Dr Winter ***Retired***

Rossville

can you buy Pregabalin over the counter PRIVATE

PERSONAL

PROFESSIONAL

PHYSICIAN LEVEL SERVICE

NORTH IDAHO LOCATION – EASY ACCESS –

POST FALLS off I-90 Seltice

OPIOID and opiate abuse/addiction medication assisted treatment (MAT) with Suboxone, Buprenorphine, Subutex.  PHYSICIAN level service.  PRIVATE.  Successful integration into daily life without fear and guilt.  START TODAY.

EXPECTATIONS ARE:  Come to your appointments, seek a counselor, use your medication as prescribed.  ABSOLUTELY no diversion is tolerated.  Not following the simple rules will leave you without medication.  The Clinic believes in great care, open listening, and the enjoyment of successful renewal to self and your family.  

DR WINTER – Opioid – Suboxone – Buprenorphine – Subutex – CALL 208-626-2949 – Addiction

PRIVATE

PERSONAL

PROFESSIONAL

PHYSICIAN LEVEL SERVICE

CALL 208-626-2949

NORTH IDAHO LOCATION – EASY ACCESS –

POST FALLS off I-90 Seltice

OPIOID and opiate abuse/addiction medication assisted treatment (MAT) with Suboxone, Buprenorphine, Subutex.  PHYSICIAN level service.  PRIVATE.  Successful integration into daily life without fear and guilt.  START TODAY.

EXPECTATIONS ARE:  Come to your appointments, seek a counselor, use your medication as prescribed.  ABSOLUTELY no diversion is tolerated.  Not following the simple rules will leave you without medication.  The Clinic believes in great care, open listening, and the enjoyment of successful renewal to self and your family.  COME MEET WITH ME!

CALL 208-626-2949

DR WINTER – MEDICATION ASSISTED TREATMENT – OPIOID OPIATE ADDICTION – POST FALLS ID

PRIVATE

PERSONAL

PROFESSIONAL

PHYSICIAN LEVEL SERVICE

CALL 208-626-2949

NORTH IDAHO LOCATION – EASY ACCESS –

POST FALLS off I-90 Seltice

OPIOID and opiate abuse/addiction medication assisted treatment (MAT) with Suboxone, Buprenorphine, Subutex.  PHYSICIAN level service.  PRIVATE.  Successful integration into daily life without fear and guilt.  START TODAY.

ADDICTION – ABUSE – OVERUSE – OPIOIDS – SUBOXONE(R) – BUPRENORPHINE – CALL 208-626-2949 WHY WAIT ANY LONGER? Dr Winter POST FALLS

CALL ME…..

208-626-2949

WHY WAIT?

BUPRENORPHINE – Subutex(R) – Suboxone(R) – MAT TREATMENT – CALL 208-626-2949 – Dr Winter POST FALLS ID

  • OPIATE OVERUSE OR ADDICTION USE – buprenorphine
  • PRIVATE
  • PERSONAL
  • CONFIDENTIAL
  • PROFESSIONAL
  • CALL ME.  208-626-2949

OPIOID/OPIATE CLINIC – MED ASSISTED TREATMENT – CALL 208-626-2949 – Dr Winter POST FALLS ID

Information about Medication-Assisted Treatment (MAT)

 

Medication-assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies, which is effective in the treatment of opioid use disorders (OUD) and can help some people to sustain recovery.

More must be done to facilitate treatment options and the development of therapies to address OUD as a chronic disease with long-lasting effects. This means helping more people secure MAT, which requires us to break the stigma often associated with some of the medications used to treat OUD. It also requires us to find new and more effective ways to advance the use of medical therapy for the treatment of OUD.

There are three drugs approved by the FDA for the treatment of opioid dependence: buprenorphine, methadone, and naltrexone. All three of these treatments have been demonstrated to be safe and effective in combination with counseling and psychosocial support. Everyone who seeks treatment for an OUD should be offered access to all three options as this allows providers to work with patients to select the treatment best suited to an individual’s needs. Due to the chronic nature of OUD, the need for continuing MAT should be re‐evaluated periodically. There is no maximum recommended duration of maintenance treatment, and for some patients, treatment may continue indefinitely.

FDA-approved buprenorphine products approved for the treatment of opioid dependence include:

Bunavail (buprenorphine and naloxone) buccal film
Cassipa (buprenorphine and naloxone) sublingual film
Probuphine (buprenorphine) implant for subdermal administration
Sublocade (buprenorphine extended‐release) injection for subcutaneous use
Suboxone (buprenorphine and naloxone) sublingual film for sublingual or buccal use, or sublingual tablet.
Subutex (buprenorphine) sublingual tablet
Zubsolv (buprenorphine and naloxone) sublingual tablets

FDA-approved methadone products approved for the treatment of opioid dependence include:

Dolophine (methadone hydrochloride) tablets
Methadose (methadone hydrochloride) oral concentrate

FDA-approved naltrexone products approved for the treatment of opioid dependence include:

Vivitrol (naltrexone for extended-release injectable suspension) intramuscular

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DIARRHEA – THE NOT SO TALKED ABOUT SERIOUS ILLNESS

Diarrhea is certainly a “not so talked about” medical condition. But today, at least one kind of diarrhea is becoming quite a medical problem. It is the Clostridium Difficile colitis (colon infection and inflammation).

Physicians, nurses, clinics and hospitals as well as Public Health agencies are seeing a rise in the incidence of this C. Difficile associated diarrhea. This change in the demographics of this disease is toward a younger and healthier group of patients, and not the classic patients.

