Andrea Rubinstein

Anesthesiologist, Pain Physician and Researcher. Speaker on opioids safety and efficacy.. Passionate proponent for #buprenorphine for pain

[Andrea Rubinstein @rubinsteinmd]

A rare opportunity for LCSW/MFT to join a world class multidisciplinary pain team that includes MD/PT/RN/PharmD psychologist/ acupuncture in the heart of the California Wine country with Kaiser Permanente. DM me

[Andrea Rubinstein @rubinsteinmd]

@UCDavisPain @UCDavisHealth @UCDavis_CAPR @ScottPritzlaff @RaviPrasadPhD @RNalamasuDO @sjsheth1204 I have had the privilege and honor of co-leading a talk with Rebecca Hoss for @ucdavis train the trainer program. She is nothing short of amazing and a huge asset to the UC Davis Pain Program. S

[Andrea Rubinstein @rubinsteinmd]

DHL sucks. My package went Paris to San Francisco in 3 days. Now it has been In Francisco for 10 days. They are awful on the phone horrible. But they did tell me if the package is a wedding dress or documents they will get it to me tomorrow. Otherwise it is the 11th.

[Gurwinder @G_S_Bhogal]

My peoples, the time has come for a MEGATHREAD.

In 40 tweets I will explain another 40 concepts you should know.

Strap in. Here we go:

[Andrea Rubinstein @rubinsteinmd]

If you live in #CathedralCity you might be interested to know your city council woman Rita Lamb just had her 4th property busted for illegal cannabis cultivation in the high desert.

[Andrea Rubinstein @rubinsteinmd]

@DrMelissaWeimer @suenlw @CarolynAChan @leyde_sarah @AMERSA_tweets @StefanKertesz I guess i am confused about the advantages of methadone, a QT prolonging opioid with multiple half lives and complex pharmacokinetics over virtually any other opioid as a bridge to being opioid free

[Andrea Rubinstein @rubinsteinmd]

@DrMelissaWeimer @suenlw @CarolynAChan @leyde_sarah @AMERSA_tweets @StefanKertesz Methadone may make it easier to get off a fentanyl drip, but my no means are they off opioids at discharge if they are discharged on methadone. How now do they get off methadone?

[Andrea Rubinstein @rubinsteinmd]

@Loura_Stories @davidthekick @deedeestoutHRR Actually buprenorphine was developed in the 1960’s for pain. It was only reluctantly brought to market to treat opioid use disorder.

[Andrea Rubinstein @rubinsteinmd]

@Loura_Stories @davidthekick @deedeestoutHRR Actually the brain cant tell whether the opioid you use was obtained legally or illegally. I work with patients who have been prescribed opioids for many years and work to get them off. Many do get off but some just can’t. For these people buprenorphine is often the best.

[Andrea Rubinstein @rubinsteinmd]

@Loura_Stories @davidthekick @deedeestoutHRR Also, the definition of addiction is 1. Inability to control, use, 2. Continued use despite adverse consequence. Using buprenorphine as prescribed is neither of these. Physical dependence does not equal addiction.

[Andrea Rubinstein @rubinsteinmd]

@HillPharmD @AACPharmacy In the non-fee for service world, we rely heavily on PharmDs to do a myriad of essential patient care. From tapering opioids to managing Coumadin, osteoporosis and so much more. This is 21st century medicine.

[Andrea Rubinstein @rubinsteinmd]

@ACLakeMD I have wondered this too. My neighbor, who has lymphoma and AIDs said that within the HIV community they are not seeing as much COVID as they would have expected. Not an expert in this area at all, just interesting.

[Andrea Rubinstein @rubinsteinmd]

This is wonderful. Everyone who cares for patients who have an opioid use disorder really needs to be able to prescribe buprenorphine for the appropriate patient. #buprenorphine #primarycare #MedTwitter

[Kitae (Tye) Chang @tyechang]

This is a huge win! Graduating or already graduated M4s consider investing 8 hours of your time to obtaining your DATA2000 waiver - enables you prescribe #buprenorphine

#MedStudentTwitter #MedTwitter

@StefanKertesz @DrSarahWakeman

[Andrea Rubinstein @rubinsteinmd]

@StefanKertesz Amen. Next year.... anywhere and I am good.

[Andrea Rubinstein @rubinsteinmd]

@StefanKertesz California has eased rules on methadone and buprenorphine treatment allowing telephone or video visit in place of in person visit for the start of these medications.

[Andrea Rubinstein @rubinsteinmd]

@rpjpac @JeffreyFudin This is not our experience at all. We find that if we just ask “hey would you like to reduce your dose if we could do it comfortably and without increasing pain or decreasing function (which we can) over. 90% of patients say “sure.”

[Andrea Rubinstein @rubinsteinmd]

@rpjpac @JeffreyFudin Why taper? Or why have pharmacist do it? Our tapers are patient driven and are not arbitrary. Many people want to lower their doses if they can achieve good pain control with fewer risk and side effects. Pharmacists are perfect for this.

[Andrea Rubinstein @rubinsteinmd]

@rpjpac @JeffreyFudin As chief of a department of pain medicine, I can say I depend on my clinical pharmacist daily as does the rest of our team. Our patients really like working with him and he handles the vast majority of our opioid tapers.