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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…

Size Matters?

I’ve received several complaints from patients and readers about one of the current buprenorphine formulations.  The primary complaint is that the tablet is ‘not ‘working as well as the other formulations;’ that it seems to wear off earlier, or that people feel compelled to take more than what is prescribed. 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…

Cinderella and Snow White Smuggle Suboxone

I’ll often joke with others who have histories of addiction over the ingenuity of addicts when it comes to finding or using drugs.  If that amount of creativity and work ethic were ever harnessed for legitimate reasons, the opportunities would be limitless! I have similar thoughts when I read the Read more…

Chapter 4, Pt 2: Stages of Addiction

I am always impressed by how similar addiction progresses in one individual versus the next.  The next reader’s comments and my comments afterward demonstrate a pattern that I have observed in one opioid addict after another.  Throughout the book, comments that I receive from others will be italicized. I started Read more…

Withdrawal from Suboxone

I often receive e-mails asking for advice on tapering Suboxone, or asking how long Suboxone withdrawal should last.  People who read my blog know my approach to stopping Suboxone; I see it as an exercise in futility even in the rare cases where the person is successful, because of a 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…

Sick from naloxone, maybe?

A person wrote about feeling sick after taking Suboxone, thinking that naloxone is to blame and frustrated that her physician would not prescribe Subutex: I first read your blog last week as I was going through the despair and misery of withdrawal from Percocet, and considered suicide. I didn’t want Read more…

Clonidine and Opiate Withdrawal

For those of you who like to do some scientific reading, a recent meta-analysis looked at clonidine’s efficacy in reducing the symptoms of opiate withdrawal.  A meta-analysis, by the way, is when someone takes a number of studies that sometimes didn’t reach significant conclusions and combines the numbers, creating a Read more…

Kratom and Suboxone; Being 'Clean' and Recovery

On a message board called ‘opiophile’, a person wrote about being a long-term opiate addict, then taking methadone for a couple years, then going on Suboxone for a couple years.  He eventually stopped Suboxone, and had a miserable period of withdrawal… which never, by his recollection, ever totally went away.  Read more…

Sick When Starting Suboxone: Abres Los Ojos!

An interesting case from a reader: Thanks Doc for your efforts. I appreciate you. I am a four year hydrocodone addict 55 years old. I became addicted when I used the drug for an injured cervical disc. A couple of years ago I found out about suboxone and got in Read more…