1/ Had a patient present to the ER with severe nausea and vomiting. As has become my practice, I asked "Have you struggled with pain killers, heroin, or fentanyl?" and to my surprise he answered yes. This was his first episode of severe opioid withdrawal....
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2/ I gave him buprenorphine and within minutes, his symptoms were relieved. Avoided labs, CT scan. Wrote him a prescription to get him through next week. Couple of weeks go by, got a message from a primary care doc colleague that he has been doing great in clinic. Made my day
3/ I've learned from asking this question regularly that there's a lot of occult opioid withdrawal out there and patients are ashamed to bring it up, but once you ask and offer a path out, they are very willing to engage. Working on making universal screening routine. stay tuned
4/ Another key for success is having someone who has been through recovery help shepherd patients through the process of picking up bridge prescriptions & navigate their way into treatment. Our health system is lucky to have @nicolemodonnell who makes this happen
5/ And finally, shout out to my primary care physician colleague @m_lowenstein who is continuing his addiction treatment in primary care and helping to make evidence-based addiction treatment in primary care more routine. I appreciate you Maggie, thanks for the message!
