Archives for Buprenorphine

Addiction

Buprenorphine’s Relationship with Traditional Recovery

Regular readers of my blog know that I believe buprenorphine is the most important development for treating addiction during my lifetime.  At the same time, my own recovery from opioid dependence began over 20 years ago, long before the use of buprenorphine.  I am grateful for the change in my perspective that occurred one desperate afternoon, when I first recognized the uselessness of ‘will power’ for stopping opioids.  I was one of the lucky...
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Buprenorphine

What Standard of Care for Mothers on Suboxone?

Newborn abstinence syndrome from buprenorphine provokes strong emotions.  Expectant patients rightly anticipate harsh attitudes from doctors and nurses. They read in forums and chat rooms about experiences of women who say that CPS was called after delivery, or about babies who were kept on opioid tapers, in the hospital, for weeks or even months after mom’s discharge.  And in the absence of appropriate support from the medical profession, they worry that their use of buprenorphine...
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Addiction

Why the Suboxone Doctor Shortage?

With all the recent attention over the epidemic of opioid dependence, why do some parts of the country report a shortage of physicians who are DATA-2000 certified, able to prescribe Suboxone and other buprenorphine products? The shortage of buprenorphine-certified doctors parallels shortages of mental health practitioners in general, including psychiatrists and addictionologists. Larger cities and areas near the east and west coasts are less likely to have shortages of doctors than are smaller and more-rural...
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A Deeper Look at Suboxone Diversion

In ‘Addiction Treatment with a Dark Side’, Deborah Sontag of the New York Times shared her observations of the clinical use of buprenorphine for treating opioid dependence, warts and all.  Readers of the Talk Zone know my bias—that buprenorphine/Suboxone is one of the only effective treatments for opioid dependence, and many patients are best-served by long-term, perhaps life-long treatment with buprenorphine.   But I read the article the article with interest because I know that Ms. Sontag ‘did her homework’, including visiting a...
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Addiction

Now the Tough Part

The forces of nature appear intent on reversing mankind’s progress toward better health.   An example is the ever-increasing resistance of bacteria to antibiotics.  A timeline of the existence of humans and bacteria shows that bacteria have been around for a very long time--- much longer than mammals, and much, much longer than humans.  In fact by the dawn mankind, bacteria had been thriving, relatively uninhibited, for over 2 billion years.

Modern humans have been around for 40,000-200,000 years or so, depending on...
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Addiction

Guilt by Association?

A local District Attorney wrote to me last week to express his concern about the increased diversion of buprenorphine.  I often sense an undercurrent of tension when I cross paths with attorneys, aware of the different attitudes that we hold that arise from our different roles in society.

The DA wrote about the dramatic increase in overdose deaths in the Midwest.   Overdose scenes are often littered with a variety of substances, ranging from bags of heroin to...
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Addiction

Drug Testing: Not Always the Whole Answer

A recent exchange with a reader:

I have been on buprenorphine for 5 yrs.  Recently my doctor stated that my u/a t looked like I have been ‘loading my meds.’  He said my levels where ‘backwards’ and that would happen if I took just a few doses just before my appt.   My doc had me come back in two weeks to go over my next u/a, and again it came back funky.  So my doc starts having...
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Buprenorphine

Sudden Infant Death from Buprenorphine?

In a recent Google search about Suboxone and pregnancy, one of the top links included the frightening statement that Suboxone and buprenorphine have been linked to SIDS or sudden infant death syndrome, commonly called ‘crib death.’

The statement was from a health forum where a woman wrote about taking Suboxone during pregnancy.  She wrote that her child went through opioid withdrawal after delivery, recovered, and then died two months later from SIDS. ...
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