Fentanyl plays a role in more and more opioid overdose deaths. Most fentanyl used ‘on the streets’ starts in China, with precursors shipped to California or Mexico before distribution throughout the US. Fentanyl acts very potently at the same receptors as heroin, morphine, and oxycodone. Reports of overdose deaths caused by fentanyl usually blame potency, … [Read more…]
I came across this public-accesss story, and wanted to share the perspective: Pauline Bartolone, Kaiser Health News Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups. The shortage, … [Read more…]
First Posted 10/21/2013 I have received MANY messages over the years from patients on buprenorphine/naloxone (Suboxone) who required surgery, but whose doctors refused to provide post-op analgesia. Those of you not on Suboxone– can you imagine having surgery, and being told that ‘it is too much hassle to give you any medicine for pain relief’? … [Read more…]
First Posted 8/28/2013 I realize that I am halfway through a post called ‘Suboxone Abuse Part I’. This is poor form, but I am now going to get halfway through a second topic before finishing the first one. Sorry. I recently came across a problem relating to the new healthcare law. I was thinking about … [Read more…]
Originally Posted 8/12/2013 I will get to ‘Part II’, but today I talked with a patient about something that happens too often, that deserves to be pointed out. The person was in the ER with an injury that resulted in tib/fib francture. The ER doc provided no analgesia, in the ER or at discharge, telling … [Read more…]
Originally posted 12/19/2012 I’ve written about this topic a number of times, but I continue to receive emails from people on buprenorphine who describe inadequate pain control following surgery. I have prepared a document for my own patients to provide to surgeons, dentists, and ER staff to be used in the case of injury or surgery. A copy of that … [Read more…]
I wrote this a couple years ago, and still get questions about the topic today. Studies show that a small fraction of the amount of buprenorphine in a tablet or film strip actually gets absorbed through mucous membranes; the rest is swallowed. The 15%-30% amount of absorption is referred to as the ‘bio-availability’ of the … [Read more…]
I recently resumed writing for the expert forum on addiction at MedHelp.Org. One result of writing for MedHelp is that I receive a number of e-mails from people with questions about specific issues related to buprenorphine. The most common questions are from people on buprenorphine undergoing surgery, asking about the safety of anesthesia and about … [Read more…]