Tolerance is an Important Consideration

It is nice to see the growing number of buprenorphine prescribers on the ASAM forums. There are many APNP’s getting involved, and many of them will probably be better at the job than physicians. One concern I have, though, is whether those prescribers fully understand that tolerance is an important Read more…

Fentanyl Also Complicates Buprenorphine Induction

Most buprenorphine docs know that long-acting agonists like methadone complicate induction. In fact, doctors who induce 24 hours after a patient stops methadone learn never to do it again – or to ensure the patient does it at home! I write ad nauseam about precipitated withdrawal on this blog, so Read more…

Data from open-source VAERS for COVID vaccines

If A Tree Falls and Nobody Tells VAERS, Did It Really Happen?

My last post teased my summer illness story that I’ll continue writing on my ‘personal’ blog. Springtime is coming, which will create some writing challenges. But for now, understand that I had lifesaving open-heart surgery at UC San Diego, called pulmonary endarterectomy, that included hours of deep hypothermic cardiac arrest. Read more…

The Summer of Walking Through Ashes

I walked two miles with my wife each night after work in three of our four Wisconsin seasons. The loop through our neighborhood passed from an open area lined with Ash trees through wooded areas. The road gradually dropped and rose about 200 feet in one wooded area and then Read more…

A Wisconsin Tesla Story

A friend brought his new Tesla to our Wisconsin home over Christmas. We didn’t worry too much about charging because he lived only an hour away. That was a mistake. Read on for a Wisconsin Tesla Story. He left home with 100% charge after charging in his garage overnight. He Read more…

SuboxoneTalk Logo

Taking New Suboxone Patients in Wisconsin

I mentioned that the DEA removed limits on the number of patients a prescriber may have on buprenorphine medications. I can treat more patients, so I am taking new Suboxone patients in Wisconsin. Search engines like to see relevant words over and over, so I’ll add that I’m taking new Read more…

A Growing Annoyance with Experts

The older I get, the more I have a growing annoyance with experts.    I have patients to see in a few minutes so this will be brief – and followed by a longer discussion at some point.  Besides, my hosting service is down this morning so who knows when I’ll Read more…

Why am I Ornery?

Why am I ornery? I get that alot. When I’m not writing this blog I’m in a pretty-good mood. This blog was very popular up until about 2013 when it was featured in a NYT story. My dad passed away about 2 weeks before that story came out and for Read more…

Another Day, Another (Walgreens) Pharmacy Hassle

Here’s a surprise… patient’s who were addicted to opioids from the age of 15 and seek help at age 30 sometimes have issues. Some pharmacists seem to think that every patient should be perfect. Those of us who work in the psychiatric and addiction fields know that such patients are Read more…

SuboxForum is….. Back! THIS time for SURE!

So sorry to promise and not deliver. “But you PROMISED!” I know. I screwed it up. But I made it better – honest! The Forum is back, this time for sure… on a secure server with SSL. Seriously!! It is free, and asks for NO personal information. I noticed that Read more…

Psychotherapies in Addiction Medicine

One of my favorite aspects of addiction medicine is the relationship that I am allowed to build with my patients. The relationships are different than in other areas of psychiatry, where the doctor is always working to maintain a certain distance from patients. Too far and the psychiatrist won’t build Read more…