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Average dose (morphine mg equivalents/day) Dosage in morphine mg equivalents/day 350 300 343 By opioid of choice 250 220 218 200 150 100 50 123 106 0 methadone fentanyl morphine oxycodone hydrocodone Opioid of choice Average: 184 morphine mg equivalents/day Range: 30-1290 morphine mg equivalents/day
Number Number Number 60 40 Co-morbid History 59 38 S.U.D. History 20 17 0 Alcohol Cocaine Marijuana 25 20 15 10 5 23 15 15 9 Medical History 6 5 0 80 60 40 20 0 Hep C D.M. C.A.D. Sleep Apnea C.K.D. Seizures 69 43 Psychological History 16 4 Depression PTSD Anxiety Bipolar
Page 1 and 2: Patricia Pade, MD University of Col
Page 3 and 4: Objectives • To provide a brief o
Page 5 and 6: Chronic Pain • 116 million people
Page 7 and 8: Opioid Use • Use of opioids has i
Page 9 and 10: Fatal Drug Poisoning • Between 19
Page 11 and 12: Opioid Pharmacology: How do these M
Page 13 and 14: • Tolerance: Repeated Dosing: Opi
Page 15 and 16: Brief pharmacology overview: full o
Page 17 and 18: Brief pharmacology overview: opioid
Page 19 and 20: The Use of Buprenorphine/Naloxone t
Page 21 and 22: The Problem for Veterans
Page 23 and 24: Improvement Change: Creation of Co-
Page 25 and 26: Patient population • Referrals fr
Page 27 and 28: Initial Evaluation A. PAIN Detailed
Page 29 and 30: Buprenorphine induction process •
Page 31 and 32: Study participants Participant Data
Page 33: Months Average duration of opioid u
Page 37 and 38: Adjuvant Medications Na and Interve
Page 39 and 40: Ongoing monitoring for compliance
Page 41 and 42: 93/143 patients remained in treatme
Page 43 and 44: Conclusions 11. Patients with co-oc
Page 45 and 46: Office Based Opioid Treatment: Bupr
Page 47: References 1. Institute of Medicine

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