The Veterans Administration recently released guidelines for chronic pain that recommend using buprenorphine if opioids are indicated. That idea has some validity, but the VA, and commenters, get much of the issue wrong. Buprenorphine is a very potent opioid, a partial agonist, with a ‘ceiling effect.’ That means that buprenorphine Read more…
Many people looked for a return to normalcy when they pulled the Biden lever in 2020. Since then we changed the English language, encouraged young children to explore their pre-pubertal sexuality through gender-changing hormones or surgery, and committed ourselves to energy sources that, after 20 years of development, currently provide Read more…
In the last post we discussed some of the misconceptions about tapering off opioids. Today we will discuss a couple basic principles, and then describe the approach I recommend for my patients tapering off buprenorphine. Presenting how to stop buprenorphine or Suboxone, Pt 2 Opioids act at receptors that normally Read more…
Many patients taking buprenorphine live in fear of a dark world around the corner where they will have to taper off the medication. They see horror stories on YouTube posted by people who, for some reason, abruptly stopped the medication and kept a video log of their experiences. My own Read more…
I found this old post from ten years ago that I never got around to publishing it. A person doesn’t like taking Suboxone and blames the drug for the lack of change in his life. It plays into the discussion about methadone because it shows the attitudes that can develop Read more…
Can a person get high from Suboxone or buprenorphine, the active part of that medication? I suspect most pharmacists, police officers, and legislators would answer ‘yes!’, but the answer is more complicated. The people who serve patients who take Suboxone should learn how the medication works, when it is dangerous, Read more…
This is a ‘bone to pick’ post. Yesterday a patient who has done well on buprenorphine for the past 6 years shared his pharmacy experience. His experience is typical of whatI hear far too often. I understand that pharmacists are overworked and understaffed, but the complaints I hear so often Read more…
I’ve spent 15 years treating addiction, mostly to opioids. I’ve worked in residential treatments, methadone programs. I have testified in cases related to overdose deaths. I know the harm that is possible from excess opioid precribing or use. But I also hope that some day, pain treatment becomes more rational. Read more…
The FDA stated last week that transmucosal buprenorphine has been associated with dental problems, including tooth loss. The statement was based on 305 reports to the FDA Adverse Event Reporting System (FAERS) database since buprenorphine was approved 20- years ago. Many of my patients on buprenorphine medications have had dental Read more…
I’ve been writing longer and longer posts on SuboxForum so maybe I need to write more here. This blog archives twelve years of frustration over the ignorance toward buprenorphine, at least until I ran out of steam a year ago. I grew used doctors refusing to treat people addicted to heroin Read more…
A forum reader wrote about concerns over a partner on buprenorphine. Her concerns pointed out a common misperception about the goals of treatment of opioid use disorder using buprenorphine, or using methadone for that matter. Her question, amended for privacy: I married the love of my life. He is still Read more…
I’ll share an interesting story about the data used for the prescription drug database in Wisconsin and other states. I’ve been holding back on writing about this issue in hopes that the reason for the story would be corrected, and I would have no story to tell. But that hasn’t Read more…