Who Is Nadine and Why Do I Need Her Number?

Ukrainian art from ETSY – by Dmitry

“Babe, remind me what your Nadine number is?” yelled my husband, who has a Master’s degree in Addictions Counseling, provides counseling for all of my own office-based buprenorphine patients, does patient scheduling, takes payments, reads drug screens, and takes random pharmacy calls.

That last chore is by far the most vexing.

Regular readers of my blog will recall my mystification when I first learned of NADEAN (pronounced “Nadine”), which stands for Narcotic Addiction Drug Enforcement Administration Number. I posted a blog about this on March 1, 2020.

So now, a CVS pharmacist was calling my office to get my NADEAN information. I had typed it onto the prescription in my electronic medical record, but probably didn’t get the format just right. My husband, because the pharmacist told him so, thought Nadine was a separate and special number but it is not. It’s just the usual DEA “X” number typed in a special format.

I see office-based patients at two locations. One is at the opioid treatment program, and I use a completely different software system called Rcopia. That system automatically enters NADEAN:XB1234567 (obviously not my real DEA number) on all buprenorphine-containing prescriptions. The system I use in my own office does not have that feature.

Only CVS pharmacies have the peculiar NADEAN format requirement. I asked my husband to please see if we could switch vendors, so that CVS pharmacists would stop calling about Nadine.

But we discovered Rcopia costs significantly more than my present system. I’m basically cheap, and I run a very lean office so I can charge my patients the lowest rate in town. I’m going to stick with my cheap-ass electronic medical prescribing system, and I’m trying to accept that I will be talking about Nadine with CVS pharmacists for the foreseeable future.

Our next phone call was about a patient who has tapered down to .5mg of buprenorphine per day. I prescribe buprenorphine/naloxone 2/.5mg films for him, and he cuts these into eighths. He takes two eighths per day, for a total of a half milligram per day. I prescribe eight films per month, which is technically a half film too much, but since I can’t prescribe a half a film, I round up.

His pharmacist called me recently, worried he was taking too much because he was asking to fill the prescription two days early.

I asked her to please go ahead and fill the prescription, as I wasn’t worried this patient was taking too much. I am pleased to say I refrained from any sarcastic humor, in the interest of having better relationships with all pharmacists.

I’m trying to be more collegial to all fellow healthcare professionals to reduce my stress and discord.

I’m also going to be taking a short break from blogging but I’ll be back next month.

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