At initiation of buprenorphine treatment, approximately 21% (1,343 patients) were prescribed 8 mg, 50% (3,264 patients) 16 mg, and 10% (668 patients) 24 mg. stomach pain. Sublingual preparation conversions. Youngstown, OH 44515. Buckeye Clinic is a buprenorphine clinic in Columbus, Ohio. 35 Behavioral health integration and group visits can enhance this model but. com. It is covered by some Medicare and insurance plans, but some pharmacy coupons or cash prices may be lower. L Ö × d È È IsÈ «È. Therefore, this list is not inclusive of all practitioners able to prescribe buprenorphine. Naloxone reversal of buprenorphine-induced respiratory depression. Feeling dizzy or a sensation of spinning (vertigo) Confusion. 7 mg naloxone, 6. Managing opioid withdrawal precipitated by buprenorphine with buprenorphine. It belongs to a group of medications called opioids. The pharmacology of buprenorphine increases the risk of a precipitated opioid withdrawal when commencing patients on. Buprenorphine is an opioid partial agonist. Buprenorphine comes in different forms, including under-the-tongue products, skin patches, and injections. Section 1262 of the Consolidated Appropriations Act, 2023 (also known as Omnibus bill), removes the federal requirement for practitioners to have a DATA 2000 waiver (“x-waiver”) or submit a Notice of Intent to prescribe medications, like buprenorphine, for the treatment of opioid use disorder (OUD). Find practitioners authorized to treat opioid dependency with buprenorphine by state. Buprenorphine is a partial opioid agonist that relieves opioid withdrawal symptoms and cravings for 24 hours or longer. While there is no agreed-upon threshold for “low” values, the. Medications like methadone and buprenorphine (Suboxone) can help prevent the symptoms of hydrocodone withdrawal and make recovery easier. It is a Schedule III drug, which means that it has some potential for moderate or low physical dependence or high psychological dependence. buprenorphine 300mg and were released from the research clinic one hour after the injection. buprenorphine for a stable patient provided in a certified OTP, including medication and twice-weekly visits: $115. 1. 09. Apply to Nurse Practitioner, Psychiatric-mental Health Nurse Practitioner, Recovery Coach and more!17 Buprenorphine jobs available in Worldwide USA on Indeed. 30. rapid breathing. 13228. 00 per year. Buprenorphine injection is used to relieve moderate to severe pain. Buprenorphine is a weak partial mu-opioid receptor agonist and a weak kappa-opioid receptor antagonist used for the treatment of severe pain. quantitative urine buprenorphine and norbuprenorphine levels in office-based clinical practice. In a double-blind, randomized study 12 that examined the effectiveness of buprenorphine. We strongly recommend that, 5-7 days before your surgery, you transition from buprenorphine to another long-acting opioid. Buprenorphine is a Schedule III opioid analgesic with unique pharmacodynamic and pharmacokinetic properties that may be preferable to those of Schedule II full μ-opioid receptor agonists. LC Chambers, et al. Learn More. Al-Tawil and associates collected plasma samples during 5 µg/h BUP transdermal patch dosing. warning: addiction, abuse, and misuse: risk evaluation and mitigation strategy (rems); life-threatening respiratory depression; accidental exposure; neonatal opioid withdrawal syndrome; and risks from concomitant use with benzodiazepines and other cns depressantsHypersensitivity to buprenorphine or any other ingredients in BRIXADI. Avoid discontinuation or holding of > 16 mg/day Suboxone, Subutex, < 16 mg/day Suboxone, Subutex, buprenorphine doses. 02, which is 88% off the average retail price of $300. It describes addiction and withdrawal, how buprenorphine works, its proper use, its side effects, and how it fits with counseling in the recovery process. Buprenorphine can be initiated in untreated patients with OUD and acute pain in the perioperative setting to decrease the risk of opioid recurrence and overdose death. It’s considered the gold standard for. Sublocade is another brand of buprenorphine injection used to treat opioid addiction. These findings highlight the imperative for. Each buprenorphine injection slowly releases the drug into your body over a month. S. The drug is long-acting, works slowly, and, similar to methadone, helps prevent the intense cravings and with-drawal symptoms associated with opioid use. (A DATA waiver (X-waiver) is no longer needed to prescribe buprenorphine. These figures assume you are using. [ 44]Buprenorphine for pain Brand names: Butec, Buvidal, Espranor, Suboxone, Subutex. The Biden administration says new federal guidelines released Tuesday will allow far more medical practitioners to prescribe buprenorphine, a drug proven to reduce opioid. Urine drug screens may also be used in criminal justice and child protection settings. Buprenorphine Practitioner Locator. 