Why Did I Get CTEPH pt 3: The Null Hypotheses

The Null Hypothesis WARNINGNERD ALERT. NERD ALERT.Only #2 Pencils Beyound This PointWARNING– I REALLY liked this post. I was actually proud of it, and proud of how I explained the null hypothesis. My wife, on the other hand, called it ‘boring.’ Go figure. I am sorry for you folks who Read more…

Tissue removed from pulmonary arteries

Why Did I Get CTEPH? Pt 2: Now What?

After my diagnosis, my new pulmonologist said “if I was in your shoes. I’d get to San Diego”. That initiated a flurry of research about my illness and my options. I even went to Twitter and learned my account was suspended in 2018 for selling Rayban sunglasses. I don’t know Read more…

Addiction Treatment, Science, and Dead Rats

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…

Leadership on Opioids

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…

Opioid Withdrawal Treatments

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…

Broken Bones on Suboxone; Need Pain Relief

Originally Posted 1/11/2014 I 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 Read more…

Short Term Suboxone

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…

Toward Understanding Ibogaine

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…

Buprenorphine Diversion: Beyond a Superficial Understanding

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 for Read more…

Withdrawal Work-Up II

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…

Codeine Never Works for Me

Originally published 10/29/2012 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 Read more…

Up and Running

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…