Transcript five minutes to make a difference

FIVE MINUTES TO MAKE A DIFFERENCE
Presentation by: Mark Barnes
Agenda








Introduction
Opiates
Opiate Withdrawal
Methadone
Methadone Maintenance Treatment
Five Minutes to Make a Difference
Life of a Methadone Patient
Questions
Introduction




Pharmacy manager and owner of Westboro
Pharmasave
Methadone certified dispensary
Expanded the methadone program
Support program fully
Opiates



A narcotic substance either natural (opium/
poppy seed) or synthetic (morphine)
Narcotic- any drug derived from opium with
potent analgesic effects associated with both
significant alterations of mood, behavior, and
potential for dependence and tolerance
Excellent medication for advanced pain
management (cancer)
Opiates Cont’d



Tolerance vs. dependence vs. abuse
Tolerance- happens to anyone
Dependence- is a long lasting disorder that
leads to distress and disability
- Changes in brain structure and function
- Compulsive drug seeking
- Abuse of narcotic

Abuse- misuse of the narcotic
Examples of Opiates







Morphine
Codeine
Hydromorphone
Oxycodone
Fentanyl
Heroin
Methadone
Opiate Withdrawal


Caused after the amount of opiate is
significantly decreased or abruptly
discontinued after regular use
The body has adapted the presence of the
drug and cannot re-adapt quickly enough to
its absence
Opiate Withdrawal Cont’d

Some symptoms may include:







Insomnia
Muscle Aches
Dilated pupils
Restlessness
Depression
Anxiety
Discomfort
Methadone




Made in 1941 for pain control in Germany for
WWII
Very safe long term on organs
When prescribed correctly is does not impair
psychomotor performance
Some side effects may include: sweating,
constipation, insomnia, and weight gain
Methadone Cont’d




Can still cause withdrawal
No euphoric “rush” when stabilized
Once daily dosing
Stops cravings for other drugs and drug
seeking behavior
Methadone Maintenance
Treatment (MMT) Dosing



Initiation- Starts at ~ 30mg
- No matter what street drug
Stabilization- Slowly increases every 3 days
until patient is stable
- Takes 2-6 weeks for most
Taper- Decrease down over time
- Miss 3 doses- restart needed
MMT Urine Screening




Valuable information for practitioners
Verifies patient self reporting and compliance
Assess appropriateness of “carries”
‘Snapshot’ of how the patient is doing
MMT Carries






Carries are when a patient can take home a
dose of methadone to be taken unsupervised
Happens once the patient is clinically stable
Must have consistent negative urine tests
Must be on methadone for 2 months
Requires lock box
Carries can be taken away
Five Minutes to Make a
Difference

Pharmacists CAN make a difference

Respect, Respect, Respect



Methadone patients become friends of the
pharmacy
Valuable insight for patients’ activities of daily
living
Reward great behavior
Life of a Methadone Patient







Go to the pharmacy every day
See a doctor 3 times per week
Give a urine sample 2 times per week
See a councilor 2 times per week
Stay “clean” every minute of everyday
Deal with past legal issues
Once stable, can be a positive member of
society
Questions