6%, p; 0. Buprenorphine is a partial agonist acting at the mu‐opioid receptor with high receptor affinity. The clinic induction was discontinued due to the degree of the patient’s distress secondary to these symptoms. Equianalgesic oral morphine dose for pain . Buprenorphine, a semi-synthetic opioid, was first developed in the 1970s as an analgesic with parenteral. Van Dorp E , Yassen A, Sarton E, Romberg R, Olofsen E, Teppema L, et al. Sublingual buprenorphine to oral morphine 12 13. 3. F. Suboxone, a branded version of buprenorphine and naloxone, is used to treat opioid addiction. Withdrawal symptoms from methadone can increase dependence on the medication. R. From 1997 to 2012, the annual incidence proportion of youth (age 15-19). 1093/pm/pnz356. A limited understanding of testing can negatively influence UDS interpretation and clinical decision making. Of the people who started buprenorphine at the mobile clinic, 56% remained in treatment one month after starting and 26% at three months. [3]Search the for Website expand_more. Buprenorphine skin patches are packaged in sealed pouches. Transdermal patch. Suboxone™, SL tab. 223. During the study period, the mobile clinic served 569 people—of these, about 74% received prescriptions for buprenorphine and 70% were tested for at least one infectious disease. Buprenorphine is not the same as Suboxone; Suboxone is a two-ingredient drug used to treat opioid dependence. Pain Management Guidelines A guide from the Tennessee Department of Health on clinical practice guidelines for outpatient management of chronic pain. It has antagonist activity at kappaBuprenorphine (Butrans) is an expensive drug used to treat moderate to severe pain. Transdermal buprenorphine to subcutaneous morphine or oxycodone infusions 12 12. 001. Buprenorphine patches may cause side effects. 52. buprenorphine 10 microgram/hour patch, 2. The advantages and disadvantages of buprenorphine (Suboxone, Subutex, Zubsolv, Probuphine, Sublocade) Buprenorphine is a partial opioid agonist medication. Buprenorphine treatment is associated with decreased mortality and morbidity, 1 yet the treatment gap remains wide. Conclusions: This study supports previous anecdotal reports of buprenorphine-precipitated withdrawal from fentanyl. Buprenorphine: Unlike methadone, which is a “full” agonist, buprenorphine is a partial agonist (partially binding to opioid receptors in the brain). We reviewed the medical records of 281 patients living in halfway houses and treated at an office-based buprenorphine MAT clinic following a diagnosis of OUD between July 1, 2018 and June 30, 2019. Conflict of Interest Disclosures: Dr Compton reported having stock holdings in General Electric, 3M, and Pfizer outside the. Headaches. She has emerged as a. Each transdermal patch contains 10mg of buprenorphine in a patch size of 12. UPDATE: This story was updated on May 23, 2022 to remove a trade name associated with buprenorphine. Select a state from the map or use the dropdown lists to view practitioners by city, state or zip code who previously held a DATA-2000 waiver to prescribe buprenorphine for the treatment of opioid use disorder (OUD). Buprenorphine can be used for detoxification or. The authors discontinued oxycodone for a period of time and then discontinued morphine. In an effort to get evidenced-based treatment to more Americans with opioid use disorder, the Department of Health and Human Services (HHS) is releasing new buprenorphine practice guidelines that among other things, remove a longtime requirement tied to training, which some practitioners have cited as a barrier to treating. Buprenorphine is a semi-synthetic opioid derived from thebaine, a naturally occurring alkaloid of the opium poppy, Papaver somniferum. Buprenorphine is an opioid agonist used to treat opioid dependence OR for treatment of moderate-to-severe pain. counties did not have a single doctor or clinic who prescribed buprenorphine. Target dose: 16 mg sublingually once a day; range 4 to 24 mg/day. 00 2. 