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…
First Posted 11/19/2013 In ‘Addiction Treatment with a Dark Side’, Deborah Sontag of the New York Times shared her observations of the clinical use of buprenorphine for treating opioid dependence, warts and all. Readers of the Talk Zone know my bias, that buprenorphine/Suboxone is one of the only effective treatments Read more…
First Posted 11/4/2013 I recently saw a new patient who described treating her own opioid dependence with diverted Suboxone. She sheepishly described reading everything she could find about buprenorphine and meticulously using half of her friend’s medication to avoid other opioids, without fail, for four years. She would likely be Read more…
First Published 4/20/2013 I realize that practice patterns differ between practices, even those treating the same condition (opioid dependence) with the same medication (buprenorphine). Differing patient characteristics result in different regional standards of care, for example. And some areas have access to services (e.g. group treatments or laboratory testing) that 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 2/23/2013 I’ve written in detail about the bold move by Reckitt-Benckiser, maker of Suboxone, that few people outside the company saw coming. In brief, the company has been cruising across the Atlantic for the past ten years, fueled by stellar growth of its flagship medication, even as the expiration of Read more…
First Posted 2/15/2013 A recent exchange with a reader decribes some problems from urine drug testing on Suboxone: I have been on buprenorphine for 5 yrs. Recently my doctor stated that my u/a t looked like I have been ‘loading my meds.’ He said my levels where ‘backwards’ and that Read more…
Readers of this blog know that I have often questioned whether there is any clinical difference between Suboxone and generic buprenorphine. Naloxone is an opioid-blocking chemical added to buprenorphine, supposedly in order to reduce intravenous diversion of the medication. But it increases the cost of buprenorphine. Are we wasting resources on Read more…
Originally posted 1/13/2013 In a recent Google search about Suboxone and pregnancy, one of the top links included the frightening statement that Suboxone and buprenorphine have been linked to SIDS or sudden infant death syndrome, commonly called ‘crib death.’ The statement was from a health forum where a woman wrote about 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…
This is a repost of an article from 10/2/2012 I’m going to start by paraphrasing John Le Carre’s comments in his book The Constant Gardener: “Nobody in the letter below is based upon an actual person or outfit in the real world. But I can tell you this; as my knowledge of the pharmaceutical Read more…
I received the following question earlier today: Hello Dr. Junig, I am opiate dependent or rather an opiate addict. I want to seek treatment because I can’t continue this life style. I have questions about treatment. Do I have to be in full withdrawals when I go to see a Read more…