Part 1
22-year-old Caucasian male Peter is currently
being treated with buprenorphine/naloxone, which is sold worldwide under the
brand name Suboxone. It is actually a combination medication that consists of
naloxone and buprenorphine. At this stage, I think buprenorphine/naloxone is
suitable for Peter and doctors should carry on with this treatment option.
Besides its benefits, the side effects should not be forgotten, which include
breathing problems, restlessness, sleepiness, low blood pressure, and stomach problems.
It does not look like Peter has any of these problems, which is a plus point
since buprenorphine/naloxone will help him get rid of addiction in next few
weeks or months if he acts upon the advice of his physician and does not tell a
lie to them regarding his day-to-day activities.
While dealing with the patient, the doctor
should make him understand that the excessive use of buprenorphine or naloxone
may cause problems for him in the long run. At the lower dose,
buprenorphine/naloxone results in significant effects. According to M. Killias,
injecting buprenorphine/naloxone is dangerous for a person who has been using
heroin, methadone or morphine for quite a long time, which means Peter should
not think of injecting it on his own. Instead, he should always seek the help
of the doctor in order to be ensured of health (Killias, 2009).
At this point, Peter can also be treated with
detoxification and residential treatment. Getting the patient off drugs with
detoxification has now been possible. During detox, the alcohol or drug is
flushed out of the body under the supervision of health experts. Similarly,
Peter can be encouraged to attend the residential treatment session that may
last for two to five months. Psychotherapy is also a good idea for such a person.
Part 2
If I am one of the PMHNPs with a DEA Waiver
at the office-based multidisciplinary mental health clinic and initiate
home-based SL Buprenorphine-Naloxone treatment for Peter, I would ask the
22-year-old male to change his lifestyle and to try to bring positivity to his
life. An appropriate dose of buprenorphine/naloxone looks normal to me for the
patient, and Peter has denied taking any other prescription drugs such as BZs.
Still, I would want to get his blood and serum tests done once a week.
In the meantime, he should be educated
regarding how to avoid drugs or alcohol in the future, once he is discharged
from the hospital. To patients like Peter, I would like to recommend fresh
fruit juices, green vegetables, fruits and grains (Silva & Fonseka, 2009).
If he increases his dependence on these things and does brisk walk early in the
morning, his body may show visible signs of fitness in the first seven days.
Currently, Peter looks weak to me, which we would have to pay utmost attention
to. In the next few days, I would also see if Peter’s behavior changes
significantly or not. Self-examination is very important for him, meaning he
should be capable of examining his own lifestyle so that changes could be made
according to the instructions of his physician.
References
Killias, M. (2009). Effects of
Drug Substitution Programs on Offending Among Drug-Addicts.
doi:10.4073/csr.2009.3
Silva, P. D., & Fonseka,
P. (2009). Drug Addicts and Their Behaviour Related to Drug Addiction Among the
Institutionalized Addicts of the Galle District. Galle Medical Journal, 13(1),
9. doi:10.4038/gmj.v13i1.886
Methadone May not be the Perfect
Drug But it has Helped Many Drug Addicts. (2013). The Pharmaceutical
Journal. doi:10.1211/pj.2013.11128731
