2/7/2017. Avoid compassion traps. Avoid All or Nothing Traps. Some Explanatory Models of Addiction
|
|
- Emerald Clarke
- 6 years ago
- Views:
Transcription
1 Avoid compassion traps Do you want me to lose my job, do you want me to be on the street? I want you to have safe and effective pain control and it is my medical opinion that your current medicine won t give you that. Do you have pain? I want to use every minute of our time today to talk about your pain management plan. I wish you could feel my pain. I know you re suffering and I m sure that we can work together to reduce pain, so you don t have to suffer. Avoid All or Nothing Traps So you re going to do nothing for me then? You re cutting me off and I have to live with my pain? There are many, many things that people with chronic pain can do other than opiates to manage their pain. Would you like to hear about them? I ve tried all of that stuff, none of it works. I want to hear what you ve tried so we can find a way for it to be more helpful this time. Some Explanatory Models of Addiction Impaired model Dry moral model Wet moral model Self medication hypothesis Psychoanalytic model Family interaction model Old and new medical models Bio-psycho-social model 1
2 Stay firmly within the medical model Are you accusing me of being an addict? I have never accused anyone of diabetes but I ve diagnosed them with it and that is what I am trying to now, diagnose. Don t label me as a druggie I have no interest in labels at all, I am interested in helping people who are struggling with medical problems. So you re basically saying that I m a junkie. I m saying that addiction is a medical problem that responds to treatment not a problem of bad morals or behavior. Avoid the Policing Role If you become aware of diversion or misuse Control what you can control Prescribing Report what you are mandated to report Child abuse/neglect Don t take it personally Managing Threats I heard it s illegal for you to let me go into withdrawal. Withdrawal is uncomfortable but not life-threatening, I can prescribe you medicines to help with the withdrawal symptoms. I ll just go and use heroin. I certainly hope you don t because you know that I don t think any type of opiate will help your pain. Don t bother with any other meds, I ll just kill myself. I need to ask you some more questions about your thoughts about suicide. I m getting a lawyer. I m calling KGW. You do what you feel is right, of course. That s what I m doing for you, too. You have a family, don t you doc? Call the police 2
3 Endgame There is nothing you can do or say that will cause me to prescribe. Now, how do you want to spend the rest of our time? The Language of Addiction Listen to what people say, our language betrays what we think and feel Patients take lisinopril but the doctor has them on oxycodone Taking other meds vs eating opiates Refer to opiates with personal pronoun, My Vicodin Use slang names for opiates Use supposed to, try to, etc when describing how they take opiates as opposed to what they actually do The Language of Addiction Listen to what people say, our language betrays what we think and feel Patient says med gives me energy Use to treat non-targeted symptoms Unsanctioned dosage increases Meds eaten by dog, fell in toilet, left in Seaside, picked up by ex-wife, etc... 3
4 Diagnosing Addiction Ask yourself Has this patient developed a relationship with this medication beyond what I prescribed it for? Does this patient go to lengths to get this medication that most of my patients don t? Discussing Toxicology Speak to what you know to be true, trust your science I did not use cocaine, are you calling me a liar? I know it s very hard to talk about drug use, even with your doctor, but I want you to know that I m not here to judge you but to help you. I know it s embarrassing to change your story now I am concerned that your use of alcohol (or drugs) may be causing some of your symptoms and actually making you feel worse. I know that this can be a difficult subject to discuss, even with your doctor, but it is important to consider this medical condition so that we can work together to help you feel better. A helpful lab test for diagnosing this is a urine test, which I am ordering for you. General Recommendations Stay in the medical expert roll Emphasize concern and condition Speak to what is behind a patient s comment, not to the comment itself Speak to what you know to be true, trust your science 4
5 Concern Condition Convert Continue Very Brief Intervention - Express clinical concern - Medical issue - Elicit some change talk - Next steps? Next time? F R A M E S How to FRAME What You Say The results of your questionnaire indicate that your use of alcohol puts you at risk from problems due to drinking. Of course, any decisions regarding a change are yours to make. As your doctor, I would like to share some advice with you on modifying your drinking habits would that be ok? I want you to know that we have a lot of options to help you, should you decide to make a change.. I know that change can be difficult and at the same time, I am confident that if you decide to change you will be able to do so. Would you like to talk about some options that we have for supporting you in this? Situation Recommended length of taper Degree of Shared Decision Making about Opioid Taper Intervention/Setting Substance use disorder No taper, immediate