Buprenorphine Overdose After Naltrexone Treatment

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…

Avoiding Precipitated Withdrawal

I received the following question earlier today: Hello Dr. Junig, I am opiate dependent or rather an opiate addict. I want to seek treatment because I can’t continue this life style. I have questions about treatment. Do I have to be in full withdrawals when I go to see a Read more…

Tough Choice

I have been struggling with part II, primarily because there are no easy answers to the situation. I realize that I could easily criticize whichever path a doctor suggests for our imaginary patient. As an aside, I believe that a major reason for the lack of sufficient prescribers of buprenorphine Read more…

Do You Prescribe Buprenorphine?

I’m not sure about the make-up of readers of this blog.  I know that there are about 20,000 page views each month, but I don’t know how many are by people addicted to opioids, people taking buprenorphine, family members of addicts, or physicians who prescribe buprenorphine.  If you fall into Read more…

Sick from naloxone, maybe?

A person wrote about feeling sick after taking Suboxone, thinking that naloxone is to blame and frustrated that her physician would not prescribe Subutex: I first read your blog last week as I was going through the despair and misery of withdrawal from Percocet, and considered suicide. I didn’t want Read more…

Opiate withdrawal: hell beyond words– does your doctor care?

I am often told by opiate addicts that they would kill themselves rather than go through withdrawal again.  I assume  that the comments are  exaggerations to make a point.   But a recent nightmare helped me realize that the comments are not hyperbole– but rather are serious attempts by addicts to describe just how horrible Read more…

Sick When Starting Suboxone: Abres Los Ojos!

An interesting case from a reader: Thanks Doc for your efforts. I appreciate you. I am a four year hydrocodone addict 55 years old. I became addicted when I used the drug for an injured cervical disc. A couple of years ago I found out about suboxone and got in Read more…

Precipitated Withdrawal– Now What?

I saw this question on another board– I didn’t want to add my reply to the other five answers already listed, so I’ll put it here for hopefully the next unfortunate person in ‘precipitated withdrawal’ to find. For those who don’t know, precipitated withdrawal occurs when a person’s level of Read more…

Waiting for Suboxone after Heroin

How long do you have to wait before taking Suboxone, if one had been using heroin for almost a year? What can one take to ease the withdrawal symptoms in the meantime while waiting? Are treatment centers effective places to go to as a start or just start out with Read more…

Precipitated Withdrawal

thank you anyway for replying.. So when i do get into seeing a doctor, i must be in withdrawal? I am so confused on this issue.  I am taking suboxone, but most likely have to take the lortab when it is out of my system because of the pain i do Read more…

New Suboxone Forum

I invite anyone with an interest in Suboxone, either for one’s self or for someone else, to visit the Suboxone Talk Zone Forum at http://suboxforum.com . You can read posts without registering, but please register and take part in the discussion! You do NOT need to provide your real information Read more…

Induction, Relapse, Benzo Questions

Some questions about the induction process and my answers: If I try to just take the oxycodone for a period of time prior to meeting with you would that eliminate some of the problems and complications associated with the transition from methadone to suboxone? If I took only oxycodone for Read more…