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receptor actions

The Real Reason Fentanyl is So Dangerous

June 16, 2021 by admin Leave a Comment

Fentanyl plays a role in more and more opioid overdose deaths. Most fentanyl used ‘on the streets’ starts in China, with precursors shipped to California or Mexico before distribution throughout the US. Fentanyl acts very potently at the same receptors as heroin, morphine, and oxycodone. Reports of overdose deaths caused by fentanyl usually blame potency, … [Read more…]

Posted in: Addiction, Anesthesia, receptor actions Tagged: drug deaths, fentanyl, overdose

Tapering off Buprenorphine or Suboxone, Pt 2

August 15, 2018 by admin 10 Comments

In the last post we discussed some of the misconceptions about tapering off opioids.  Today we will discuss a couple basic principles, and then describe the approach I recommend for my patients tapering off buprenorphine. Opioids act at receptors that normally bind endorphins, which are released by neurons in response to a range of stimuli … [Read more…]

Posted in: Addiction, Buprenorphine, pharmacology, receptor actions, Suboxone, Withdrawal Tagged: opioid tolerance, stopping suboxone, suboxone detox, Suboxone taper, tapering off buprenorphine

Tapering Off Buprenorphine or Suboxone pt. 1

August 8, 2018 by admin 9 Comments

Many patients taking buprenorphine live in fear of a dark world around the corner where they will have to taper off the medication.  They see horror stories on YouTube posted by people who, for some reason, abruptly stopped the medication and kept a video log of their experiences.   My own patients sometimes ask, nervously, if … [Read more…]

Posted in: Buprenorphine, receptor actions, Suboxone, Withdrawal Tagged: buprenorphine treatment, opioid taper, stopping suboxone, Suboxone withdrawal

Buprenorphine Overdose After Naltrexone Treatment

February 14, 2017 by admin 7 Comments

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 buprenorphine or naloxone allergy led … [Read more…]

Posted in: Buprenorphine, Induction, pharmacology, receptor actions, side effects, Suboxone, tolerance Tagged: buprenorphine induction, buprenorphine overdose, naltrexone treatment, Suboxone after vivitrol, Suboxone allergy

Cannabinoid Hyperemesis: How Rare?

January 4, 2017 by admin Leave a Comment

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 search reveals articles calling the … [Read more…]

Posted in: Acute Pain, Chronic pain, pharmacology, receptor actions Tagged: abdominal pain and THC, cannabinoid hyperemesis syndrome, CHS, marijuana, nausea and THC, THC

Post-op Pain on Suboxone

November 29, 2015 by admin Leave a Comment

Many patients on Suboxone or buprenorphine eventually require pain treatment, just like people who aren’t on buprenorphine products.  I’ve written about post-op pain control several times, but I continue to get emails from patients who haven’t seen my comments and who view an upcoming surgery with the same fear experienced by patients before the early … [Read more…]

Posted in: Acute Pain, Buprenorphine, pharmacology, receptor actions, Suboxone, surgery Tagged: Buprenorphine, buprenorphine and acute pain, post-op pain, Suboxone, surgery and Suboxone

Media Bias Against Suboxone

March 1, 2015 by admin Leave a Comment

First Posted 2.8.2014 After Philip Seymour Hoffman’s death, I anticipated a flood of articles describing the ineffectiveness of non-medication treatments for opioid dependence.  I assumed the media would finally report on the need for long-term treatment of a long-term illness.  Instead we read more articles describing Suboxone (i.e. buprenorphine) as a ‘bad drug’, since Hoffman may have used the … [Read more…]

Posted in: Buprenorphine, receptor actions, recovery, Suboxone, treatment Tagged: addiction treatment options, buprenorphine and opioid dependence, naltrexone and suboxone treatment, vivitrol treatment

Does Suboxone Stop Working Over Time?

December 11, 2014 by admin Leave a Comment

First Posted 12/31/2013 Buprenorphine is relatively unique among opioids in having a ‘ceiling’ to mu opioid effects.  There are other known molecules that act as partial agonists at mu opioid receptors, but buprenorphine is the most useful, at this point, because of other traits of the molecule– such as having few side effects from actions … [Read more…]

Posted in: receptor actions, Suboxone, tolerance, treatment Tagged: buprenorphine long term, how long does suboxone work, long term suboxone, suboxone tolerance
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