referral None provider choice alone Diversion No taper* None provider choice alone At risk for immediate, large harms Weeks to months Moderate provider led & patient views sought Therapeutic failure Months Moderate provider led & patient views sought At risk for future, smaller harms Months to Years Moderate provider led & patient views sought Intervention: Transition to medication assisted treatment (buprenorphine or methadone) for OUD, Naloxone rescue kit Setting: Inpatient or Outpatient Buprenorphine (OBOT Determine need based on actual use of opioids, if any Intervention: Supportive care Naloxone rescue kit Setting: Outpatient opioid taper Intervention: Supportive care Naloxone rescue kit Setting: Outpatient opioid taper Option: Buprenorphine (OBOT) Intervention: Supportive care Naloxone rescue kit Setting: Outpatient opioid taper Option: Buprenorphine (OBOT) 5
6 The brain cares more about the percentile decrease than the absolute decrease. On the red curve 1 to 9 and 1 to both represent absolute decreases of one unit but the first is a 1% decrease and the second is a 1% decrease. DOSE 6 5 On the blue curve the first decrease is the same but the second decrease (1 to.875 at time unit 24 to 25) is a 1% decrease Percentage Absolute TIME DOSE weeks 8 weeks 12 weeks 16 weeks 2 weeks 24 weeks 28 weeks TIME 6
7 Opioid taper options Percent decreases per 4 week blocks Weeks 1 to 4 5 to 8 9 to to to 2 21 to to 28 4 weeks 25,33,5,1 8 weeks weeks weeks weeks weeks weeks
8 Key Concepts for Tapering Opioid Medications Establish a relationship They don t care how much you know until they know how much you care. Set Expectations Shared decision making Discuss withdrawal symptoms and temporary increase in pain Advise patient to keep a journal, reviewing helps to normalize the process Set goals for points in time Tapers are unidirectional, decide if you want to allow breaks or pauses Maintain best practices Urine drugs screens, pill counts, PDMP review, etc Key Concepts for Tapering Opioid Medications Allow patient to choose taper speed, when appropriate Addiction becomes apparent during taper (unable to make dose reduction or even increases dose) Detox or agreement of taper by certain date or detox, but no further Rx Inform patient of happy paradox that their pain will be much more manageable once they are off their pain medication! Most patients say they had made the change a lot earlier, that they can think better, get more done and are more present for family and work. 8
Difficult Conversations
Difficult Conversations D R. L Y D I A A N N E M B A R T H O L O W, D N P, P M H N P, C A R N - AP Skill Building Patient centered Boundaries and self-protection Trauma informed Care 1 Skill Building Trauma
More informationTrauma-Informed Difficult Conversations: building capacity for resilient clinical relationships
Trauma-Informed Difficult Conversations: building capacity for resilient clinical relationships Eugene, Or May, 2018 Lydia Anne M Bartholow, DNP, PMHNP, CARN-AP No Relevant Disclosures Disclosures? Psychiatric
More informationPractical Tools to Successfully Taper Prescription Opioids. Melissa Weimer, DO, MCR
Practical Tools to Successfully Taper Prescription Opioids Melissa Weimer, DO, MCR Objectives Understand how to calculate morphine equivalents per day Understand the steps necessary to plan a successful
More informationThe science of the mind: investigating mental health Treating addiction
The science of the mind: investigating mental health Treating addiction : is a Consultant Addiction Psychiatrist. She works in a drug and alcohol clinic which treats clients from an area of London with
More informationAFSP SURVIVOR OUTREACH PROGRAM VOLUNTEER TRAINING HANDOUT
AFSP SURVIVOR OUTREACH PROGRAM VOLUNTEER TRAINING HANDOUT Goals of the AFSP Survivor Outreach Program Suggested Answers To Frequently Asked Questions on Visits Roadblocks to Communication During Visits
More information18 INSTRUCTOR GUIDELINES
STAGE: Ready to Quit You are a community pharmacist and have been approached by a 16-year-old girl, Nicole Green, who would like your advice on how she can quit smoking. She says, I never thought it would
More informationsuicide Part of the Plainer Language Series
Part of the Plainer Language Series www.heretohelp.bc.ca What is? Suicide means ending your own life. It is sometimes a way for people to escape pain or suffering. When someone ends their own life, we
More informationten questions you might have about tapering (and room for your own) an informational booklet for opioid pain treatment
ten questions you might have about tapering (and room for your own) an informational booklet for opioid pain treatment This booklet was created to help you learn about tapering. You probably have lots
More informationConversations As Medicine Compassion-Based Difficult Conversations
Conversations As Medicine Compassion-Based Difficult Conversations October 27, 2016 Laura Heesacker, LCSW Behavioral Health Innovation Specialist And Jim Shames, MD Public Health Officer Jackson County
More informationPrinciples and language suggestions for talking with patients
SAFER MANAGEMENT OF OPIOIDS FOR CHRONIC PAIN: Principles and language suggestions for talking with patients Use these principles and language suggestions when discussing opioid risks and safety monitoring
More informationQuestion: I m worried my child is using illegal drugs, what should I do about it?
