Little Things make a Difference in Healthcare

A quick one if I don’t get distracted. Ooops… there it goes. First I’ll admit that I’ve been frustrated by needing oxygen. It isn’t just the hoses, batteries, and loud machines… it is going upstairs to get from the tank to the bedroom concentrator and racing to turn it on, 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…

Scam City

When Suboxone first became an option for treating addiction to pain pills back in 2003, some people were excited about having a cure for opioid dependence. Those people were mistaken. It is true that Suboxone has been a huge benefit for treating opioid dependence, but the medication cannot cause the Read more…

Almost Ready to Get Help?

Another chapter from my untitled book, ‘Clean Enough,’ begins with comments from a reader of my blog.  The picture has nothing to do with anything, except that the Packer win was pretty awesome.  The view is from my seat at Lambeau during a game this season. I have been using Read more…

Clean Enough, 2.8 and 2.9

Treating myself In the spring of 1993 I took codeine cough medicine for a cold.  A few weeks later I was still taking the codeine each evening.  It worked so well; finally I could relax and get some quality sleep!  I started feeling more irritable in the morning as the Read more…

Clean Enough, Chapter 2.5, 2.6, and 2.7

My Story (continued) Treating myself In the spring of 1993 I took codeine cough medicine for a cold.  A few weeks later I was still taking the codeine each evening.  It worked so well; finally I could relax and get some quality sleep!  I started feeling more irritable in the 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…

The book

I’ve been writing teasers for a book about buprenorphine for a couple years now.  I keep very busy trying to maintain a solo psychiatry practice, and for awhile there I was running constantly… keepiing the practice going by day and writing nonstop at night.  I’m not sure what possessed me Read more…

More about counseling and stigma

One of my patients sent me a link to a Kentucky newspaper article that described the recent surge in cases of opioid dependence and treatment with buprenorphine. The article described the increased costs for medicaid programs because of the need to pay for buprenorphine. The reporter said that the problem 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…

Anxiety, step-work, and gratitude

One of the primary insights that I want addicts to gain from reading this blog is the similarity between their own thoughts, feelings, and pattern of use and the thoughts and patterns of use of other opiate addicts.  We are all dealing with the same beast, we have all felt Read more…