Suboxone Treatment over Fifteen Years

I have teased this…. a description of Suboxone treatment over fifteen years, described in 183 pages as I grew to treating 279 and eventually 300 patients on buprenorphine medications. In those early days I battled many different forces. Insurance companies demanded reasons to cover a person beyond one year. Most Read more…

VA Gets it Right and Wrong on Buprenorphine

The Veterans Administration recently released guidelines for chronic pain that recommend using buprenorphine if opioids are indicated. That idea has some validity, but the VA, and commenters, get much of the issue wrong. Buprenorphine is a very potent opioid, a partial agonist, with a ‘ceiling effect.’ That means that buprenorphine Read more…

Nonsense from American Addiction Centers about Suboxone

There is plenty of nonsense on the internet, but nonsense is most-annoying when it comes from ‘experts’. I’m referring to nonsense from American Addiction Centers about Suboxone. If you go to their heavily-advertised site there is no mention of the scandals involving ‘sober treatment programs’ that filled the Florida news Read more…

Tapering Suboxone

How to Stop Buprenorphine or Suboxone, Pt 2

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. Presenting how to stop buprenorphine or Suboxone, Pt 2 Opioids act at receptors that normally Read more…

Tapering Suboxone

How To Taper Off Buprenorphine or Suboxone pt. 1

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 Read more…

Opioid withdrawal stinks

A Person Doesn’t Like Taking Suboxone

I found this old post from ten years ago that I never got around to publishing it. A person doesn’t like taking Suboxone and blames the drug for the lack of change in his life. It plays into the discussion about methadone because it shows the attitudes that can develop Read more…

pain pill overdose deaths

Can I Get High From Suboxone?

Can a person get high from Suboxone or buprenorphine, the active part of that medication? I suspect most pharmacists, police officers, and legislators would answer ‘yes!’, but the answer is more complicated. The people who serve patients who take Suboxone should learn how the medication works, when it is dangerous, Read more…

Pharmacists, Do Better

This is a ‘bone to pick’ post. Yesterday a patient who has done well on buprenorphine for the past 6 years shared his pharmacy experience. His experience is typical of whatI hear far too often. I understand that pharmacists are overworked and understaffed, but the complaints I hear so often Read more…

FDA: Dental Problems with Buprenorphine

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…

Stopping Buprenorphine in Three Steps

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…

A hazard for kids?

Buprenorphine, Not Subbies

I’ve been writing longer and longer posts on SuboxForum so maybe I need to write more here.  This blog archives twelve years of frustration over the ignorance toward buprenorphine, at least until I ran out of steam a year ago.  I grew used doctors refusing to treat people addicted to heroin Read more…