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Leadership on Opioids

Anyone who proposes an easy solution to the overdose epidemic is either a simpleton or a politician.  But far too many people entrusted with the power and responsibility to set priorities decry the number of overdose deaths, then stigmatize and demonize every effort to save lives.   “Suboxone can be diverted.”   “Someone might Read more…

Short-Timers

Another question from a reader: The current blog brings up the notion of long term use of Bupe or short term detox.  You say you are a fan of long term use, and that is clearly a good thing when the patient is one headed back to a drug culture Read more…

Mean Streak

I guess I do get irritable sometimes…  but I’m getting better at controlling my anger as I get older.  One cool thing about a blog is that I can go back and see what I wrote years ago.  In this case, I was looking for a post about telling the difference  between opioid Read more…

Brattleboro Vermont To Addicts: Stay Stoned!

I was stunned to see this story about the town of Brattleboro, a town in Vermont with a name famous for the rats that grew up there. As an aside, my PhD thesis involved working with vasopressin receptors in the brain, and that is why I’m familiar with Brattleboro rats– Read more…

Consequences Section

Weeks ago I posted a few new ideas—things like a memorial wall for victims of opioid dependence, and a ‘wall of shame’ for doctors who are known for reckless prescribing of opioids.  I mentioned these ideas over at SuboxForum as well. I received good feedback from readers here, and from Read more…

Endorphin Deficiency Syndrome and Buprenorphine

Every now and then I receive an e-mail  or comment that is sufficiently long to warrant a post of it’s own.  Below is the comment without interruption;  a bit lower I repeat parts of the comment, interspersed with my own responses.  I hope you find it interesting. The comment: I Read more…

Clean Enough: An Educational Process

Clean Enough continues: An Educational Process I was able to stop using codeine after returning home and to my job in the operating room.  I dodged a bullet– or so it seemed.  I continued to drink wine, beer, and the occasional margarita, but I had convinced myself that drinking was Read more…

Unintended Consequences

I saw a patient from up north earlier today, and we tallked about the economy in his part of Wisconsin and in the Michigan Upper Peninsula.  From what he had to say, things are the ‘same old same old;’ i.e. jobs are few and far-between.  Seems as if it has been Read more…

A true epidemic, with no easy scapegoats

Today an article on the web site Medscape describes the epidemic of opioid dependence in this country.  The article describes what people who work with addiction already know– that use of opioid medications has increased in a way never seen before for any medication.  The article does a good job Read more…

The point of addiction treatment

I worked for several years as the medical director of a residential treatment center in Wisconsin, leaving the position several weeks ago.   On my last evening in the place I took a moment to look around and think about how addiction treatment has changed in the past decade.  I looked 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…