I am moving the post below from the comments section to here because many readers will benefit from the information.  As a doctor treating chronic pain I can attest to the problems and challenges from all angles.  I worry about leaving patients in pain– but at the same time I know that for long-term pain, opiates are rarely the answer because of tolerance and the eventual erosion of personality that occurs with opiates.  I also worry about regulators and licensing boards.  I also worry about contributing to the problem of opiate diversion– nothing makes me more angry than the thought of a patient that I trust and believe going out and selling meds that I have prescribed for pain.  In my home town, the local health system tries to scare the docs into not prescribing pain meds, putting the burden on the few docs in town who work independently.  With all of these concerns it is good to see efforts to bring the issues involved in treating pain out into public awareness.  I also am optimistic that buprenorphine, the active ingredient in Suboxone, will make a big difference for a number of patients struggling with chronic pain.
The Comment:
The readership here might be interested in the following item from War on Doctors/Pain Crisis blog, which has links to other medical-blog discussions of buprenorphine for pain from the Pallimed blog. Hopefully some of you will find this interesting.
“High Dose Transdermal Buprenorphine for Pain”– Barutell et. al, Pain Practice, 2008.
which discusses the presented Abstract from a large multi-center study in Spain published just recently. Find also links to the discussion on PRN’s Chronic Pain Forums, which are informative, and to the discussion on Pallimed mentioned above.
Enjoy! Thank you for your efforts with this blog.
Alex DeLuca, M.D., MPH
Senior Consultant, Pain Relief Network


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