Case Study: Sleight of Hand During Buprenorphine Administration - Combing Drug Testing, Observed Dosing and Telehealth to Support a Challenging Patient
A 26-year-old F with opioid use disorder ‘reconnects’ with an outpatient treatment program “to get back on Suboxone and then get the shot.” She has a history of fentanyl use disorder with use, despite Rx of buprenorphine/naloxone. Also, UDS showed her to stop taking, or only intermittently take, the buprenorphine around her fentanyl use. At the start of COVID-19, the plan was to have sufficient obs doses and on-site dosing to safely give the SC buprenorphine, but she didn’t follow-up. “Now I’m ready.” This case features a discussion of buprenorphine induction and stabilization in order to safely give the SC buprenorphine monthly injection. Drug testing during COVID-19 as well as supporting challenging patients with limited ‘on-site’ resources will be discussed. On the on-site obs dose, the patient was caught taking a piece of buprenorphine/naloxone film pre-wrapped with cellophane, which she reported “was an accident. I had it open and didn’t want to lose it, so I wrapped it up.”
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Full Case Discussion can be found here: https://youtu.be/jiKiuzgmUuE
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