Question: I m worried my child is using illegal drugs, what should I do about it? Answer: Many parents worry about whether their son or daughter is using illegal drugs and what they should do about it.
More information9 INSTRUCTOR GUIDELINES
STAGE: Ready to Quit You are a clinician in a family practice group and are seeing 16-yearold Nicole Green, one of your existing patients. She has asthma and has come to the office today for her yearly
More informationHaving suicidal thoughts?
Having suicidal thoughts? Information for you, and for family, whänau, friends and support network Prepared by skylight for the New Zealand Guidelines Group CONTENTS Having Suicidal Thoughts? 1 Asking
More informationScreening, Identification, Counseling, and Treatment of Opioid Use Disorder
Screening, Identification, Counseling, and Treatment of Opioid Use Disorder Joji Suzuki, MD Assistant Professor of Psychiatry, Harvard Medical School Director, Division of Addiction Psychiatry, Brigham
More informationNORTHWEST AIDS EDUCATION AND TRAINING CENTER. Opioid Use Disorders. Joseph Merrill M.D., M.P.H. University of Washington April 10, 2014
NORTHWEST AIDS EDUCATION AND TRAINING CENTER Opioid Use Disorders Joseph Merrill M.D., M.P.H. University of Washington April 10, 2014 Opioid Use Disorders Importance of opioid use disorders Screening and
More informationInsight Addictionary
Insight Addictionary This resource contains a range of definitions of common clinical terms in the alcohol and drug sector and suggested ways that they can be explained to clients. It has been developed
More informationToday the overuse of opioids is a problem. Many of
A PPENDIX B A Word About Opioid Use Today the overuse of opioids is a problem. Many of these opioids are prescribed and thus are legal. Other people steal or buy opioids on the streets. These are illegal.
More informationsome things you should know about opioids before starting a prescription an informational booklet for opioid pain treatment
some things you should know about opioids before starting a prescription an informational booklet for opioid pain treatment This booklet was created to help you learn about opioids. You probably have lots
More informationFACING ADDICTION OVER DINNER
FACING ADDICTION OVER DINNER The NATIONAL NIGHT of CONVERSATION November 17, 2016 The dinner table is one of the most important places in the house for improving the health of your family, but not only
More informationFor young people living with someone s excessive drinking, drug use or addiction
Taking the Lid Off For young people living with someone s excessive drinking, drug use or addiction When your mum, dad, or other family member has been drinking or using drugs, do they: Embarrass you?
