tag:blogger.com,1999:blog-7579373589295053000.post5510763097873211033..comments2009-09-08T08:54:00.550-05:00SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-7579373589295053000.post-12631094044510596842009-09-08T08:39:19.247-05:002009-09-08T08:39:19.247-05:00

Regarding Dr. Purtzer's concerns; from what I've read, there is an enzyme that is used to metabolize certain opiate medications - CYP2D6 - and some people are rapid metabolizers resulting in high levels of opiates in their system. http://www.pharmacytimes.com/issue/pharmacy/2008/2008-07/2008-07-8624

Pathttp://www.blogger.com/profile/07472975863825391073noreply@blogger.comtag:blogger.com,1999:blog-7579373589295053000.post-8774906941429961702009-09-06T12:18:56.141-05:002009-09-06T12:18:56.141-05:00

Concern for patient safety is, of course, a vital component of opioid analgesic therapy. However, the accuracy of *quantitative* assays of opioids and/or their metabolites in urine needs further refinement. So called “therapeutic levels” of opioids are subject to many patient-dependent factors and, according to considerable research evidence, allegedly toxic or even lethal opioid serum levels may

SB. Leavitt, MA, PhDhttp://www.blogger.com/profile/11568656049984688554noreply@blogger.comtag:blogger.com,1999:blog-7579373589295053000.post-80582703356284266462009-09-05T23:24:09.425-05:002009-09-05T23:24:09.425-05:00

I am a pain doctor and order a lot of UDS including quantitative testing. These tests have been showing a lot of patients with very high levels of opiates in their systems, way above levels recommended as theraupeutic levels. They appear to be on toxic levels of medications. I have started to cut these patients back to their outrage and dismay. I do not want to have a patient overdose on these

Thomashttp://www.blogger.com/profile/03848859024264769240noreply@blogger.comtag:blogger.com,1999:blog-7579373589295053000.post-16707044441854210992009-08-31T13:23:46.887-05:002009-08-31T13:23:46.887-05:00

I work at a large HMO with > 80 PCPs. Over the past 2 years we have instituted a monitoring protocol for all patients who are being prescribed daily opioids for non-terminal pain unless specifically excluded by their PCP. This protocol includes random UDS. It also includes a written agreement outlining possible adverse effects, pt responsibility for safekeeping of opioids, etc which is signed

Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7579373589295053000.post-74681789882791196442009-08-31T09:57:30.457-05:002009-08-31T09:57:30.457-05:00

I read this article and it raised an eyebrow because I recently had 'questionalble' UDT results. My metabolites were low which indicated that perhaps I wasn't taking my medication as prescribed (enter the thought of diversion), when in actuality I was. This raised several questions... what other meds were inhibiting metabolization of opiates and/or was I (genetically) a poor

Anonymousnoreply@blogger.com