Pregnant, in jail

Methadone, a Dead Baby, and a Rushed Judge

Now and then, an attorney will ask me to provide an expert opinion on addiction. I can usually quickly review records to find issues that attorneys might miss.   Moreover, with access to electronic libraries, it usually does not take long to find articles supporting my opinion. I come from a Read more…

More Methadone, If WE Can Profit From It.

A short holiday post today. Reading my newsfeed I came across an article by Jason Kletter, President of BayMark Health Services, complaining about Section 4 of the proposed Opioid Treatment Act that would allow pharmacies to dispense methadone for the treatment of opioid use disorders. At present, no opioid, including Read more…

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…

Is Counseling What it is Cracked Up to Be?

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. Today I wonder, is counseling what it is cracked up to be? Excuse the 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…

Withdrawal on Suboxone?

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…