1988 Aug;32(6):490–2. The NP or PA is contracted into the MCO’s enhanced buprenorphine MAT Provider Network. Buprenorphine (brand names: Buprenex®, Simbadol®, Belbuca®, Vetergesic®, Buprenodale®, Sublocade®, Suboxone®, Subutex®, Temgesic®) is an opioid analgesic used to treat pain, or is used as a preanesthetic in the hospital or clinic setting. Buprenorphine is a partial mu-opioid agonist which is commonly utilized to treat patients with opioid-use disorders. The lowest BuTrans dose (BuTrans 5 microgram/hour transdermal patch) should be used as the initial dose. For the full list of excipients, see Section 6. com. We followed the patients who were enrolled in the buprenorphine substitution treatment for a period of five years, to be more precise in the period from May 2017 August 2022. nausea, vomiting, constipation; headache, back pain; fast or pounding heartbeats, increased sweating; or. covers opioid use disorder treatment services in opioid treatment programs. Doctors and advocates are concerned a federal proposal to roll back a pandemic policy allowing remote. Buprenorphine is a partial mu -opioid-receptor agonist with applications for the treatment of chronic pain and OUD. These common side effects of buprenorphine happen in more than 1 in 100 people. To apply a patch, follow these five simple steps: Wash your hands with soap and water. Introduction. The Facts about Buprenorphine for Treatment of Opioid Addiction This brochure informs patients about buprenorphine and medication-assisted treatment for opioid use disorder. S. 1 Buprenorphine has an improved side effect profile compared with several other full-opioid agonists. Buprenorphine prolonged-release injection (Buvidal) is licensed for treating opioid dependence within a framework of medical, social and psychological treatment in people aged 16 years and over. Transdermal patches are available in strengths of 5, 10, 15 and 20 micrograms/hour as 7-day formulations; and 35, 52. 200 microgram . Though each drug is often dosed once daily for addiction, their analgesic effects last only six to eight hours. 800. 1,2 With a total of 50 042 lives lost in 2019 because of opioid overdose deaths, projections. The higher strengths of this drug (7. 0. Buprenorphine extended-release (long-acting) injection comes as a solution (liquid) to be injected subcutaneously (just under the skin) by a health care provider into the stomach area. Buprenorphine affects everyone differently. 22. Buprenorphine injection is used to relieve moderate to severe pain. Transdermal buprenorphine to oral morphine 10 11. 3 mg buprenorphine with 1 mg naloxone. Buprenorphine is an essential treatment for opioid use disorder (OUD). 5) as well as to the current general condition and medical status of. The halfway house staff closely monitored the patients’ medication intake; therefore, the residents were less likely to be non-compliant. Prescribing buprenorphine for opioid use disorder just got easier. 85, which is 70% off the average retail price of. Site visitors can search for physicians authorized to provide OUD treatment with buprenorphine. 26 Buprenorphine jobs available in Trainer, PA on Indeed. Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain. Scenario 1: The values tell us that buprenorphine has been taken recently, but we cannot draw conclusions about the amount taken. Buprenorphine is used to help relieve severe ongoing pain. Buprenorphine is a partial opioid agonist commonly used to treat opioid dependence. 1 Buprenorphine has an improved side effect profile compared with several other full-opioid agonists. New Season Treatment Center – Akron. 2020 Apr 1;21 (4):714-723. Drug Alcohol Depend 2017;180:46–51. • Buprenorphine is long acting. Following buccal administration (placed in the cheek area to dissolve) buprenorphine is detectable for up to 140 hours (about 6 days). skin irritation, itching, swelling, or redness in the area where you wore the patch. or is using the registration of a hospital or clinic operated by a department or agency of the United States a registered under Section 823(f). Mentor Metro Treatment Center provides opioid addiction help. 4 60 mgBuprenorphine. At that point, the full opioid agonist is stopped. loss of bladder control. It is available as an injection (including brand names Buprenex® and Sublocade®), an oral film that dissolves in the mouth (Belbuca®), and a patch worn on the skin (Butrans®). belbuca® (buprenorphine buccal film), ciii . Buprenorphine administration dose-dependently increases buprenorphine plasma concentration and occupancy of brain mu-opioid receptors (MORs) that translate into beneficial clinical outcomes. Buprenorphine or buprenorphine/naloxone, a prescription drug, also referred to as "Bupe", helps people to stop using heroin or other opioid drugs. Approximately $889,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds. 1600-0536. com. 50 per month or $14,112. Akron, OH 