More informationOPIOIDS. Questions about opioids, and the Answers that may SURPRISE YOU. A booklet for people who may benefit from reducing or stopping their opioid
OPIOIDS Questions about opioids, and the Answers that may SURPRISE YOU A booklet for people who may benefit from reducing or stopping their opioid Generic Name morphine hydromorphone oxycodone tramadol
More informationOPIOIDS. Questions about opioids, and the Answers that may SURPRISE YOU. A booklet for people who may benefit from reducing or stopping their opioid
OPIOIDS Questions about opioids, and the Answers that may SURPRISE YOU A booklet for people who may benefit from reducing or stopping their opioid Generic Name morphine hydromorphone oxycodone tramadol
More information2 INSTRUCTOR GUIDELINES
STAGE: Not Ready to Quit (Ready to cut back) You have been approached by Mr. Faulk, a healthy young male, aged 28, who has applied to become a fireman and has a good chance of being offered the job. His
More informationOpioids 101. Washington Prevention Summit. Alison Newman, MPH November 6, 2018
Opioids 101 Washington Prevention Summit Alison Newman, MPH November 6, 2018 Opioids Class of drugs that work on the endorphin system. What are some examples? What are some of the risks? Opioid use disorder
More informationLatest Press Release. How much for 30 mg adderall
corp@stantec.com Latest Press Release How much for 30 mg adderall S 14-2-2008 Hi my name is Rachel i have been on suboxone for almost a year as of OCT 1st, and I have become the person I guess I am to
More informationWelcome to the Opioid Overdose Prevention Project
Welcome to the Opioid Overdose Prevention Project Narcan Training TODAY S OBJECTIVES Define drug addiction Identify symptoms of addiction Treatment options including support for family members How to recognize
More informationI don t want to be here anymore. I m really worried about Clare. She s been acting different and something s not right
I just can t take what s happening at home anymore Clare 23 mins Instagram When your friend is thinking about suicide I don t want to be here anymore... I m really worried about Clare. She s been acting
More informationHow to empower your child against underage drinking
How to empower your child against underage drinking There is a high chance that your teenage child has or will have an encounter with alcohol either through experimenting or through someone else s drinking.
More informationTalking to someone who might be suicidal
Talking to someone who might be suicidal To some it s a tea bag. To others it s a lifeline... Support the Zero Suicide Alliance campaign. Help us tackle the stigma that stops so many from asking for help.
More informationMotivational Interviewing in Healthcare. Presented by: Christy Dauner, OTR
Motivational Interviewing in Healthcare Presented by: Christy Dauner, OTR The Spirit of MI Create an atmosphere of acceptance, trust, compassion and respect Find something you like or respect about every
More informationPsychological wellbeing in heart failure
Patient information Struggling to cope? Can trelax? Psychological wellbeing in heart failure Stressedout? Trouble sleeping? Feelinglow? i Living with heart failure can be challenging mentally as well as
More informationHarm reduction for drug users
In Northern Ireland, 3 out of 4 drug-related deaths involve more than one drug or a combination of one or more drugs and alcohol. In many cases, prescription drugs (for example diazepam or tramadol) are
More information11 INSTRUCTOR GUIDELINES
STAGE: Recent Quitter Ms. Barnes is a 28-year-old woman who has been filling her oral contraceptive prescription at your pharmacy for the past 6 years. Four months ago, you assisted her in quitting smoking
More informationA patient s journey. Can you describe your struggle with addiction? Nathan Patient, US
A patient s journey Nathan Patient, US Nathan s journey I had reached rock bottom, but through determination and humility I worked my way back up. I attended meetings. I found a job where I started cleaning
More informationAnti-smoking vaccine developed
www.breaking News English.com Ready-to-use ESL/EFL Lessons Anti-smoking vaccine developed URL: http://www.breakingnewsenglish.com/0505/050516-nicotine-e.html Today s contents The Article 2 Warm-ups 3 Before
More informationHow long to wait to take suboxone after oxycodone
How long to wait to take suboxone after oxycodone 13-2-2011 How long til I can take a Suboxone a fter Percocet from not taking percocets or other opiates anyway so I never wait til I get withdrawls to
More informationPatient and Family Agreement on Opioids
Patient and Family Agreement on Opioids We care about our patients and are committed to their recovery and wellness. We offer our patients medications and options for various services to keep them from
More informationHow to not blow it at On Campus Mock Trial Competition. with Tyler
How to not blow it at On Campus Mock Trial Competition with Tyler Why listen to me? I m a professional (now.) I have tried over 100 jury trials. I have made my share of mistakes. I teach/coach mock trial
More informationInformation for women who have experienced domestic abuse
Ending Violence and Abuse Information for women who have experienced domestic abuse Supporting women who have experienced physical, emotional and/or sexual abuse About Domestic Abuse Domestic abuse means
More informationManaging conversations around mental health. Blue Light Programme mind.org.uk/bluelight
Managing conversations around mental health Blue Light Programme 1 Managing conversations around mental health Managing conversations about mental wellbeing Find a quiet place with an informal atmosphere,
More informationWhat is Down syndrome?
