Archives for History

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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Anxiety

The End of Times: Aren’t We Special?!

Several of my patients have warned me about the world ending in a few days, on December 21, 2012.  There are variations on the theme, but the basic idea is that the Mayans, who were accomplished mathematicians and astronomers, used an advanced calendar to measure planetary cycles… and that calendar ends at the end of this week.   Some patients tell me that the end of the Mayan calendar coincides...
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History

I Told You So

The FDA recently released a Drug Safety Announcement regarding the use of codeine in young children after tonsillectomy/adenoidectomy surgery for obstructive sleep apnea.  I was somewhat surprised to see a safety announcement on a medication that has been in use for decades, but the release underscores our improved knowledge of drug metabolism, and the broadening demographics of the United States.

Codeine has little activity at opioid receptors.  The analgesic effects of codeine...
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Addiction

A Typical History

I received the following email last week.  I considered trimming it down, but the story is well-written and describes a history that is similar to that of many of my patients.  As usual, I will write a follow-up post in a week or so.

Dear Dr. J,

I have read many of your posts over the past few years. Like many, I started out disagreeing with your comments and insight, while blaming my inability to...
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Addiction

Opioids for Chronic Pain (?)

I've written about the spectrum of medical and scientific opinion (not, unfortunately, always the same thing) over the use of opioids for treatment of chronic pain.  For those who missed the earlier discussion-- one that produced a heated response from readers-- I invite you to review those posts.

The essence of the issue is that over many years, there has been significant effort to increase patient access to potent opioids.  This effort has come in part from the...
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Addiction

Did I Say ‘Epidemic’?

I will get to my promised response to my last post-- the one that called out the detractors from Suboxone.  But first I have to share the story I read in the Maine Sunday Herald today about the surge in overdose deaths over the past year or two.  The article mentions the 28,000 overdose deaths across the US in 2007-- the last year for which we have such numbers;  numbers that have...
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Addiction

Reactions to Suboxone

As many readers know, I maintain a forum for people who take buprenorphine for opioid dependence. The initial purpose of the forum  was to serve as a source of accurate information about the new medication. Now, several years later, the forum is also a gathering place for people who share certain interests.

Studies have established a connection between opioid dependence and certain personality traits, including a tendency toward depression. In my conversations...
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Addiction

Methadone, for One Thing or Another

As I’ve mentioned, I receive several e-mails each day asking questions about opioid dependence.  There are a number of confusing opinions, attitudes, and regulations that ultimately get in the way access to treatment.  And with opioid dependence, access to treatment can mean the difference between life and death.

One area of confusion relates to the use of methadone to treat opioid dependence.  Methadone is a potent, low-cost pain medication.  While a month’s prescription for...
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Addiction

Saving ALL The Starfish

I have several blogs and forums, all part of the mission to educate people about opioid dependence and buprenorphine.  Because of my online presence I am frequently contacted by reporters or journalists, and asked to provide my opinion about some aspect of opioid dependence.  The requests have become more frequent over the past year, suggesting that either my name recognition has increased, or that there is greater awareness—finally—that an epidemic of opioid dependence...
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Addiction

Is Addiction REALLY A Disease?

I would like to lay out a road map for the next few posts.  I would like to write about several issues that relate in some way to the ‘disease theory of addiction.’  I want to explain why addiction is best considered a ‘disease;’ something that most people who work in the addiction field consider to be a fact, not a theory.

From there I would like to point out the differences...
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