Don’t Spend A Lifetime In Treatment

I described how seeking methadone-assisted treatment for OUD can lead to a lifetime dependency.  Informed patients can take steps to reduce that risk of life-defeating attachment.   Clinics could do the same, although doing so may harm the business model of some companies. People entering treatment, follow this advice so you Read more…

The Other Opioid Crisis: Hospital Shortages Lead To Patient Pain, Medical Error

I came across this public-accesss story, and wanted to share the perspective: Pauline Bartolone, Kaiser Health News Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition Read more…

Should Addiction Treatment Include 'Shame'?

Originally Posted 3/23/2013 I generally write positive articles about the use of buprenorphine for treating opioid dependence, and my articles have been reflective of my attitude toward the medication. The field of psychiatry encompasses more conditions than it does effective treatments for those conditions, and my initial experiences treating people Read more…

Wow (!) in Taipei, Taiwan

I often talk to my patients on buprenorphine (aka Suboxone) about the need to fill their minds with new ideas, plans, and experiences.  For years, those of us with addictions were focused on one thing– finding a way to avoid being sick for the next few hours.  That one issue became Read more…

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…

Clean Enough, Chapter 1.3: Bias of the book

Introduction Bias of the book You will notice the several times throughout the book I take issue with people over what they say about buprenorphine treatment of opiate dependence.  On my web sites I have been told by those who favor ‘total sobriety’ that I am biased in favor of Read more…

Opiate dependence and Sleep– You're not crazy; it never comes back to normal.

I was searching the literature this AM and I came across an article that reviews findings related to sleep and addiction.  On a side note, I always have so much fun with literature searches!  I did my PhD in the 1980’s using the latest technology-  a Mac computer with 128 Read more…