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 Read more…
In regard to my last post… There are many directions that we could take as we review that message. My overall impression, as I read the letter, was of a person struggling to accept the reality of his condition. Over and over, the person repeated the same behavior, starting Suboxone, Read more…
I received the following email last week. I considered trimming it down, but the story is well-written and describes a history that is similar to that of many of my patients. As usual, I will write a follow-up post in a week or so. Dear Dr. J, I have read Read more…
I guess I do get irritable sometimes… but I’m getting better at controlling my anger as I get older. One cool thing about a blog is that I can go back and see what I wrote years ago. In this case, I was looking for a post about telling the difference between opioid Read more…
It has been a while, it seems, since I’ve checked in. I’m at the point in the life cycle of a ‘blogger’ where I feel like I’ve said most of what I came here to say… so help me out by sending your questions, particularly those with broad implications, and Read more…
A recent experience with a patient helped me realize some of the dramatic differences in the treatment of relapse in an era of buprenorphine. I drug-test patients who are treated with buprenorphine or Suboxone. The point of testing is not to catch someone messing up, but rather to determine when Read more…
When Suboxone first became an option for treating addiction to pain pills back in 2003, some people were excited about having a cure for opioid dependence. Those people were mistaken. It is true that Suboxone has been a huge benefit for treating opioid dependence, but the medication cannot cause the Read more…
I received the following e-mail a couple days ago: Hi I had been on Suboxone for 9 years. I was put on it the week it was approved by FDA. I found your posts in a blog. I was looking for a class action suit against this terrible drug. That Read more…
Ah yes…. another post about my book… Over the past few years, I’ve taken posts from this blog, posts from other sources that I’ve written, some sections of a ‘memoir’ that I have not gotten around to writing… and combined them in a book about addiction. The book does not Read more…
On May 27th, 2011, actor Jeff Conaway died from complications of opioid dependence. His death has been attributed to several causes—sepsis, pneumonia, and aspiration among them— but there is little debate over the ultimate cause of his death at the age of 60 years, that being addiction to opioid pain Read more…
Sorry about the re-run—I wrote this several years ago, and I still agree with the concept of ‘dynamic character defects.’ As I read it now, I recognize how things have changed; buprenorphine (Suboxone) has been incorporated into many of the major treatment centers, and even the smallest programs have at Read more…
Since I began using buprenorphine to treat opioid dependence in my psychiatry practice, I’ve learned quite a bit about what works and what doesn’t work. Buprenorphine is an amazing medication when used properly, and undoubtedly saves thousands of lives each year. Even when used improperly, buprenorphine has life-saving properties. Addicts Read more…