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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…

Get Help. Get Buprenorphine, Not Methadone.

In the first part of this series I described my experiences working in methadone-assisted treatment, including aspects of that industry that, in my opinion, warrant serious consideration. In the second part I described steps that potential patients can take that might help them avoid spending their entire lives attached to Read more…

Tapering 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…

Missing the Point of Buprenorphine Treatment

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 Read more…

Raising the Suboxone Patient Cap

HHS Secretary Sylvia Burwell announced yesterday that the cap on buprenorphine patients would be raised in the near future.  Details were not released, but she emphasized that measures would be taken to increase availability of this life-saving treatment, while at the same time taking caution to prevent misuse of the medication. Read more…

Menzies Gets it Wrong

In Opioid Addiction Treatment Should Not Last a Lifetime, Percy Menzies resurrects old theories  to tarnish buprenorphine-based addiction treatment.  Methadone maintenance withstood similar attacks over the decades, and remains the gold standard for the most important aspect of treating opioid dependence:  preventing death. Menzies begins by claiming that a number of ideas that never Read more…

Another Suboxone Argument

It has been awhile since I posted a give and take with a misguided reader. I’ve taken that interval as good news that education is winning over misinformation. But then I read this comment.  I didn’t fix her typos, as I think they provide insight into her opinion: My daughter Read more…

Quantitative Urine Drug Testing and Buprenorphine: Tainted Motives?

First Posted 11/23/2013 As fear of buprenorphine diversion sweeps the nation, some states have passed legislation adding more rules for practices that treat addiction using buprenorphine.    Never mind that buprenorphine is linked to about 400 deaths over ten years, one tenth of the number of deaths from acetaminophen during that Read more…

Is Suboxone Abuse Harming People? Pt I

First Posted 8/11/2013 We’ve all read articles about the epidemic of opioid dependence during the past ten years.  We’ve heard the concern over pain medications being overly-prescribed by some physicians.  Some of us older docs even remember the claims, by the Joint Commission on Hospital Accreditation and other medical watchdogs, that Read more…

Addicted to Suboxone

First Published 7/23/2013 I hear from the anti-buprenorphine people now and then, less than I used to.  I also hear from fans of this blog’s early days, when I routinely lost my temper in response to those people.  Their general line was that things on heroin weren’t all that bad, but Read more…

An Interview with the ATTC

For those who missed it, I recently provided some opinions about buprenorphine treatment for The Bridge, a journal produced by the Addiction Technology Transfer Center Network.  The discussion was published in The Bridge Volume 4, Issue 3, and is copied below. Question 1. The introduction to buprenorphine treatment in the Read more…

Urine Drug Testing on Suboxone

First Posted 2/15/2013 A recent exchange with a reader: 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 would happen if I took just a few doses Read more…