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 Post subject: Addiction medicine sites
PostPosted: Fri May 22, 2009 7:45 pm 
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Sites that I use regularly-- for medical help in my practice, but also for professional groups and continuing education.


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PostPosted: Fri May 22, 2009 7:46 pm 
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Used to calculate from one dosage of one substance to an equivalent amount of another substance.

Narcotic Calculator


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PostPosted: Fri May 22, 2009 8:47 pm 
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Here is a different one, with Bupe

http://www.medcalc.com/narcotics.html

Its a little weird, apparently 8mg Buprenorphine = 2600mg Codeine, or 200mg methadone.. holy crap no way :D :D


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PostPosted: Tue Jun 09, 2009 12:22 am 
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Hey James-- the problem is the non-linear kinetics of buprenorphine. You can't just extrapolate out with bupe, like you can with agonists that don't have a 'ceiling effect'.

In other words, one mg of buprenorphine is as potent as about 20 mg of methadone, 2 mg of buprenorphine is as potent as 30-40 mg of methadone, and 4 mg, 8 mg, or 24 mg of buprenorphine are all as potent as 30-40 mg of methadone! The calculator works fine as long as you use doses for buprenorphine below the 'ceiling' effect-- say down in the microgram ranges. But you cannot use those numbers to project out in a straight line-- because the potency of buprenorphine, being a 'partial agonist', doesn't follow a straight line.


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PostPosted: Tue Jun 09, 2009 1:26 am 
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Yeah doc, I figured that knowing about the ceiling effect of Buprenorphine. I was commenting on the fact that the calculator seemed to have no idea about it though! That could be misleading for a doctor who uses that you know?


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PostPosted: Tue Jun 09, 2009 6:08 pm 
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jamez70 wrote:
Here is a different one, with Bupe

http://www.medcalc.com/narcotics.html


Its a little weird, apparently 8mg Buprenorphine = 2600mg Codeine, or 200mg methadone.. holy crap no way :D :D


Actually, after playing with that calculator, it looks like those equivalence values are for the injectable versions of those drugs. For the PO (oral) versions it says:
8mg Buprenorphine = 4000mg Codeine, or 400mg methadone.

But you do have to be really careful about extrapolating too much information from drug equivalence charts/calculators. Most such medical equivalence charts/calculators are specifically designed to show analgesic (pain relieving) equivalence and are only valid within normal recommended dosing ranges. The equivalence values for other objectives, like euphoria or abating withdrawal symptoms are often very different from the analgesic equivalence values. Then individual patient response to specific drugs can also vary significantly. The normal dosage range for buprenorphine for analgesia (in opiate naive patients) is fractions of a milligram, so 8mgs is way outside the range of normal analgesic dosing, so you wouldn't expect the calculator to give you valid equivalence values for an 8mg buprenorphine dose. But it does highlight what a powerful drug buprenorphine is.


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PostPosted: Wed Mar 16, 2011 6:13 am 
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What can I replace my cigarette addiction with? I need a new addiction. I quit smoking a few months ago. But for some reason when someone gets around me and they smell like cigarettes. So I need a temporary side addiction to help me out with this addiction. Something I can hide from my husband for at least a month.


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PostPosted: Sat Mar 19, 2011 9:42 pm 
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:D nicotene gum. Candy. Gum. How about a chew?

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PostPosted: Sun Mar 20, 2011 9:35 am 
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What about taking the medication Chantix?

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PostPosted: Sun Mar 20, 2011 12:58 pm 
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rumsheya wrote:
What can I replace my cigarette addiction with? I need a new addiction. I quit smoking a few months ago. But for some reason when someone gets around me and they smell like cigarettes. So I need a temporary side addiction to help me out with this addiction. Something I can hide from my husband for at least a month.


LOL, you are funny. I'd do sugar free candy or something like that. They have super yummy sugar-free suckers that come in different Baskin and Robbins flavors. YUM!

Chantix will work too. My sister quit smoking using Chantix, and if you knew my sister, you'd know it's a miracle. It made her want to barf whenever she thought of a cigarette. So, just to really help her out and drive that point home, I kept on saying 'CIGARETTE!' to her and she'd get a funny face and then gag. :lol: It worked though. She's a year out and no relapse.

laddertipper

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