Archives for General

General

Suboxone Alternatives?

There have been a number of events over the past couple weeks that have been 'game changers' in the efforts by Reckitt Benckiser to hang onto their profitable treatment for opioid dependence, Suboxone.  Reckitt Benckiser (RB) had asked the FDA to deny any future generic drugs based on Suboxone tabs because of deaths of several chldren, who might have confused the tabs for candy.

The FDA gave RB's comments some thought and then discarded them, even stating that...
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General

Compassion or Murder?

I subscribe to Google news alerts for the phrase 'overdose deaths.'  Google Alerts are a great way to follow any topic; subscribers receive headlines from newspapers and web sites for certain keywords from around the world. One thing that has become clear from my subscription is that there is no shortage of stories about deaths from opioids! Every day I see one article after the next, as news reporters notice the loss of...
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Addiction

A Tool, Not a Cure

Please review my prior post, as my comments will refer to an email in that post.

There are many directions that we could take as we review that message.  My overall impression, as I read the letter, was of a person struggling to accept the reality of his condition.  Over and over, the person repeated the same behavior, starting Suboxone, stopping, and thinking this time will be different.

One thing...
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General

Surgery on Suboxone

I often receive emails from patients on buprenorphine (or Suboxone) who are preparing for surgery or other painful medical procedures.  Ideally in such cases, the surgeon would have a discussion with the person prescribing buprenorphine, in order to coordinate the plan for treating postoperative pain.

In practice such discussions don't seem to take place, leaving patients to scramble for effective pain control after surgery-- when it is too late to take the...
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Addiction

Tolerate THIS, Part II

I have been struggling with Part II, primarily because there are no easy answers to the situation.  I realize that I could easily criticize whichever path a doctor suggests for our imaginary patient.

As an aside, I believe that a major reason for the lack of sufficient prescribers of buprenorphine in some parts of the country is the ‘damned if I do, or damned if I don’t’ scenario.  All docs are aware...
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Buprenorphine

Treating Depression with Opioids?

I received this message today:
Hi, you probably answer this quite a bit. I've been depressed for as long as i can remember.

Ive been on the ssris, snris, amphetamines and methylphenadate but none of these have worked as well as opiates. (Certainly short term,I don't take for long periods of time). But have you ever used suboxone or oxymorphone for depression?
Depression is probably a broad term, for what may be multiple...
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Addiction

Another Pain Advocacy Group Goes Under

I've written about the Pain Relief Network in prior posts -- one side of the battle between those trying to limit access to schedule II opioids (led by PROP, or Physicians for Responsible Opioid Prescribing), and until recently, the Pain Relief Network, or PRN.

If you haven't read my earlier posts on the subject, I encourage you to do so;  the final chapter, including the death of PRN's...
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Addiction

Opioids and BPD

I appreciate the feedback to my last post.  I had no doubt that the thoughts expressed in the original letter would ring such a chord, as I hear similar comments on a daily basis.  For people new to my blog this week, please review the letter in last week’s post, as that is where I’m starting today.

I had the same ‘love at first site’ reaction to opioids described by many...
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General

More of a Painful Topic

Thank you for your comments about my post about treating chronic pain with opioids.  I was in the middle of adding a response to one of the comments this morning, when I decided to elevate my response to a post of its own. Starting a new post might, I hope, keep the discussion going… and besides, I was struggling to find a stopping point!

Here are highlights from the...
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