FREQUENTLY ASKED QUESTIONS PRIMARY What is Down syndrome? People have Down syndrome because they have an extra chromosome. Our bodies are made up of millions and millions of cells and each cell usually
More informationCognitive Behavioral and Motivational Approaches to Chronic Pain. Joseph Merrill MD, MPH University of Washington October 14, 2017
Cognitive Behavioral and Motivational Approaches to Chronic Pain Joseph Merrill MD, MPH University of Washington October 14, 2017 Motivational and Cognitive Behavioral Approaches Assessment basics Components
More informationThis factsheet covers:
Healthcare in Prison Prisoners should have the same access to healthcare services as everyone else. This factsheet looks at what health services you can get if you are in prison and what to do if you are
More informationScript for Contacting People that you Know
Script for Contacting People that you Know Hi this is, I ve been thinking a lot about you and wanted to share something with you that I feel passionate about that has changed my life. Is this a good time
More informationRISK-REWARD ANALYSIS
RISK-REWARD ANALYSIS FOR ALCOHOL AND OTHER DRUGS To drink or not to drink. To use or not to use. What will break the log-jam of conflicting thoughts? Let s start by getting the pro s and con s of quitting
More informationORIENTATION SAN FRANCISCO STOP SMOKING PROGRAM
ORIENTATION SAN FRANCISCO STOP SMOKING PROGRAM PURPOSE To introduce the program, tell the participants what to expect, and set an overall positive tone for the series. AGENDA Item Time 0.1 Acknowledgement
More informationHere are a few ideas to help you cope and get through this learning period:
Coping with Diabetes When you have diabetes you may feel unwell and have to deal with the fact that you have a life long disease. You also have to learn about taking care of yourself. You play an active
More informationGOALS AND OBJECTIVES
SUBOXONE AND VIVITROL: ARE THERE DISPARITIES SURFACING IN MEDICATION ASSISTED TREATMENTS? P R E S E N T E D B Y D R. K I AM E M AH A N I A H & D R. M Y E C H I A M I N T E R - J O R D AN GOALS AND OBJECTIVES
More informationMotivational Interviewing Enhancing Motivation to Change Strategies
Motivational Interviewing Enhancing Motivation to Change Strategies Learning Objectives At the end of the session, you will be able to 1. Describe the stages of change. 2. Demonstrate at least two methods
More informationMethadone Treatment. in federal prison
INFORMATION FOR FEDERAL PRISONERS IN BRITISH COLUMBIA Methadone Treatment in federal prison This booklet will explain how to qualify for Methadone treatment in prison, the requirements of the Correctional
More informationProblem Situation Form for Parents
Problem Situation Form for Parents Please complete a form for each situation you notice causes your child social anxiety. 1. WHAT WAS THE SITUATION? Please describe what happened. Provide enough information
More informationPatient Information Leaflet
Page 25 Patient Information Leaflet PATIENT INFORMATION SUBOXONE (sub-ox-own) (buprenorphine HCl/naloxone HCl dihydrate, sublingual tablet) (C*) SUBUTEX (SUB-u-tex) (buprenorphine HCl, sublingual tablet)
More informationChoosing Life: Empowerment, Action, Results! CLEAR Menu Sessions. Substance Use Risk 2: What Are My External Drug and Alcohol Triggers?
Choosing Life: Empowerment, Action, Results! CLEAR Menu Sessions Substance Use Risk 2: What Are My External Drug and Alcohol Triggers? This page intentionally left blank. What Are My External Drug and
More informationUniversity Staff Counselling Service
University Staff Counselling Service Anxiety and Panic What is anxiety? Anxiety is a normal emotional and physiological response to feeling threatened, ranging from mild uneasiness and worry to severe
More informationTook 2 hydrocodone by mistake what will happen
Search... Took 2 hydrocodone 10 325 by mistake what will happen Took 2 hydrocodone 10 325 by mistake what will happen 11/13/2017 Sisters of the coadt 2 walkthrough 11/15/2017 Neurogenic cough uptodate
More informationOverdose. Everything you need to know. Includes free DVD!
