It has been a while, it seems, since I’ve checked in. I’m at the point in the life cycle of a ‘blogger’ where I feel like I’ve said most of what I came here to say… so help me out by sending your questions, particularly those with broad implications, and Read more…
Below is an e-mail that I changed just enough to hide the person’s identity. Every week, I receive messages that describe similar situations. My husband has struggled GREATLY with substance abuse since in his 20’s; he is now in his mid-40’s. He is the kindest sweetest man and he is Read more…
A recent experience with a patient helped me realize some of the dramatic differences in the treatment of relapse in an era of buprenorphine. I drug-test patients who are treated with buprenorphine or Suboxone. The point of testing is not to catch someone messing up, but rather to determine when Read more…
I received the following e-mail a couple days ago: Hi I had been on Suboxone for 9 years. I was put on it the week it was approved by FDA. I found your posts in a blog. I was looking for a class action suit against this terrible drug. That Read more…
Sorry about the re-run—I wrote this several years ago, and I still agree with the concept of ‘dynamic character defects.’ As I read it now, I recognize how things have changed; buprenorphine (Suboxone) has been incorporated into many of the major treatment centers, and even the smallest programs have at Read more…
I’ve shared my history many times, including mention of my ‘spiritual awakening’ in 1993 that kicked off about 5 years of active AA invovlement. After struggling with an obsession to use opioids for months, a meeting with a psychoanalyst sparked the ‘awakening’ on my drive home. I was suddenly very Read more…
I worked for several years as the medical director of a residential treatment center in Wisconsin, leaving the position several weeks ago because they were angry about my support for buprenorphine. On my last evening in the place I took a moment to look around and think about how addiction treatment Read more…
For those of you who prefer watching to reading, here is a video with a few thoughts about why will power is NOT any kind of strategy for staying clean. As I describe, believing in will power is not only unhelpful; it even INCREASES one’s chance for relapse, and serves Read more…
Below is one chapter of my long, long book– the one that I will probably never finish. I wrote this chapter about two years ago, and have not published it anywhere else, at least not that I can remember. It is LONG, but if you are addicted to opiates and Read more…
I might as well keep this run of posts going with an e-mail exchange from earlier today. As usual, minor aspects of the message were changed to protect anonymity. The message: I am interested in setting up a tele-psychiatry appointment with you. My boyfriend is a heroin addict who has Read more…
Remember back when I used to write those ANGRY posts, where I would take people to task for their silly comments about buprenorphine? I remember them. THOSE were the days! I was always ready to go nuclear on anyone who tried to debate whether buprenorphine treatment was ‘good’ or ‘bad.’ Read more…
What follows is a lightly-edited version of one of my posts from a couple years ago. I still think that this is a good model for understanding the actions of buprenorphine. Buprenorphine and the Dynamic Nature of Character Defects ‘Suboxone’ and ‘Subutex’ are the trade names for medications that contain buprenorphine, a substance used to Read more…