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Legal

What Should Doctors Risk for their Patients?

The LA Times ran a very interesting story a few days ago about deaths from overdose of narcotic pain medications.  I strongly encourage readers of this blog to read the story, which discusses the issue from the perspectives of doctors, patients, and family members.

The story reports that a small number of Southern-California doctors wrote prescriptions that have killed a large number of patients. Over the past five years, 17% of the deaths...
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Addiction

(Un)Intended Consequences

A couple weeks ago the manufacturer of Suboxone, Reckitt-Benckiser, filed a Citizens Petition with the FDA, announcing a voluntary recall of one of the company’s signature products, Suboxone Tablets.  Suboxone was sold in tablet form for almost ten years, and the patent ran out on Suboxone Tablets last year.  A couple years ago the same company began making Suboxone Film; a rapidly-dissolving form of the medication that comes with each dose individually packaged.

Suboxone...
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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

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

Clean Enough?

Yesterday I received the following e-mail:

Hi Dr. Junig,



Please let me first say - Suboxone SAVED MY LIFE. I was down and out until 2 years ago, when I began using Suboxone. Now, having completed all the pre-req's for medical school with nothing less than straight A's, I find myself on track to apply to medical school.



But here's the problem. I'm still taking Suboxone and have no desire to stop....
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Addiction

Try A Little Harder

Like many people with opioid dependence, I did not progress to a severity of illness where I decided that I needed addiction treatment.  It would have been less burdensome for my family, of course, had I come to such a realization.  But I needed stronger ‘encouragement,’ in the form of life falling apart and having nowhere to turn, except treatment.
The nature of opioid dependence leads the addict to cling to the illusion of...
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Legal

Over-Prescribing: I Know It When I See It

I've described the gray area between appropriate treatment of chronic pain using opioid medications, versus deliberate or accidental over-prescribing of narcotics for patients who don't need them.  In many cases, the decision whether the prescribing is justified depends on who is making the determination.

There are clearly physicians who act too aggressively at increasing dosages of narcotics, and there are clearly patients who are too careless in their use of addictive medications.  At the same time, there...
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