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 comments include a summary of … [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 the medication after taking it … [Read more…]
Originally posted 1/26/2013 Readers of this blog know that I have often questioned whether there is any clinical difference between Suboxone and generic buprenorphine. Naloxone is an opioid-blocking chemical added to buprenorphine, supposedly in order to reduce intravenous diversion of the medication. The combination of buprenorphine plus naloxone is branded as Suboxone. I’ve pointed out over … [Read more…]
I received a question from a reader about withdrawal symptoms from stopping buprenorphine. My answer has relevance to opioid withdrawal in general, and to a common misconception about the duration of withdrawal symptoms. The message: Basically I quit Suboxone about 18 days ago. When I decided to quit I was taking about 8 to 12mgs per day. I … [Read more…]
I’d like to share a recent email exchange with a reader. The post is long, but there are several interesting aspects to the discussion. I’ve removed the conversational parts, as well as the identifying information. The initial message: I was an intravenous heroin user for three years. After treatment I was able to stay clean … [Read more…]
I received a question about Kratom, and searched for a earlier post about that plant/substance. That post came shortly after Obama’s inauguration, after someone wrote to compare his experience at that event to his experience taking opioids. Funny how every ‘high’ has its own ‘morning after!’ That Post: On a message board called ‘opiophile’, a … [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 seem to take place, leaving … [Read more…]
I received this message today: Hi, you probably answer this quite a bit. I’ve been depressed for as long as i can remember. Ive been on the ssris, snris, amphetamines and methylphenadate but none of these have worked as well as opiates. (Certainly short term,I don’t take for long periods of time). But have you … [Read more…]