Buprenorphine and Microdosing

Friday Chalk Talks are a weekly, live-audience, short-and-sweet, 20-30 minute presentation and discussion, for the entire multidisciplinary Palliative Care team (physicians, nurses, social workers, chaplains, pharmacists, and others). A grassroots project to share knowledge, experiences, and lessons learned with other Palliative Care specialists. Presentations are focused on smaller topics meant to spark further interest in a subject and provide listeners with pearls that may help impact their practice.
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[@fridaychalktalk-palliativecare]

Kyle and Max, such a pleasure having you gentlemen join us today. Thank you for sharing your experience and knowledge!

[@mikecastro4923]

Holy shit yall are some smart men!

[@mikecastro4923]

Im on methadone ive gotten myself down to 40 mg from 100mg in a month and now im trying to figure out how to safely switch to Suboxone. Unfortunately i live in DE and many clinics and physicians wont even take me until im on 30-40 mg and i have to be off for over 72 hours and unfortunately i have sooo many responsibilities along with a busy career i cant just withdraw for days ugh 😢

[@bigs1356]

So if I’m on heroin (not cut with fet) I test it to make sure always . It’s low potency . But I do a good amount a day . I do 2 gs a Day . How would I micro dose , how much do I take , how many days , and how much should I use while doing the micro dose and should I get high before or after I take the dose ? If you could please help me I would appreciate it so much please 🙏🏽

[@fridaychalktalk-palliativecare]

I am glad you are looking to get help. And thanks for the question. Here are my thoughts: Medicine has come a long way in the past decade in changing its perspective that addiction is not a moral failure, but instead addiction touches most of us and is an illness that deserves the same compassion and care that every other chronic illness should get. In the past, addiction was approached from a punitive perspective and dismissal from care, and now we are seeing we need to lean into those struggling with addiction and provide more support. AND... even better, this past year the DEA changed its licensure to allow more clinicians to be able to help prescribe buprenorphine to help. If I were in your shoes today, I would feel pretty confident now that I could either ask my Primary Care doc for help, or a referral to another clinician who has some experience with helping with addiction. I think you will find (I hope you will find) that there is a lot more support out there now a days. I wish you good luck.

[@fridaychalktalk-palliativecare]

Community Resource for Low-Dose Buprenorphine Initiation Protocol: www.mypcnow.org/fast-fact/buprenorphine-initiation-low-dose-methods/