Wow, what a mess. But I think all of this is good for me, because I’m typing better and making fewer mistakes.
Why can’t I upload files to my domains? Like plugins, or photos? Is that normally blocked by the host? I need to ‘contact the administrator’, which I’ve done all day. He (me) has no idea what to do.
As part of my goal of regaining good habits, I want to get everything up again. Yes, everything. I’m still ‘suboxdoc’ on youtube if you want to see my stuff from 12 yrs ago… but those are old and grainy, and many of my old sites are down. First priority is to get the Forum going. I used to be there every day, answering questions and arguing with the AODA counselors who said ‘oh, the orange stuff that comes out of their noses?’
The program I referred to in the article let me go the next day. So much for ‘all press is good press’! Later, the NYT story: https://www.nytimes.com/2013/11/17/health/in-demand-in-clinics-and-on-the-street-bupe-can-be-savior-or-menace.html
I worked with that reporter for almost a full year, making sure she got everything right. She never mentioned her angle though — that buprenorphine might be a dangerous ‘menace’, and ‘gasp’ many doctors who have experienced addiction, practice addiction medicine. For the latter I would have pointed out ‘because nobody else will, we realize what a raw deal those suffering addictions are getting, and because we know that with treatment, a new human being will emerge, maybe even for the first time!’
For the first part I would have said that yes. it is a potent opioid and like all opioids, it can cause overdose. BUT…. it is not an attractive medication to abuse, especially to people with established addictions. First, a person must wait at least 12 and often 24 hours after a prior dose of an opioid agonist, or he/she will become very ill. And if a person likes it and takes it daily, poof! They are now ‘on buprenorphine’ and no other opioids will work for days, maybe weeks. They are not ‘treated’, but they are better off.. and within a couple days they feel NOTHING from buprenorphine either. Is that a problem?
Listen to the guy with the sudden mojo….
Buprenorphine CAN kill people. That happens about as frequently as a person is struck by lightning in the US. Seriously – 40-50 per year, at least back when I did the NYT article (I probably Googled it!).
To kill an adult or teen almost always requires 1. no recent prior use of buprenorphine; 2. little or no opioid tolerance, like a first-time user, and 3. a second respiratory depressant, usually alcohol or a benzo.
There was a guy in the article who lost his son to overdose, and I am directing this at the author, not at him. His son was on buprenorphine for 2 years as he continued to abuse a variety of drugs, all non-opioids of course. Then he stopped buprenorphine and died months later. You all understand what happened. I LOVE helping people taper off buprenorphine, a process that usually takes 1-2 years. You cannot do it during a pregnancy, and you need LOTS of time, and lots of motivation. I’ve had several hundred patients taper off over the past 15 yrs. Many of my current patients want to stay on it for life, and that’s fine. It is a better drug to be on, than say… Coumadin. Or Amiodarone. I will never be off the first, but I hope to stop the second (which is for A Fib) in a few weeks. Hopefully.
I’ve had several patients die after being on buprenorphine for many years and then tapering off. Most recently, I believe, in 2018. I never see it coming, as I would never recommend such a thing for someone who hasn’t done well for a long time. But those cases are rare. I would guess that the fatal overdose rate after 5 yrs or more of good living, no other addictions (including alcohol) is around 1%. Relapses happen, but (from my view) more often in stimulants like meth than in opioids. I’ve had a few (maybe 2-3%) of former buprenorphine patients who returned and asked to restart the medication, for a range of reasons.
The poor young man who lost his life in the NYT story never estabished recovery, or even abstinence, from any of the drugs he was using. Very sad, but nothing that makes buprenorphine a ‘menace’.
Sometimes I wonder if the people who write news stories, divide us, anger us….. are the real menace. Just one man’s opinion. Hey, can I even say that anymore???!
Mojo feels good. Just need to keep it in moderation. You folk let me know if I’m going off the rails!!