The FDA stated last week that transmucosal buprenorphine has been associated with dental problems, including tooth loss. The statement was based on 305 reports to the FDA Adverse Event Reporting System (FAERS) database since buprenorphine was approved 20- years ago. Many of my patients on buprenorphine medications have had dental Read more…
Readers will sometimes ask for my thoughts about buprenorphine. I’m always happy to respond, time permitting. I’ve described how my patients taper off buprenorphine in prior posts, but the interest out there warrants revisiting the topic. Most people who become dependent on opioids become very fearful of withdrawal. That fear Read more…
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 Read more…
Today on SuboxForum people were writing about their experiences with different buprenorphine formulations. Doctors occasionally have patients who prefer brand medications over generics, but buprenorphine patients push brand-loyalty to a different level. The current thread includes references to povidone and crospovidone, compounds included in most medications to improve bioavailability. Some Read more…
First Posted 3/24/2014 I recently came across the blog of a person who has dedicated his life to trashing buprenorphine treatment. I won’t provide the name or link, as I don’t want to waste my own ‘page rank’ on supporting his misplaced anger. But I suspect many readers of my Read more…
I’ve received questions over the years from people claiming a range of symptoms from Suboxone or buprenorphine, from back or muscle pain to fatigue, depression, or irritability. I didn’t invent Suboxone, so I don’t take it personally when people blame commonly-occurring symptoms on the drug. But I get bored by Read more…
First Posted 1/13/2014A viewer on YouTube commented on my video about hot flashes from Suboxone, but I don’t know if that is because the symptoms dissipate, or if people learn to deal with the symptoms. I suspect that both are true. But for some people, the sweating and heat are Read more…
Um no… but I thought I’d share a quickie from a reader, who asked if Suboxone or buprenorphine were affecting his vision. He asked: One thing I’ve noticed when I’m not on any drugs is my pupils are fairly large. For some reason after I stopped the Vicodin, my vision Read more…
I will get to ‘Part II’, but today I talked with a patient about something that happens too often, that deserves to be pointed out. The person was in the ER with an injury that resulted in tib/fib francture. The ER doc provided no analgesia, in the ER or at Read more…
Originally Posted 7/18/2013 Like most of you, I’m not thrilled with modern healthcare. I miss how things were twenty years ago, when I had a sense of ‘having a doctor’ who actually knew me, who had my best interests in mind. I remember my father, a defense attorney in a Read more…
Originally posted 3/6/2013 A late post tonight, since my new exercise program has pushed my blogging back by an hour or so each night. My suspicions about exercise were correct, by the way; it is much easier to suggest exercise to other people than it is to actually exercise. I’ve Read more…
Originally posted 1/2/2013 We can now leave naloxone out of the discussion, and focus on the side effects of Suboxone that are caused by buprenorphine. Side effects are symptoms caused by a given medication that are not part of the therapeutic benefit of that medication. Whether a symptom is a side Read more…