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 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 recently read a CBS news story about CHS, or Cannabinoid Hyperemesis Syndrome, describing a 100% increase in cases in Colorado since the legalization of marijuana there. A search for ‘THC’ and ‘CHS’ pulls stories from a range of sources including High Times, Wikipedia, Fusion.net, and Current Psychiatry. A broader 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 don’t have pull with the addiction-related organizations out there. I’m never been a joiner, and I tend to notice the problems caused by medical societies over the good things that they supposedly accomplish. For example PROP, or ‘Physicians for Responsible Opioid Prescribing’, have a specific mission. Once a Read more…
I often receive emails with requests for my opinion about various aspects of buprenorphine treatment. A recent exchange, for what its worth: Hi Dr. Junig, I hope you are well. I know you have written a lot about this, and I have read most of it. But I still needed Read more…
Originally Posted 7/18/2013 Like most of you, I’m not thrilled with modern healthcare. I miss how things were twenty years ago, when I had a sense of ‘having a doctor’ who actually knew me, who had my best interests in mind. I remember my father, a defense attorney in a Read more…
I recently received a note from an area drug court, asking for help tapering one of my patients off buprenorphine. The patient came to me 4 years ago after being treated for a congenital pain condition. He had been treated with 150 mg of methadone per day, becoming dependent on Read more…
First posted 11/15/2012 The LA Times ran a very interesting story a few days ago about deaths from overdose of narcotic pain medications. I strongly encourage readers of this blog to read the story, which discusses the issue from the perspectives of doctors, patients, and family members. The story reports that a Read more…
The FDA recently released a Drug Safety Announcement about the use of codeine in young children after tonsillectomy/adenoidectomy surgery for obstructive sleep apnea. I was somewhat surprised to see a safety announcement on a medication that has been in use for decades, but the release underscores our improved knowledge of drug Read more…
I subscribe to Google news alerts for the phrase ‘overdose deaths.’ Google Alerts are a great way to follow any topic; subscribers receive headlines from newspapers and web sites for certain keywords from around the world. One thing that has become clear from my subscription is that there is no Read more…