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Archives for December, 2010

Addiction

The Universal Nature of Addictive Experience

Over the past several years I’ve written a book about my experiences with addiction, and about my take on traditional treatment methods, buprenorphine, and on the psychodynamic factors at play in those with addictions.

I went through the standard process of sending requests to agents and publishers to take a look at a few of the 300-some pages, and received the standard series of rejections.  I then discovered...
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Suboxone and Sleep Apnea

On my personal blog about opioid dependence I often respond to specific questions about buprenorphine or addiction.  I would like to invite questions from readers here as well, using the ‘comments’ section.

Specific questions or comments can generate an interesting give and take that in...
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Addiction

Buprenorphine over Methadone for Pregnant Opioid Addicts

I have a number of patients under treatment for opioid dependence taking buprenorphine who have become pregnant, deliberately or accidentally, forcing the decision whether to continue on buprenorphine, taper off the medication, or even whether to terminate the pregnancy.

The decision is not made any easier by the large amount of misinformation people are subjected to, or by the shaming attitudes of some family members and even healthcare workers.

I produce a website...
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Addiction

The Importance of Addiction as Disease

Addiction fits any definition of ‘disease’ that a person might use.  Addiction is progressive; there are familial and environmental influences; the course of a case of addiction bears certain similarities between individuals; the progression of illness is predictable; and recovery from illness is possible with appropriate treatment.

There is a definite behavioral component to addiction in that people who become addicts often engage in behaviors that are ultimately harmful.  But most illnesses...
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Addiction

Just Another Incurable Disease

Buprenorphine does not ‘cure’ opioid dependence.  When buprenorphine is discontinued, the stimulation of opioid receptors ceases, the neurons with the receptors stop firing, and the craving for opioids returns. Moreover, since buprenorphine does have some agonist activity, discontinuation results in withdrawal—although the withdrawal is usually less-severe than the withdrawal after discontinuation of opioid agonists.

At the same time, buprenorphine does much more than act as a ‘replacement medication;’ it treats the very essence of...
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Buprenorphine

Why the Naloxone?

I will take a moment to clarify the difference between the two major forms of buprenorphine on the market, namely Suboxone and Subutex.

Suboxone is a medication that contains buprenorphine plus naloxone, an antagonist at the mu receptor used clinically to reverse opioid overdose.  Subutex and the generic equivalent of Subutex contain only buprenorphine.

The role of naloxone is difficult to understand without knowing a couple facts...
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Addiction

How Buprenorphine (Suboxone) Eliminates Opioid Cravings

Most people with a healthy curiosity about the mind and brain know that nerve cells transmit information in the form of electrical impulses.  When an electrical impulse reaches the end of the axon of one neuron, packets of molecules (called neurotransmitters) are released from that neuron into the narrow space between that neuron and the next neuron.

This space is called a ‘synapse.’  The neurotransmitters, after their release, have actions at molecules...
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Addiction

Neurochem 101

Suboxone is the trade name for a medication that contains buprenorphine and naloxone. A similar medication, Subutex, contains buprenorphine without naloxone.  Both are manufactured and sold by Reckitt-Benckiser, a company based in the UK with operations world-wide.

Both medications are indicated for the treatment of opioid dependence.  Both medications are also used 'off label,' or without FDA indication, to treat chronic pain and in rare cases, refractory depression.  Because of longstanding...
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