatal care, and babies born to moms on methadone have higher birth weights than mothers in active addiction. If the mother is dosed with methadone, the baby is much less likely to be exposed to infectious agents like HIV and hepatitis from shared needle use. The baby also won’t be exposed to adulterants that can cause fetal damage, if heroin is being used.

D- The patient reports being stable on her dose. Denies cravings/withdrawals. The patient admits to using last week, heroin-4 bags by IV. The patient denies any trigger use for her relapse, but says, " Girl, I was bored." This writer addressed with the patient that boredom is a trigger and then proceeded to discuss alternatives. This writer then proceeded to discussed with the patient about the opiate postive list for the month of March as the patient is listed for ongoing use for at least 6 months. The patient agreed to participate in a self-help at this clinic. This writer completed a group referral to the Spanish Recovery Group. The patient then reports about her upcoming court date on 05/06/2016 at 9am to address the sentencing. The last

Currently in Ontario there are approximately 30,000 people, between the ages of 15 and 49, using illicit opioids on a regular basis. (Hart 2007) Opioid use is a costly and dangerous social problem and is the fastest growing drug problem in the country. The good news is that there is a treatment that has been proven by research and evidence to be effective. Methadone Maintenance Treatment (MMT) is a long term treatment program used to treat opioid dependence and addiction.(Source) MMT works by preventing withdrawal symptoms in opiate users. It also prevents the euphoria the user is seeking from other opiates. MMT uses the drug of Methadone to do this. Methadone is a synthetic opioid commonly used to treat opioid dependence.(Source)

69,000 patients in substance abuse treatment revealed that methadone was fourth for risk of abuse out of 11 opiate based prescription drugs. Worse, after adjustment for prescriptions, methadone advanced to the number one position for abused compounds. Even more startling was a simple random population sample, surveyed by telephone, which reported methadone as the second most used drug. However, Butler et al. cite a major limitation in that the data examined came from subjects who had entered treatment for substance use disorders. Like Plater et al. (2012) aside from the telephone survey, they were unable to examine data for abusers not in treatment (2011).

Having a close family member, that suffers from an opiate addiction, has made the last few years difficult and educational. I have found myself transformed from being judgmental to being more understanding and curious about addiction. Researching articles for this assignment, I stumbled across an article about opiate addiction and pain management. Chronic and Acute and Pain Management for Patients in Methadone Maintenance Treatment explores the impact of chronic and acute pain among MMT patients, how pain is treated in MMT patients, and the barriers to effective pain management in MMT patients. Methadone maintenance treatment (MMT) is one most used and successful treatments for patients addicted to opioids. In short, patients are given a daily dose of methadone that is gradually decreased to limit the effects of withdrawal, making recovery easier for the patient. According to Dr. Elizabeth Eyler (2013), MMT patients tend have higher rates of pain and report more chronic pain than the general

Centers for Disease Control and Prevention (CDC) reported that there are about 100,000 of deaths per year and there are approximately 8 million people in United States who have substance abuse problem (CDC, 2015). A better understanding and greater attention to the commonly abused substance and its treatment would be beneficial in a providers practice and will also protect the provider from the legalities of prescribing these medications. There are several forms of treatment for every abused substance and the main goal is to help the patient to stop the stop and helping them during the phase of withdrawal. The intent of this paper is to discuss the commonly use substance for abuse