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FDA: Dental Problems with Buprenorphine

January 17, 2022 by admin Leave a Comment

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 problems, and the topic was … [Read more…]

Posted in: Buprenorphine, Chronic pain, pharmacology, side effects, Suboxone, Subutex Tagged: Buprenorphine

Tapering off Buprenorphine or Suboxone, Pt 2

August 15, 2018 by admin 10 Comments

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. Opioids act at receptors that normally bind endorphins, which are released by neurons in response to a range of stimuli … [Read more…]

Posted in: Addiction, Buprenorphine, pharmacology, receptor actions, Suboxone, Withdrawal Tagged: opioid tolerance, stopping suboxone, suboxone detox, Suboxone taper, tapering off buprenorphine

Tapering Off Buprenorphine or Suboxone pt. 1

August 8, 2018 by admin 9 Comments

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 patients sometimes ask, nervously, if … [Read more…]

Posted in: Buprenorphine, receptor actions, Suboxone, Withdrawal Tagged: buprenorphine treatment, opioid taper, stopping suboxone, Suboxone withdrawal

Buprenorphine, Not Subbies

April 8, 2018 by admin 20 Comments

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 and other opioids.  I became … [Read more…]

Posted in: Addiction, Buprenorphine, recovery, Suboxone, treatment Tagged: addiction treatment, Buprenorphine, stigma, Suboxone, subs

Missing the Point of Buprenorphine Treatment

June 17, 2017 by admin 39 Comments

A forum reader wrote about concerns over a partner on buprenorphine.  Her concerns pointed out a common misperception about the goals of treatment of opioid use disorder using buprenorphine, or using methadone for that matter. Her question, amended for privacy: I married the love of my life.  He is still he love of my life … [Read more…]

Posted in: Addiction, Buprenorphine, Suboxone, treatment Tagged: buprenorphine treatment, opioid taper, rapid detox, Suboxone taper

Ten Gripes of Buprenorphine Doctors

March 25, 2017 by admin 18 Comments

I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from the latter group comes across … [Read more…]

Posted in: Acute Pain, Addiction, Buprenorphine, Chronic pain, Suboxone, surgery Tagged: buprenorphine stigma, Chronic pain, Suboxone, surgery

Buprenorphine Overdose After Naltrexone Treatment

February 14, 2017 by admin 7 Comments

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 buprenorphine or naloxone allergy led … [Read more…]

Posted in: Buprenorphine, Induction, pharmacology, receptor actions, side effects, Suboxone, tolerance Tagged: buprenorphine induction, buprenorphine overdose, naltrexone treatment, Suboxone after vivitrol, Suboxone allergy

Opioid Induced Hyperalgesia Prevented by Buprenorphine?

February 5, 2017 by admin 8 Comments

“Buprenorphine is a kappa receptor antagonist. For these reasons, buprenorphine might be unique in its ability to treat chronic pain and possibly OIH.” The opioid crisis has been fueled by the use of opioids to treat chronic pain.  Practice patterns have changed, but doctors are still criticized for their roles in the overuse of opioids.  I’ve sat … [Read more…]

Posted in: Acute Pain, Buprenorphine, Chronic pain, Suboxone, treatment Tagged: buprenorphine treats chronic pain, chronic pain treatment, opioid induced hyperalgesia, opioid pain relief, pain vs. addiction
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