Archives for Treatment

Is Xanax or Klonopin Killing You?

I’ve written about the dangers of Xanax (alprazolam), Klonopin (clonazepam), and other drugs in a class of drugs called ‘benzodiazepines’.  The drugs are grossly over-used by patients, and over-prescribed by psychiatrists, usually for patient complaints of anxiety.

My primary concern over use of benzodiazepines is that when used to treat anxiety, they are more likely to aggravate than improve a patient’s symptoms, especially if taken regularly.  Patients develop physical and psychological dependence to benzodiazepines very quickly.  Once physically tolerant, patients experience withdrawal symptoms if...
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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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Pharmacology

Psych Treatment Gray Areas

I recently heard parts of a lecture by a healthcare provider (not a psychiatrist), who was speaking to a group of general practitioners about psychiatry.  She answered questions about the best approach for treating depression, anxiety, and other psychiatric disorders by relating anecdotes from her own experience and suggested by her favorite mentor.  “Add a little of this, and if that doesn’t work, try adding some of that” she said.  “Psych is all a gray area. ...
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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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