In my last post I teased that I would write about fake science. I’ll try to make it interesting. The internet allows everyone to do research about symptoms and treatments for any condition. If not for need for prescriptions, people could act as their own doctors. But a huge dose Read more…
Anyone who proposes an easy solution to the overdose epidemic is either a simpleton or a politician. But far too many people entrusted with the power and responsibility to set priorities decry the number of overdose deaths, then stigmatize and demonize every effort to save lives. “Suboxone can be diverted.” “Someone might Read more…
A post on the Forum asked about the best remedies for opioid withdrawal. I will review the medications and other treatments for opioid withdrawal that I have heard discussed by physicians or by people on the internet. Hopefully readers will leave comments about medications or approaches that they have found Read more…
Originally Posted 1/11/2014I received the following email from a Suboxone patient (from another practice) after he experienced a painful injury. He shared what happened at the hospital when he was trying to get relief from pain, while taking Suboxone (the active component is buprenorphine). Hey there. Just to let you Read more…
Firsted Posted 1/8/2014 I received an email today containing an angry comment about Suboxone/buprenorphine that I’ve read a number of times before on forums about addiction. The essence of the comment was that Suboxone has caused tons of problems, including diversion, people stuck on the medication, and buprenorphine abuse. He Read more…
First Posted 12/30/2013 Paul Dessauer, Outreach Coordinator at WASUA, the Western Australian Substance Users’ Association, often adds insight to issues that come up on my blog. He shared a few comments in response to my post about ibogaine, and at my request gave permission to post his remarks here. His Read more…
First Posted 11/19/2013 In ‘Addiction Treatment with a Dark Side’, Deborah Sontag of the New York Times shared her observations of the clinical use of buprenorphine for treating opioid dependence, warts and all. Readers of the Talk Zone know my bias, that buprenorphine/Suboxone is one of the only effective treatments Read more…
First posted 11/11/2012 In my last post, I wrote about the work-up of a patient who experiences symptoms similar to opioid withdrawal that start about an hour after each dose of Suboxone. We decided that the symptoms were signs of withdrawal—i.e. reduced activity of mu-opioid pathways—and that the symptoms were Read more…
I apologize for the hiatus. For some reason, all of the posts from the past year suddenly disappeared… and backup files, which would normally be used to restore the site, were corrupt. At least one of the IT experts I consulted believed that the site was infected by a malicious Read more…
I often receive emails from patients on buprenorphine (or Suboxone) who are preparing for surgery or other painful medical procedures. Ideally in such cases, the surgeon would have a discussion with the person prescribing buprenorphine, in order to coordinate the plan for treating postoperative pain. In practice such discussions don’t Read more…
A question was asked about the last post that warrants top billing: “Buprenorphine acts similar to opioid agonists in lower doses, with the same addictive potential as oxycodone or heroin. In higher doses—doses above 8 mg or 8000 micrograms per day—the ‘ceiling effect’ eliminates interest and cravings for the drug.” Read more…
I often talk to my patients on buprenorphine (aka Suboxone) about the need to fill their minds with new ideas, plans, and experiences. For years, those of us with addictions were focused on one thing– finding a way to avoid being sick for the next few hours. That one issue became Read more…