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PCSS-M Topics and DesignThe PCSS-M is designed to offer support to clinicians USING METHADONE TO TREAT OPIOID DEPENDENCE on the following topics:
1. Patient Assessment
2. Induction
3. Methadone dosing and patient's response
4. Monitoring, support and referral networks
5. Treatment of poly-substance dependence or co-morbid conditions, including
6. Issues related to treatment of special populations
7. Clinical logistics
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The PCSS-M is designed to offer support to clinicians on the following PAIN topics: 1. Patient Assessment
Patient selection for pain management with methadone treatment Safety considerations for pain management with methadone, including QT prolongation, respiratory conditions such as sleep apnea Considerations of appropriateness for methadone treatment 2. Induction
Induction methods - concerns about use of equianalgesics conversion tables or algorithms Monitoring during induction Monitoring peak dose effects 3. Dosing and response
Methadone dosing – variable duration of analgesic efficacy Appropriate use of additional medications Managing poly-pharmacy Initial screening and ongoing screening for methadone drug interactions Managing methadone side effects Methadone tolerance and hyperalgesia Use of methadone serum monitoring 4. Monitoring, support and
referral networks Obtaining collateral information about the patient’s use and response to methadone Collaboration with other healthcare providers Integrating urine toxicology into pain treatment Education material for family members and significant others Timing and processes of referring to pain management or addiction specialists Diversion safeguards and use of prescription monitoring programs Developing a methadone treatment exit strategy
5. Office Logistics Staff education on monitoring safe use of methadone Pregnant patients
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