An Addict's Story

I received the following email last week.  I considered trimming it down, but the story is well-written and describes a history that is similar to that of many of my patients.  As usual, I will write a follow-up post in a week or so. Dear Dr. J, I have read Read more…

Jerk Counselor

Every now and then I hear about a therapist or addiction doc who is doing such a disservice to the practice of addiction medicine as to deserve special mention.  This week’s award goes to a certain counselor at a treatment program in Oshkosh, WI, who I’ll refer to as ‘This Read more…

Relapse in an Era of Buprenorphine

A recent experience with a patient helped me realize some of the dramatic differences in the treatment of relapse in an era of buprenorphine. I drug-test patients who are treated with buprenorphine or Suboxone.  The point of testing is not to catch someone messing up, but rather to determine when 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…

Clean Enough: Some Distorted Thinking

Some distorted thinking You see where this is going. My behavior was an example of cross addiction, where an addict stops one substance but continues to use another, only to find that the previously safe substance becomes the drug of choice. My use of alcohol increased, and soon I was Read more…

Why do some docs kick patients off buprenorphine?

I often receive e-mails from people that go something like this:  I was addicted to oxycodone and heroin for 5 years, and lost my marriage, several jobs, and the trust of my children.  I was completely broke, and considering suicide.  Then I heard about treatment with buprenorphine and found a Read more…

Monday Morning Anti-Suboxone Quarterback

I spend some time on this post at the forum so I will share it here as well.  First, a post from a person who uses the name ‘Suboxone7yrs’: I was addicted to vicodin for 10 years popping 50 pills a day of Vicodin ES or NORCO, I then decided Read more…

A Common Mistake

I brought a note from the ‘comments’ section up here because it presents a topic that comes up over and over with opiate dependence and Suboxone.  I am the expert on MedHelp.org’s addiction forum;  I get questions and comments like this one quite frequently on that site– although I have Read more…

Suboxone talk

Suboxone is OK– If Used ‘Short-Term’?

For the sake of a good night’s sleep I will share the post I just left with my good friend over at ‘arm-me’ blog– see the blogroll for the link.  The conversation there arose over the recent Suboxone-related deaths in Milwaukee, Wisconsin, and I was responding to a writer who Read more…

Addiction and Will Power

A person posted the following after one of my youtube videos about Suboxone: While SuboxDoc knows what he’s talking about in his videos, not everything he says is always true. Not everyone needs permanent blocker therapy. Everyones willpower varies. The simple fact is, the worse withdrawal is, the more likely Read more…

Darn That Suboxone!

This guy doesn’t like Suboxone– or the horse it rode in on.  He has been trying to write angry posts under my youtube videos, but I have been blocking them– His feelings about Suboxone popped up on one of the health sites out there this morning, catching my attention through Read more…

Started Suboxone, Used, When to Start Suboxone Again?

A fairly specific question, but also a fairly common situation. All is not lost; buprenorphine has a long half-life and binds very tightly to the opiate receptor, so the use probably had minimal effect on what is happening at the receptor level. I recommend just continuing the Suboxone each morning, Read more…