Overdose Everything you need to know Includes free DVD! Please read this booklet. We guarantee you ll learn something new. When you ve read it, you ll know about overdose myths and: what to do if you
More informationMethadone Treatment. in federal prison
INFORMATION FOR FEDERAL PRISONERS IN BRITISH COLUMBIA Methadone Treatment in federal prison This booklet will explain how to qualify for Methadone treatment in prison, the requirements of the Correctional
More informationVERMONT SUICIDE PREVENTION & INTERVENTION PROTOCOLS FOR PRIMARY CARE PROFESSIONALS
VERMONT SUICIDE PREVENTION & INTERVENTION PROTOCOLS FOR PRIMARY CARE PROFESSIONALS CONTEXT & RESOURCES RESPONDING TO A THREAT OF SUICIDE: IN PERSON RESPONDING TO A THREAT OF SUICIDE: REMOTELY RESPONDING
More information7/7/2016 Journal of the American Medical Association,
1 2 Journal of the American Medical Association, 2008 3 The Clinical Trial 152 Adolescents and Young Adults (Age 15 to 21) randomly assigned to either; 1. 2 weeks of Buprenorphine detox 2. 12 weeks of
More informationBuprenorphine treatment
South London and Maudsley NHS Foundation Trust Buprenorphine treatment Information for service users Page Buprenorphine treatment What is buprenorphine? Buprenorphine (trade name Subutex ) is an opioid
More informationWhat to Do When a Loved One Is Severely Depressed
What to Do When a Loved One Is Severely Depressed There are no easy answers for helping someone struggling with depression, especially if you ve already tried and tried. Here are some tips from experts.
More informationDepression: what you should know
Depression: what you should know If you think you, or someone you know, might be suffering from depression, read on. What is depression? Depression is an illness characterized by persistent sadness and
More informationAppendix C Discussion Questions for Student Debriefing: Module 3
Appendix C Discussion Questions for Student Debriefing: Module 3 Frequently Asked Questions (And Responses!) Q: What is the role of biological factors in the development of depression? A: Clinical depression
More informationGOALS FOR LEADERS SAMPLE SESSION OUTLINE
THOUGHTS 1 -- THOUGHTS AND YOUR MOOD Welcome new participants Review group rules GOALS FOR LEADERS Have participants and group introduce themselves Review the cognitive behavioral treatment model Introduce
More informationThe Wellbeing Course. Resource: Mental Skills. The Wellbeing Course was written by Professor Nick Titov and Dr Blake Dear
The Wellbeing Course Resource: Mental Skills The Wellbeing Course was written by Professor Nick Titov and Dr Blake Dear About Mental Skills This resource introduces three mental skills which people find
More informationkeep track of other information like warning discuss with your doctor, and numbers of signs for relapse, things you want to
Helping you set your brain free from psychosis. www.heretohelp.bc.ca This book was written by Sophia Kelly and the BC Schizophrenia Society, for the BC Partners for Mental Health and Addictions Information.
More informationThe Challenging Patient with Chronic Opioid Usage MD ACP Meeting
The Challenging Patient with Chronic Opioid Usage. 2018 MD ACP Meeting Darius A. Rastegar, MD March 12, 2018 1 Prescribing Opioids: A question of balance Opioids are an effective treatment for acute pain.
More informationSo just what is this stuff my friends keep offering me?
