Clinicians should observe patients and use the Clinical Opiate Withdrawal Scale (COWS) to assess withdrawal severity. Treatment should begin when the patient scores appropriately on the scale, starting with a low dose of Suboxin and titrating up slowly while monitoring to prevent precipitated withdrawal.
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Why Starting Suboxone Is More Complicated Than Most People Realize追加:
Now, under normal circumstances, when someone goes into the office and they're on heroin, I would say we already had difficulty initiating someone on Suboxin, which is induction. Induction is that period of time when the patient is coming off of their opiate and you're initiating treatment with the Suboxin product, that's an induction. And ideally what you would do as a clinician is observe the patient, continue to give him a score under clinical opiate withdrawal scale. There's other scales and you sort of know given the score on that scale it's time to start lowd do suboxone and titrate it up slowly keeping an eye on the patient that you don't push them into precipitated withdrawals.
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