Buprenorphine and the Dynamic Nature of Character Defects

Sorry about the re-run—I wrote this several years ago, and I still agree with the concept of ‘dynamic character defects.’ As I read it now, I recognize how things have changed; buprenorphine (Suboxone) has been incorporated into many of the major treatment centers, and even the smallest programs have at Read more…

Buprenorphine Availability and Diversion

Since I began using buprenorphine to treat opioid dependence in my psychiatry practice, I’ve learned quite a bit about what works and what doesn’t work. Buprenorphine is an amazing medication when used properly, and undoubtedly saves thousands of lives each year. Even when used improperly, buprenorphine has life-saving properties. Addicts Read more…

Buprenorphine Down Under

Much thanks to a doc in Australia for recent comments: From one Doc to another (I’m in Australia). You may be interested (or possibly know) how we do things here. Basically, addicts can register at any Dr who’s completed a programme and is then authorised to prescribe what we call Read more…

More about counseling and stigma

One of my patients sent me a link to a Kentucky newspaper article that described the recent surge in cases of opioid dependence and treatment with buprenorphine. The article described the increased costs for medicaid programs because of the need to pay for buprenorphine. The reporter said that the problem Read more…

Counseling: Good for Addiction?

When a person asks for help with some issue in his/her life, a safe and relatively common answer is to suggest ‘counseling’. Trouble with your marriage? Get counseling. Depressed? Take an SSRI, sure, but get some counseling too. Kids acting up? Send them for counseling. Wondering about the meaning of Read more…