HEROIN BROWN, SMACK, H, SCAG So just what is this stuff my friends keep offering me? Heroin. Chemical name, diamorphine hydrochloride. A semi-synthetic drug that is a product of the opium poppy. Common
More informationUW MEDICINE PATIENT EDUCATION. Baby Blues and More. Postpartum mood disorders DRAFT. Emotional Changes After Giving Birth
UW MEDICINE PATIENT EDUCATION Baby Blues and More Postpartum mood disorders Some new mothers have baby blues or more serious postpartum mood disorders. This chapter gives ideas for things you can do to
More informationthe facts about BUPRENORPHINE for Treatment of Opioid Addiction
the facts about BUPRENORPHINE for Treatment of Opioid Addiction i I d been shot on the streets, I d been in detox. It was jails, institutions. Death, I knew, was imminent for me so I started my recovery
More informationOperation S.A.V.E Campus Edition
Operation S.A.V.E Campus Edition 1 Suicide Prevention Introduction Objectives: By participating in this training you will learn: The scope and importance of suicide prevention The negative impact of myths
More informationworking with your doctor for depression
tips for working with your doctor for depression 2011 www.heretohelp.bc.ca Talking to your health professional about depression is a very important first step. It s the beginning of your journey to wellness.
More informationBuprenorphine Patient Education
Treating Chronic Pain The management of chronic pain often takes a multidisciplinary approach in order to be more effective. In other words, it takes more than one technique used in combination with others
More informationUSING ASSERTIVENESS TO COMMUNICATE ABOUT SEX
Chapter 5: Sexual Health Exercise 1 USING ASSERTIVENESS TO COMMUNICATE ABOUT SEX Aggressive Passive Manipulative/manipulation Assertive Balance of power Sex Sexual coercion 1. To build learners communication
More informationQPR Staff suicide prevention training. Name Title/Facility
QPR Staff suicide prevention training Name Title/Facility email Learning Objectives Explain what QPR means Identify risk factors and early warning signs of suicide Apply QPR principles to help save a life
More informationTeens Living with Epilepsy
Teens Living with Epilepsy If you are a kid, please see the other side of this brochure. www.keppra.com 2005, UCB Pharma, Inc., Smyrna, GA 30080 All rights reserved. Printed in U.S.A. K1599-0505 Introduction
More informationMotivational Interviewing
Motivational Interviewing By: Tonia Stott, PhD What is Motivational Interviewing? A client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence
More informationAbout Your Pain Management
UW MEDICINE PATIENT EDUCATION About Your Pain Management Answers to common questions This handout outlines the goals of pain management treatment. It also reviews the guidelines that you are expected to
More informationControlled Substance and Wellness Agreement
Controlled Substance and Wellness Agreement You and your provider have agreed on the use of controlled substance medications to treat your: We want to make sure you know how to manage your new prescription(s)
More informationQPR Suicide Prevention Training for Refugee Gatekeepers
QPR Suicide Prevention Training for Refugee Gatekeepers 1 By the end of the training participants will be able to: Define suicide and describe how it is viewed within refugee communities. Identify risk
More informationNAMI In Our Own Voice Presenter Screening Tool
NAMI In Our Own Voice Presenter Screening Tool This tool has been developed by individuals who are currently involved in recruiting and evaluating consumers for NAMI programs. It is offered as a relevant
More informationTuscarawas County Health Department. Vivitrol Treatment Consent
Tuscarawas County Health Department Vivitrol Treatment Consent I. Vivitrol Medication Guide: a. VIVITROL (viv-i-trol) (naltrexone for extended-release injectable suspension) b. Read this Medication Guide
More informationTrends and Challenges: The Kentucky Opioid Crisis. Jason Smith, MD PhD University of Louisville
Trends and Challenges: The Kentucky Opioid Crisis Jason Smith, MD PhD University of Louisville Brief Introduction I am by no means an expert I have no financial disclosures Jokes are meant to be lighthearted
More informationMethadone Maintenance 101
Methadone Maintenance 101 OTP/DAILY DOSING CLINICS - ANDREW PUTNEY MD Conflicts of Interest - Employed by Acadia HealthCare 1 Why Methadone? At adequate doses methadone decreases opioid withdrawal symptoms
More informationSelf-Esteem Discussion Points
Self-Esteem Discussion Points 1. 2. 3. 4. 5. What does self-esteem mean? liking yourself being proud of things you ve done knowing how you re special and unique knowing you re a good person knowing you
More informationMethadone/ Suboxone Treatment in federal prison
INFORMATION FOR FEDERAL PRISONERS IN BRITISH COLUMBIA Methadone/ Suboxone Treatment in federal prison This booklet will explain how to qualify for Opioid Substitution Therapy (OST) in prison, how it is
More informationChoosing Life: empowerment, Action, Results! CLEAR Menu Sessions. Adherence 1: Understanding My Medications and Adherence
Choosing Life: empowerment, Action, Results! CLEAR Menu Sessions Adherence 1: Understanding My Medications and Adherence This page intentionally left blank. Understanding My Medications and Adherence Session
More informationUnderstanding Drug Addiction & Abuse
Understanding Drug Addiction & Abuse Original article found on YourAddictionHelp.com What is Drug Addiction? Is it a series of bad decisions? Negative environment? Or just plain bad luck? If you re reading
More informationPower of Paradigm Shift
Few Characteristics of Generations Traditionalists Baby Boomers Generation X Generation Y Work Pattern 9 to 5 Dawn to Dusk What do you mean by 9 to 5? Work smarter & Quicker till work done Work Style Tell
More informationMajor Depressive Disorder Wellness Workbook
Framing Major Depressive Disorder Major Depressive Disorder Wellness Workbook This Workbook belongs to you and you decide how to use it. You decide who to show it to and whether or not you want someone
More informationHow is depression treated?
