I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from Read more…
I’ve been frustrated by the people behind the Wisconsin PDMP, or Prescription Drug Monitoring Program, for their mistakes related to buprenorphine. Whoever came up with the numbers made a rookie error when calculating the equivalent morphine dose of patients taking buprenorphine products. The error is easy to notice by anyone Read more…
Naltrexone induces mu-receptor hypersensitivity. Buprenorphine’s protective ‘ceiling effect’ may not prevent overdose in patients with this ‘reverse tolerance’. A new patient described his recent history of respiratory failure several days into buprenorphine treatment. He was told by his doctors that he experienced an allergic reaction to Suboxone. The rarity of Read more…
The safety of buprenorphine when not combined with a benzodiazepine has been twisted to suggest buprenorphine is uniquely dangerous when combined with benzodiazepines, which is not true. I’ve heard more and more from insurers, regulators, and well-meaning agencies about the dangers of combining buprenorphine and benzodiazepines. Some insurers protest paying Read more…
I won’t weigh in on the upcoming election, for fear of being barraged with insulting tweets by one candidate or ‘offed’ by the other. But the current opioid dependence crisis provides a great chance to learn whether you stand on the side of ‘limited government’ or the alternative. The TREAT Read more…
Today on SuboxForum people were writing about their experiences with different buprenorphine formulations. Doctors occasionally have patients who prefer brand medications over generics, but buprenorphine patients push brand-loyalty to a different level. The current thread includes references to povidone and crospovidone, compounds included in most medications to improve bioavailability. Some Read more…
I was reading more about Obama’s executive order over at Dr. Burson’s blog. I guess she is a ‘competitor’ in the blogging world, but I have to admit that her blog has a lot more detail about the issue than I do. If you haven’t been there yet, check it Read more…
I just read an article in the Daily Beast that reads like a better version of something I would write about the value of medication-assisted treatment of opioid dependence. I appreciate Christopher Moraff telling a story that has been untold far too long, and I hope the story raises questions Read more…
One of the links from this page connects to the ‘OD Report‘. I set up the connection to highlight the epidemic of overdose deaths, not to sensationalize the issue. But the Prince story is sensational and tragic at the same time. And the connection to buprenorphine only magnifies the tragic Read more…
I just noticed a couple of my recent posts…. these people have it wrong, and that person has it wrong. One of these days I really need to print something positive and uplifting. But not today. Today I wonder, is counseling what it is cracked up to be? Excuse the Read more…
Today on SuboxForum members discussed how long they have been treated with buprenorphine medications. Most agreed that buprenorphine turned their lives around, and most are afraid they will eventually be pushed off the medication. Most buprenorphine patients described a reprieve from a horrible illness when they discovered buprenorphine. But most Read more…
I’ve been spending more time answering questions on SuboxForum, and less time writing blog posts. I’ll share a comment from today in the hopes that someone looking for help will stumble across this page.A newcomer to SuboxForum posted this succinct question. In short, I am Addicted to Heroin. What Should Read more…