Intranasal stadol for RFA patient who had been detoxed from opioids. Works fine, high incidence of nightmares and some get headaches. IV stadol is excellent due to sedation and analgesia w/ minimal respiratory depression.
Stadol is useful as a reversal agent when using large doses of opioids. It used to be marginally useful as a narcotic in a patient who has trouble swallowing pills, but was supplanted by opioid patches.
unlike the other partial agonist-antagonist buprenorphine, still carries risk of abuse, dependency. a lot more psychological concerns because of k-opioid receptor activity.
only really good use is probably IV, in the OB suite...
I had to call the police once on a patient hooked on intranasal stadol for headache ( prescribed elsewhere). She sent her husband to wait for me in the parking lot to try to convince me to renew it for her. Not the first HA patient I met who was hooked on Stadol
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