Major depressive disorder Amerigroup Washington, Inc. has a case management program for depression. This program will help you better understand and manage your depression. We can assist you to set health
More informationBoundaries - What is Appropriate?
Boundaries - What is Appropriate? by Rick Reynolds Much is written on the topic of boundaries so I ve never weighed in on the topic. But after a discussion in the 911 Marriage question and answer session
More informationIndex. Handbook SCREENING & TREATMENT ENHANCEMENT P A R T STEP. Guidelines and Program Information for First Felony and Misdemeanor Participants
SCREENING & TREATMENT ENHANCEMENT P A R T Index Welcome to STEP 3 What is STEP? 4 What s in it for me? 5 STEP Rules 6-8 STEP Phase Description and 9-16 Sanction Scheme Graduation 17 STEP webready STEP
More informationBuprenorphine 2.0: I have my waiver, now what? Dr. Ritu Bhatnagar, M.D., M.P.H. Dr. John Ewing, M.D., FASAM. Disclosures
Buprenorphine 2.0: I have my waiver, now what? Dr. Ritu Bhatnagar, M.D., M.P.H. Dr. John Ewing, M.D., FASAM Disclosures Dr. Bhatnagar: no disclosures to report Dr. Ewing: no disclosures to report 1 Our
More informationNavigating Conflict with Families
Navigating Conflict with Families Gordon J. Wood, MD, MSCI, FAAHPM Winter Workshop, Coleman Palliative Medicine Training Program February 28, 2014 With thanks to Bob Arnold, Elizabeth Weinstein and Jonathan
More informationMOTIVATING BEHAVIOUR CHANGE IN PATIENTS USING OPIOIDS
MOTIVATING BEHAVIOUR CHANGE IN PATIENTS USING OPIOIDS Opioid Webinar Series Laura Murphy, PharmD Disclosures No conflict of interest Acknowledgements Andrea Fernandes Anne Kalvik Pearl Isaac Karen Ng Beth
More informationBuilding Friendships: Avoid Discounting
Module 3 Part 2 Building Friendships: Avoid Discounting Objectives: 1. Explore the relationship between stress and discounting. 2. Understand what discounting is and how it relates to stress in relationships.
More informationOur Pledge to Children in Care and Care Leavers
Our Pledge to Children in Care and Care Leavers 1 Designed and printed by Bristol City Council, Bristol Design OCTOBER 15 BD7047 Bristol Corporate Parenting Strategy The Bristol Pledge The pledge is a
More informationThe Art of being Human
Science - Year 6 Animals including Humans Block 6AH The Art of being Human Session 6 Resource pack Original resource copyright Hamilton Trust, who give permission for it to be adapted as wished by individual
More informationScript and Context. RN: Thanks, Ms. Deal. May I check your name bracelet? I just want to make sure the information is correct.
Client appearance: Slouching in chair Hair unkempt Disheveled clothing Withdrawn Avoids eye contact initially Script and Context RN- adjunct clinical faculty SP- standardized patient (trained professional
More information