44313. It is available in a number of dosage forms under the brand names Belbuca, Brixadi, Buprenex, Butrans, Probuphine (discontinued), Sublocade, and Subutex (discontinued). One of the major issues of concern is the potential to overdose on one of the drugs as a result of taking two drugs that have different mechanisms of action. Choose a place where the skin is not very oily and is free of scars, cuts, burns, or any other skin irritations. Step 2. A list of Suboxone (buprenorphine) prescribers and treatment programs in Ohio. Sublingual tablet (under the tongue): 0. sleep problems ( insomnia ). After the engineering of a sublingual (noninjectable) delivery system, buprenorphine was approved for the treatment of. Suite A. Available in 2/4/8/12mg buprenorphine doses. After putting the lives of thousands of addicts back on track over a period of 32 years, the Gurdaspur Red Cross De-addiction Centre is on the verge of closure following an acute shortage. EMIT assays for testing drugs of abuse. These drugs are made with long-acting opioids that prevent withdrawal without getting you high. 2 Many patients with OUD also suffer from pain. 4 mg buprenorphine with 0. Get Directions. Some side effects may be easy to manage, too. For the full list of excipients, see section 6. In a QT study in healthy subjects, therapeutic doses (10 mcg/hour transdermal patch) had no effect on the QTc interval, but higher doses (40 mcg/hour) were. 5 Despite buprenorphine being the most accessible form of medication for OUD in the US, under current federal law, it can only be prescribed in office-based settings by clinicians with a. Naloxone is a pure opioid antagonist that blocks opioid receptor sites. 1. headache or dizziness. Cleveland Clinic is a non-profit academic medical center. Who can and cannot use it. open 24 Hours. Medication for Opioid Use Disorder (MOUD) refers to the use of medication to treat opioid use disorder. 5 mL modified release injection, 1. com. 00 32. BUPRENORPHINE treats opioid use disorder. skin reactions, if you are using a buprenorphine patch. However, if the patient was already taking ≥120mg morphine orally or equivalent, the 52. It works in the brain to change how your body feels and responds to. 12 x 75) = 9mg oral morphine / day (total conversion = (dose x24) x 75 / 1000) = dose x 1. 6. Remove the adhesive liner from the patch. S. When taken as prescribed, buprenorphine is safe and effective. To prevent constipation, eat dietary fiber, drink. Its use in dogs, small mammals, large animals, and sometimes cats to treat pain is ‘off label. BuTrans should be administered every 7th day. 1). Articles Find articles in journals, magazines, newspapers, and more; Catalog Explore books, music, movies, and more; Databases Locate databases by title and description; Journals Find journal titles; UWDC Discover digital collections, images, sound recordings, and more; Website Find information on. 35mcg/hr. Payment. Currently, buprenorphine formulations for the treatment of opioid use disorder (OUD) include an implant, as well as oral formulations combined with an opioid antagonist, naloxone. Here’s what you need to know about the new practice guidelines. Rahul Gupta, the director of the White House’s Office of National Drug Control Policy, said in an interview that about 130,000 health. Tell your doctor if any of these symptoms are severe or do not go away: difficulty falling asleep or staying asleep. acute pain. It also stays attached to those receptors for longer, which means it has a prolonged effect. [14] It can be used under the tongue (sublingual), in the cheek (buccal), by injection ( intravenous and subcutaneous ), as a skin patch (transdermal), or as an implant. A breastfeeding mother taking sublingual buprenorphine maintenance 4 mg daily during pregnancy and lactation had milk samples collected 6 times over the course of a day at 4 weeks postpartum. Sunshine and clouds mixed. lightheadedness, dizziness, or fainting. Buprenorphine, a synthetic opioid, treats pain, and opioid use syndrome. 