Methadone Treatment Can Become a Lifetime Curse

I know. Nothing brings out the boo-birds like a negative story about methadone. For the record I agree that methadone treatment, properly provided, is a vital and life-sustaining weapon against opioid overdose deaths. But too often, methadone treatment can become a lifetime curse. This is long because the story is Read more…

Help for Heroin Addiction

A couple comments for regular readers…  first, watch for an upcoming change to a new name.  For years I’ve debated whether to adopt a name centered on ‘buprenorphine’, rather than the more-recognizable ‘Suboxone’.  I believe that time has come.   Second, I’m going to ‘reset’ with some introductory comments about the Read more…

Counseling Schmounseling

I just noticed a couple of my recent posts….  these people have it wrong, and that person has it wrong.  One of these days I really need to print something positive and uplifting.  But not today. Excuse the self-flattery, but I like to think of myself as a physician scientist.  Read more…

The Downside of Methadone

An Article by Mike Berens and Ken Armstrong, Seattle Times, discusses some of the problems with using methadone as a first-line treatment for pain: When it comes to battling pain, Washington health officials have encouraged doctors to reach for methadone, a powerful and inexpensive prescription drug. For the past decade, Read more…

Making People Stop

Below is an e-mail that I changed just enough to hide the person’s identity.  Every week, I receive messages that describe similar situations. My husband has struggled GREATLY with substance abuse since in his 20’s; he is now in his mid-40’s. He is the kindest sweetest man and he is Read more…

Do You Prescribe Buprenorphine?

I’m not sure about the make-up of readers of this blog.  I know that there are about 20,000 page views each month, but I don’t know how many are by people addicted to opioids, people taking buprenorphine, family members of addicts, or physicians who prescribe buprenorphine.  If you fall into Read more…

Withholding medication in jail

Much thanks to a reader for sharing a story out of Maine from several months ago. The story refers to a common situation that doesn’t really register unless one happens to look at things with a different frame of reference.  The story refers to a woman jailed for driving on a Read more…

Buprenorphine safer than methadone for neonates born to opioid addicts

A presentation at a recent meeting of ACOG, the American College of Obstetricians and Gynecologists, compared the use of buprenorphine or methadone for treating opioid addiction during pregnancy.  I hear from pregnant women often, who write out of frustration that their OBs have never heard of buprenorphine or Suboxone and Read more…

Buprenorphine for low-dose opioid use

A reader wrote with a question that I don’t think I’ve addressed on the blog. Do you have a threshold for how much narcotic a patient must be using before you will put them on buprenorphine? I am concerned about narcotic addicts that are using 6-10 Vicodin (hydrocodone) a day Read more…

Buprenorphine and the Dynamic Nature of Character Defects

What follows is a lightly-edited version of one of my posts from a couple years ago.  I still think that this is a good model for understanding the actions of buprenorphine. Buprenorphine and the Dynamic Nature of Character Defects ‘Suboxone’ and ‘Subutex’ are the trade names for medications that contain buprenorphine, a substance used to Read more…

Withdrawal in newborns: Lay off the guilt trip!!

I will share some thoughts that I left at a discussion at a ‘linked in’ group about addiction.  I was responding to someone who was equating addiction and physical dependence in a baby born to an opiate-addicted mother.  My feeling is that such women are given way too much of Read more…

Buprenorphine, methadone, and testerone

A member at the buprenorphine forum wrote about his own health issues including hormonal imbalances, prompting me to do a literature search on buprenorphine and testosterone.    I found a couple interesting studies and invite people to visit the forum and read about them, and comment if you wish.  To find Read more…