FAQs: Physician’s Assistants

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Hello, my name is Louis Fisher. I was with the Drug Enforcement Administration for 31 years. Now retired, I refuse to see my country go the way of opioid pills and heroin without a fight.

What is IntegraMedical of North Carolina?

IntegraMedical of North Carolina is a company committed to addressing heroin and prescription opioid abuse and dependency in rural and underserved communities throughout North Carolina.

Why are you looking for physician’s assistants?

Physician’s assistants currently may not prescribe buprenorphine, but are a crucial and integral part of our plan. It is our PAs who will have direct patient contact; they will perform the initial physical examination and evaluation of each patient, in conjunction with a synchronous telemedicine visit with a physician. Once a patient is enrolled in our program, our PAs will perform follow-up patient visits, scheduled every 28 days, and will generate a report of that encounter for the physician’s review via asynchronous telemedicine.

How many physician’s assistants do you need?

At full capacity, we anticipate needing at least two PAs per mobile unit during the first year to cover our projected patient population. Please encourage your colleagues to sign up!

Is this a full-time job?

Yes, our PAs are full-time employees of our company. Our generous, comprehensive compensation package acknowledges the efforts of our employees.

What is medication-assisted treatment (MAT)?

Medication-assisted treatment (MAT) is the treatment of heroin or opioid dependency or addiction with buprenorphine. Brand names of buprenorphine include SubutexButrans, BelbucaBuprenex; brand names of buprenorphine in combination with naloxone include SuboxoneZubsolv, and Bunavail.

What is buprenorphine and how does it work?

Buprenorphine is an opioid partial agonist. This means that, like opioids, it produces effects such as euphoria or respiratory depression. With buprenorphine, however, these effects are weaker than those of full agonist drugs such as heroin and methadone.

Buprenorphine’s opioid effects increase with each dose until, at moderate doses, they level off, even with further dose increases. This “ceiling effect” lowers the risk of misuse, dependency, and side effects. Also, because of buprenorphine’s long-acting agent, some patients may not have to take it every day.

What is naloxone?

Naloxone is added to buprenorphine to decrease the likelihood of diversion and misuse of the combination drug product. When these products are taken as sublingual tablets, buprenorphine’s opioid effects dominate and naloxone blocks opioid withdrawals. If the sublingual tablets are crushed and injected, however, the naloxone effect dominates and can bring on opioid withdrawals.

Isn’t treating addiction with buprenorphine just trading one addiction for another?

Absolutely not! Opioid addiction is a chronic disease, the same as diabetes and asthma are chronic diseases. Treating a disease with medication is a common practice, with the ultimate goal being to control the disease and to prevent a relapse.

Will a patient have to take buprenorphine forever?

In some cases, yes, the same as a diabetic has to take his or her medication forever. Some patients, though, do enter treatment with the ultimate goal of completely eliminating opioids from their life. With proper care, these patients can achieve that goal.

Who should be treated with buprenorphine?

The ideal candidate for opioid dependency treatment with buprenorphine:

  • Has been objectively diagnosed with an opioid dependency
  • Is willing to follow safety precautions for the treatment
  • Has been cleared of any health conflicts with using buprenorphine
  • Has reviewed other treatment options before agreeing to buprenorphine treatment

 

Some of the information included on this page was taken from the SAMHSA website.

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