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Dr. Paul Dhillon

Practice Pearls from the Simplified Opioid Guidelines


This month’s CFP journal contains a new Opioid Use Guideline - it contains key points you need to know as a Family Physician.

This topic is increasing in importance in primary care, and because this resource was so helpful, we wanted you to have a deeper dive into the key points.

  • Family Physicians can and should treat patients with opioid use disorder. When treated in a primary care setting, opioid use disorder patients can have better outcomes.

  • Promote HARM REDUCTION with a naloxone kit and lock box for take home doses.

  • Remember that naloxone is useless if an overdose happens alone - you cannot give it to yourself! Remind your patients of this and advise further harm reduction: NEVER USE ALONE.

  • Maximum dose of buprenophine-naloxone is 24mg/day but in select cases can be increased up to 32mg/d. Use the helpful flow chart to know exactly how to dose this drug:

WORTH PRINTING & POSTING IN YOUR CLINIC: THE 2 PAGE SUMMARY for PRIMARY CARE

  • Unsure about increasing Opioid Agonist Therapy (OAT) dose? Have the patient take dose in AM and visit you in clinic 3-4 hours later to assess for sedation.

  • OAT Side Effects = C.A.T. mnemonic: Constipation, Amenorrhea, and low Testosterone.

  • If your patients are in safety-sensitive jobs - CHECK the employer standards for urine drug screen and management safety concerns.

  • Communicate with local pharmacists! They are an integral part of the management team.

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