It has been three years since I retired from regular locum (well, semi-retired, on and off I did cover my friends). Well, many people did not know I was once a locum King. I had worked in many different kind of clinics and private hospitals. My life was then, work, on-call, locum and locum. I went into so-called "retirement" after I came back to my hometown.
Now, after I passed my exam and seemed to be a little bit more free, I started doing some locum again. Sounded like a "retired old gigolo coming out to work again" and so deperate. Anyway, I do locum not because of the money,...ahem......, well actually it is for the money, yeah RM40/hour.
Besides, I feel so bored nowadays. Look like everyday I am doing the same old routine all over and over again. I feel so tired.
Unlike certain people, who never believe in locum, guess they are freak, money oh, throw it in front of them, they are so lazy to pick it up. Sorry, no offence, as certain people have their own reason and preference not to do locum.
Anyway, I see doing locum (other than the money) as something we learn and experience as well. We never stopped learning. The more patients we see, the more we learned.
So, I have been working in this particular clinic for the past two months. Interestingly, other than the usual URTI cases, this clinic has got a number of drug addict patients who come very regularly to buy Subutex. Wonder what the hell this drug is, it is not cheap though.
It is actually Buprenorphine, which is an opiod partial agonist/antagonist which is used to treat opioid drug dependance. It acts by binding to the u and k receptors of the brain and over prolonged use, minimizes the need of the addicted patients for drug.
So, how the heck is it been used?
According to the pamplet, for induction therapy, the initial dose is from 0.8 to 4 mg once daily.
* For opiod-dependent drug addicts who have not undergone withdrawal: one dose of Subutex tablet administered sublingually at least 4 hours after the last use of the opiod, or when the first signs of craving appear.
* For patients receiving Methadone: before beginning Subutex therapy, the dose of Methadone should be reduced to maximum of 30mg/day. Subutex may precipitate symptoms of withdrawal in patients dependent upon Methadone.
However, many patients I spoke to, seemed did not have the strong intention to kick off the addiction. They merely see Subutex as something alternative, cheaper and legal way of getting their fix. I wonder how much addiction this drug could produce clinically or psychologically, but looked like many patients have been on the drug for years. I was also wondered how long should we prescribe this drug? Some patients are taking it for years. It made me feel like the medical professionals have become drug supplier, albeit legally.
Anyway, I did earn and learn something while doing locum today.
Now, after I passed my exam and seemed to be a little bit more free, I started doing some locum again. Sounded like a "retired old gigolo coming out to work again" and so deperate. Anyway, I do locum not because of the money,...ahem......, well actually it is for the money, yeah RM40/hour.
Besides, I feel so bored nowadays. Look like everyday I am doing the same old routine all over and over again. I feel so tired.
Unlike certain people, who never believe in locum, guess they are freak, money oh, throw it in front of them, they are so lazy to pick it up. Sorry, no offence, as certain people have their own reason and preference not to do locum.
Anyway, I see doing locum (other than the money) as something we learn and experience as well. We never stopped learning. The more patients we see, the more we learned.
So, I have been working in this particular clinic for the past two months. Interestingly, other than the usual URTI cases, this clinic has got a number of drug addict patients who come very regularly to buy Subutex. Wonder what the hell this drug is, it is not cheap though.
It is actually Buprenorphine, which is an opiod partial agonist/antagonist which is used to treat opioid drug dependance. It acts by binding to the u and k receptors of the brain and over prolonged use, minimizes the need of the addicted patients for drug.
So, how the heck is it been used?
According to the pamplet, for induction therapy, the initial dose is from 0.8 to 4 mg once daily.
* For opiod-dependent drug addicts who have not undergone withdrawal: one dose of Subutex tablet administered sublingually at least 4 hours after the last use of the opiod, or when the first signs of craving appear.
* For patients receiving Methadone: before beginning Subutex therapy, the dose of Methadone should be reduced to maximum of 30mg/day. Subutex may precipitate symptoms of withdrawal in patients dependent upon Methadone.
However, many patients I spoke to, seemed did not have the strong intention to kick off the addiction. They merely see Subutex as something alternative, cheaper and legal way of getting their fix. I wonder how much addiction this drug could produce clinically or psychologically, but looked like many patients have been on the drug for years. I was also wondered how long should we prescribe this drug? Some patients are taking it for years. It made me feel like the medical professionals have become drug supplier, albeit legally.
Anyway, I did earn and learn something while doing locum today.
No comments:
Post a Comment