The typical patients for this “C. Diff.” diarrhea have been the elderly, those with recent antibiotic usage, and those on certain higher risk medications such as clindamycin, cephalosporins, and quinolones. Recent hospitalization and the use of gastric acid blockers, now advertised daily on television and print media are also higher risk factors.

The use of gastric acid blockers has been studied and continues to be. This arena of high use of these acid pH changing medicines in the gut may be contributing to the growth of the C. Diff. more quickly in the gut, than without the acid blocker.

The toxin in itself from the bacteria, can cause worsening symptoms such as toxic mega colon, severe sepsis, perforation of the gut, a need for colectomy (removal of the colon), and even death.

The diarrhea is many times unrelenting. It continues to be watery, sometimes mucous-like, and eventually bloody. But many patients wait to see if the diarrhea will clear. Dehydration and weight loss can be associated with such diarrhea also.

There are both blood tests for the disease and stool tests specific to the disease.

If you are on antibiotics, and develop diarrhea over 24 hours you must call your health care provider or doctor. The best treatment is to stop the antibiotic immediately with your doctor’s order if possible.

Many times two different OTHER antibiotics are used to treat the C. Diff. infection of the colon. One antibiotic for the C. Diff. is only about 80% effective now, while the backup drug is only about 90% effective. But now, resistance is starting to mount to these treatments, leaving patients in severe distress with life-threatening diarrhea and infection.

New studies are being done now using probiotics. Specifically Sacharomyces boulardii and other lactobacilli have been studied. Many are recommending the use of probiotics with the initiation of antibiotics and other antimicrobials.

There are many reasons patients get diarrhea.  But you can eliminate some high risk yourself.  So, do not use antibiotics without a reason. Do not borrow or loan antibiotics. Always talk with your doctor if you develop diarrhea while on antibiotics. When in doubt, call.

CastMD says, “You do NOT want to develop this toxic type of diarrhea.”

DRUGS IN WORKPLACE – BIGGER CONCERN THAN YOU MIGHT THINK – ARE YOUR COMPANY POLICIES IN PLACE?

DRUGS IN WORKPLACE –  ARE YOU TRYING TO SKIRT THE ISSUE?

A month or so ago the Feds released their workplace data regarding use of drugs while on duty in various jobs and employments. These are the newest data compared to previous studies in mid-nineties.

Industries that continue to have high rates of on the job drug use and use of drugs are those industries in general that continue to have high job turnover rates.

Illicit drug usage among the 18-64 year olds working full-time was the highest in food service and accommodation industry, construction work, entertainment and arts, information services, and management support companies.

The highest rate was 16.9 percent of the food and accommodation employees used illicit drugs in the last month, in the survey.

Construction workers and miners had the highest heavy use alcohol rates at 17.8 percent. Even CEO’s rate was at 8 percent for heavy alcohol usage.

Marijuana continues to lead the pack on illicit drug use for these surveys.

Over 12 percent of the illicit drug users had three or more employers in the past year! Current drug users had twice the rate of missing one or more days in the last month.

Increased rates of illicit drug use were seen in men and lesser paid jobs.

About half of the full-time workers report that their company does pre-placement drug testing. Protective services had the highest rate (76%) of this type of testing, while legal occupations had the lowest (14%) reported in the study.

Only one-third of the workers reported random drug testing policies by their employers.

ONLY one-third of the workers reported they would be less likely to work for companies with random testing programs in place.

EMERGENCY ROOM VISITS – ILLICIT DRUG ABUSE TOP TEN

poppy.gifAccording to D.A.W.N. which stands for Drug Abuse Warning Network the top ten Emergency Department visits were surprising. Although this list is published openly, it does run about 1-2 years behind.

COCAINE………………………..OVER 448,000

MARIJUANA……………………..OVER 242,000

HEROIN………………………….OVER 164,000

meth-1.pngMETHAMPHETAMINE…………..ALMOST 109,000

ECSTASY (mdma)……………..ALMOST 11,000

PCP………………………………OVER 7500

INHALANTS……………………..OVER 4300

HALLUCINOGENS……………….OVER 3700

LSD………………………………OVER 1800

GHB………………………………OVER 1800

This data is from a reporting system in the United States. Many times, GHB for instance, is gone from detection upon arrival to an Emergency Room. Many inhalants cause death, therefore do not show up in the Emergency Room, but rather the Coroner’s venue. Many times the data is also regionally directed, for instance, in high methamphetamine areas, illicit use might be seen higher in the corresponding Emergency Departments.

To round out this medical commentary today, the United States still has these top ten killers. ecg_evol1.gif

This data is from the 2004 National Center for Health Statistics, the latest full database.  Prevention is the key in almost all of these killers.  With the severe childhood obesity concern in the United States, these data may get thrown in the air, with new issues on top.  For instance, diabetes and asthma may replace the first and second positions due to the issues of childhood health management in general.

HEART DISEASE……………………………………………………………………………27.2%

CANCER…………………………………………………………………………………23.1

CEREBROVASCULAR DISEASES…………………………..6.3%

CHRONIC LOWER RESPIRATORY DISEASES…………5.1%

UNINTENTIONAL INJURY…………………………..4.7%

DIABETES MELLITUS……………………………..3.1%

ALZHEIMER’S DISEASE………………………2.8%

INFLUENZA AND PNEUMONIA……2.5%

KIDNEY DISEASES……………….1.8%

SEPTIC CONDITIONS……….1.4%

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