Clearbrook President Gets it Wrong

A blurb in the buprenorphine newsfeed (see the bupe news link in the header of this page), has the headline ‘Suboxone challenged by Clearbrook President’.  I followed the link, and after reading the ‘article’ I wanted to comment to that president but the person’s name wasn’t included, let alone an Read more…

A Save with Suboxone?

I’d like to share a recent email exchange with a reader. The post is long, but there are several interesting aspects to the discussion. I’ve removed the conversational parts, as well as the identifying information. The initial message: I was an intravenous heroin user for three years. After treatment I Read more…

Do Interventions Work?

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…

Making People Stop

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…

Relapse in an Era of Buprenorphine

A recent experience with a patient helped me realize some of the dramatic differences in the treatment of opioid dependence, 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 Read more…

Would'a Could'a Should'a…

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…

Buprenorphine and the Dynamic Nature of Character Defects

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…

Can a person find 'Recovery' without 'desperation?'

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…

The point of addiction treatment

I worked for several years as the medical director of a residential treatment center in Wisconsin, leaving the position several weeks ago.   On my last evening in the place I took a moment to look around and think about how addiction treatment has changed in the past decade.  I looked Read more…

Why will power doesn’t work

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…

Opiate dependence treatment options

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…

How do I help my addicted partner?

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…