2. Rural Health Clinics (RHCs) can still apply for a $3,000 payment on behalf of each provider who trained between January 1, 2019, and December 29, 2022 (when Congress eliminated the waiver requirement). INTRODUCTION. Posology. There are things you can do to help cope with them: Constipation. Medications used in the treatment of withdrawal symptoms include opioid agonists such as methadone and buprenorphine (a partial agonist), as well as alpha-2 adrenergic agonists such as clonidine and lofexidine. Findings In this systematic review of 22 studies that addressed prespecified outcomes of rotation to buprenorphine, low. May be prescribed for OUD from clinic if provider has X-number, and appropriate resources, or without X-number off-label for pain (if pharmacy will fill this way). But if side effects last for a longer time, or if they bother. (OHSU) The clinic, which prescribes buprenorphine, remains focused on maintaining ease of access, said senior author Bradley Buchheit, M. It is also used in patients who have received treatment with an oral form of buprenorphine that is placed under the tongue or inside the cheek for 7 days, followed by an adjustment in the dose for at least 7 days. Consumers. dry mouth. The FDA defines an opioid-tolerant patient as receiving for 1 week or longer at least 60 mg oral morphine/day or an equianalgesic dose of another opioid. Other pharmacologic benefits of buprenorphine are its superior. Within 30-45 minutes patients will be much more comfortable. However, Suboxone is not used to treat pain. The panel also provided clinical recommendations on the appropriate use of buprenorphine and conversion. Buprenorphine is a first-line treatment for opioid use disorder (OUD) that decreases all-cause mortality [] and expansion of buprenorphine treatment is associated with a decline in heroin overdose deaths []. com. 30. CDC’s National Center for Injury Prevention and Control has compiled a data file of opioid analgesic medications by National Drug Code (NDC) to help with analyzing population-level opioid prescription data. Any attenuation of buprenorphine’s effects by co-administered naloxone would therefore likely be short-lived. 5 and 2 mg respectively (to deter injection drug use). 3. Buprenorphine is a DEA Schedule III medication. This is not a complete list of side effects and others may occur. Only 1 in 8 offer buprenorphine for ongoing treatment. In 2015, buprenorphine was approved as a film to be placed inside the cheek to treat pain. Therefore, continuation of once-daily outpatient dosing for OUD alone is not sufficient for acute pain management. Buprenorphine belongs to the group of medicines called. 51 Morphine Milligram Equivalent Prescribed Over Time Last 2 Years 78. Buprenorphine is a sublingually and transdermally available, semisynthetic opioid analgesic, which is used as an analgesic and for management of opioid dependence. Results. Suboxone Treatment Centers in Mentor Get an appointment at the best Suboxone treatment centers in Mentor OH nearest to you in just minutes, without any hassle. This medicine is available in 3 different strengths and patch sizes. Buprenorphine has a half-life of 24–60 h with other clinical effects such as analgesia and euphoria lasting at least 6 h. Call your doctor for medical advice about side effects. fatigue, weakness, numbness. • Buprenorphine: o is efficacious as. In 2015, buprenorphine was approved as a film to be placed inside the cheek to treat pain. 4% for sublingual buprenorphine/naloxone tablets; treatment difference 6. Am J Med 1998 ;105: 100 - 105 CrossrefThis brochure informs patients about buprenorphine and medication-assisted treatment for opioid use disorder. dizziness. skin reactions, if you are using a buprenorphine patch. It is used to treat opioid use disorder. 002Deaths from opioid-related overdose have remained at epidemic levels for more than a decade without a clear solution in reach. Winds SSE at 10 to 15 mph. (2) Comply with all federal and state laws and regulations governing the prescribing of the. ( 30355476) The MOTHER trial showed that buprenorphine use in pregnancy causes less neonatal abstinence syndrome compared to methadone. It is therefore available as sublingual tablets. It is available in both brand and generic versions. These findings highlight a significant gap in access to evidence-based addiction treatment. iii Buprenorphine products are listed but do not have an associated MME conversion factor. 02, which is 88% off the average retail price of $300. Buprenorphine can be used for detoxification or. The safe use of buprenorphine requires close communication with your healthcare provider. A 2020 Department of Health and Human Services Office of Inspector General report found 40% of U. Background and objectives: Individuals exposed to fentanyl are at risk of precipitated withdrawal using typical buprenorphine/naloxone induction procedures. “You can’t inject a horse. This leaflet was last updated in September 2022. The drug is used to relieve pain and increase feelings of euphoria in cats. Zubsolv®. Myth #2: People frequently misuse Suboxone. Buprenorphine is an excellent home pain relief management option for cats. The effects of buprenorphine last for 24 to 36 hours. Buprenorphine was first approved for medical use in the. The transdermal delivery system (TDS) containing it has skin irritation potential, but at least two cases of contact allergy to the active principal have. Buprenorphine is a mixed agonist-antagonist with high affinity at both mu and kappa opiate receptors. AP. 58% of reviewers reported a positive effect, while 26% reported a negative effect. A positive experience with buprenorphine can be a motivation to come back or to pursue long-term treatment after a return to use. e. Initially, the only available buprenorphine product in the. 50 0. