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…
For years, people familiar with the benefits of buprenorphine have wondered– who is the idiot standing in the way of increasing access to this life-saving treatment? One of the idiots was recently identified, when an open-records request by the Huffington Post uncovered a letter to HHS Secretary Sylvia Burwell from Read more…
HHS Secretary Sylvia Burwell announced yesterday that the cap on buprenorphine patients would be raised in the near future. Details were not released, but she emphasized that measures would be taken to increase availability of this life-saving treatment, while at the same time taking caution to prevent misuse of the medication. Read more…
First Posted 12/28/2013 I’ve always assumed that stories about ibogaine curing opioid dependence were fabricated or exaggerated. But I’ve read more about ibogaine since the drug popped up on an episode of Homeland. The scene made me wonder how and when the hoopla over ibogaine began, and why it ended. After Read more…
First Posted 11/23/2013As fear of buprenorphine diversion sweeps the nation, some states have passed legislation adding more rules for practices that treat addiction using buprenorphine. Never mind that buprenorphine is linked to about 400 deaths over ten years, one tenth of the number of deaths from acetaminophen during that same Read more…
First Posted 10/13/2013 A person in my practice was stable on Suboxone/buprenorphine for several years, until he developed a painful injury. During the time the injury was treated, the person experienced significant pain. I worked with his surgeon to provide adequate pain relief, which for patients on buprenorphine or Suboxone Read more…
First Posted 9/15/2013 I’ve written the first two parts of a three-part column about unintended consequences. Part one described why discounts demanded from insurers for front-line services (e.g. office visits) create challenges for independent primary care practices that don’t have other sources of revenue, particularly revenue from procedures. Part two 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…
Originally Posted 3/14/2013 A local District Attorney wrote to me last week to express his concern about the increased diversion of buprenorphine. I often sense an undercurrent of tension when I cross paths with attorneys, aware of the different attitudes that we hold that arise from our different roles in society. Read more…
Originally posted 12/8/2012 I’ve been hearing more calls these days to change US marijuana laws (note- Colorado and Washington legalized recreational use of marijuana shortly after this article was originally posted). Legalizing marijuana has been a cause for some citizens for decades, and efforts to change marijuana laws have waxed and 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…
I’ve been in more of a chatty mood lately, as regular readers have likely noticed. I find it interesting that weeks will pass when I have little or nothing to say… and at other times, I have all sorts of random thoughts to discuss. Excuses first– I’ve been tinkering with Read more…