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…
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…
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…
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…
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…
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…
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…
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…
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…
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…
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…
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…