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins. Publication Date. Approved for clinical use since 2002, both buprenorphineand Suboxone are medications used as part of a comprehensive treatment plan that includes counseling and participation in social support programs. Apply to Nurse Practitioner, Psychiatric Nurse, Family Nurse Practitioner and more!Search the for Website expand_more. 223,224,225 Other research has. fatigue or drowsiness (especially soon after a dose) loss of appetite, nausea and vomiting. 2. It has also been used to treat pain. In April 2020, SAMHSA exempted OTPs from the requirement to perform an in-person physical evaluation (under 42 C. 1016/j. Consideration should be given to the previous opioid history of the patient (see section 4. Suboxone contains a mix of buprenorphine and naltrexone, an opioid antagonist. Both have. 3 Pharmaceutical Form. Because its effects are long-lasting, it can be taken once a day to relieve cravings,. Methadone is more addictive than Suboxone. 8-16 mg • For buprenorphine the equianalgesic dose of oral morphine is listed . While there is no agreed-upon threshold for “low” values, the. Buprenorphine 5mcg / hr X 1. The panel also provided clinical recommendations on the appropriate use of buprenorphine and conversion. However, it activates the mu- opioid receptor to a lesser extent than the full opioid agonists (for example: oxycodone, methadone or morphine). We are a multi-disciplinary outpatient practice that specializes in Dialectical Behavioral Therapy (DBT). Reality: Suboxone, like any opiate, and many other medications, can be misused. Contents of the pack and other information. In 2016, there were 42,249 opioid-overdose deaths in the United States, a 28% increase from the previous year. Each listing includes contact information (address, phone number, website). The prevalence of synthetic drugs is undercutting a previously effective and widely embraced treatment tactic. Do you need pain management 24/7? Learn about OXYCONTIN® (oxycodone hydrochloride extended-release tablets), a prescription opioid medication for moderate to severe chronic pain. The same can be said of India. In the fall of 2019, Oregon Health & Science. Step 2: The sticky side of the patch is covered with a silver, protective foil. com. Buprenorphine is a partial agonist acting at the mu‐opioid receptor with high receptor affinity. Buprenorphine is a partial mu -opioid-receptor agonist with applications for the treatment of chronic pain and OUD. 10 While relapse is a normal step on the path to recovery, it can also be life threatening, raising the risk for a fatal overdose. OTP Directory. buprenorphine treatment program. Sublingual preparation conversions . Call Today! (440) 253-9915. 5mg and 1mg doses needed for the induction protocols. The test results reported in Table 1 can be interpreted as follows: . Emergency departments (EDs) offer an. 85% of reviewers reported a positive effect, while 5% reported a negative. QUICK START GUIDE &ª»±¾Ès«È I± «È ȱ. S. Suboxone, a branded version of buprenorphine and naloxone, is used to treat opioid addiction. 1093/pm/pnz356. :U Integrate pharmacologic and nonpharmacologic therapies All medications for the treatment of theThe induction onto buprenorphine for opioid-use disorder remains fraught with barriers, such as the need to experience opioid withdrawal. It has also been used to treat pain. 7 out of 10 from a total of 1106 ratings on Drugs. Buprenorphine has a unique method of action: it is a partial agonist of mu opioid receptors and an antagonist of kappa and delta opioid receptors (). Apply to Nurse Practitioner, Recovery Coach, Specialist and more!Each transdermal patch contains 5 mg of buprenorphine in a 6. 7%, 95% confidence interval (CI) −0. Corresponding Author: Wilson M. fatigue or drowsiness (especially soon after a dose) loss of appetite, nausea and vomiting. Summarize interprofessional team strategies for improving care coordination and. Rule 4731-33-03.