Keep an eye out for Kadian prescriptions for your opioid-use disorder patients.
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1. Counselling Conundrum: a real question from a patient
2. Concise Conclusion: a straight-forward patient-friendly answer
3. Quick Wrap-up
Clearly, there are nuances that may not be captured in this format. The goal here is to provide you with helpful counselling tips which often draw from multiple sources or those which are not commonly accessed by busy healthcare providers serving the community.
Counselling Conundrum: "How many doses can I miss of my Kadian before I need to see my doctor? I know for my methadone I have to see my doctor again after I've missed 3 doses."
Concise Conclusion: You're right, however for Kadian you will need to see your doctor sooner; after 2 days of missed doses.
Quick Wrap-up: There's a recent trend with "slow-release morphine" AKA "SROM", most commonly known as Kadian, being used with methadone or buprenorphine/naloxone. This can be useful if either of the latter options have been ineffective or if it's in severe opioid use disorder. We stick with 24-hour formulations to minimize diversion/misuse, and do NOT recommend crushing/chewing/dissolving it before dosing (typically the capsule's granules are opened in a separate cup and given alongside methadone or by itself). Once 2 doses are missed, the patient needs to be reassessed and often a 40% dose reduction is needed.
Dive Deeper
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