Suboxone Forum Upgrade
Regular readers know that I’m a psychiatrist and addiction doc – not a computer guy. When I started writing about Suboxone and buprenorphine twelve years ago, there were few other people writing about the medication. Of course heroin addiction was just taking off, and fentanyl was confined to operating rooms. I put together a couple sites that skyrocketed in readers. The most-used was SuboxForum, where we discussed controversial issues like ‘is Suboxone a drug for a drug’, and ‘do the films hurt your teeth?’ I did not work on SEO stuff, because (in case I didn’t say) I&rsquo...
Source: Suboxone Talk Zone - November 2, 2019 Category: Addiction Authors: admin Tags: Uncategorized Source Type: blogs

Suboxone Forum Upgrade
Over the past year I’ve done more work ‘in the trenches’ than on this blog. I’ve been working with other forms of medication-assisted treatment, particularly methadone. In the near future I’d like to share some of what I’ve learned about the options now available for treating opioid use disorder, which will hopefully serve as one resource for guiding people addicted to opioids to the resources that are likeliest to help. Five years ago, my forum about Suboxone and buprenorphine was receiving about five times the traffic as now. I wonder – is that because I haven’t aggressi...
Source: Suboxone Talk Zone - October 9, 2019 Category: Addiction Authors: admin Tags: Buprenorphine Suboxone Forum medication assisted treatment opioid addiction Source Type: blogs

Tapering off Buprenorphine or Suboxone, Pt 2
In the last post we discussed some of the misconceptions about tapering off opioids.  Today we will discuss a couple basic principles, and then describe the approach I recommend for my patients tapering off buprenorphine. Opioids act at receptors that normally bind endorphins, which are released by neurons in response to a range of stimuli including trauma and rewarding behaviors such as eating a good meal or using addictive drugs.  Endorphin pathways elevate mood, reduce sensation of pain, and impact urine production, immune function, intestinal motility, and other bodily functions.  Endorphin pathways have...
Source: Suboxone Talk Zone - August 15, 2018 Category: Addiction Authors: admin Tags: Addiction Buprenorphine pharmacology receptor actions Suboxone Withdrawal opioid tolerance stopping suboxone suboxone detox Suboxone taper tapering off buprenorphine Source Type: blogs

Tapering off Buprenorphine or Suboxone, Pt 2
In the last post we discussed some of the misconceptions about tapering off opioids.  Today we will discuss a couple basic principles, and then describe the approach I recommend for my patients tapering off buprenorphine. Opioids act at receptors that normally bind endorphins, which are released by neurons in response to a range of stimuli including trauma and rewarding behaviors such as eating a good meal or using addictive drugs.  Endorphin pathways elevate mood, reduce sensation of pain, and impact urine production, immune function, intestinal motility, and other bodily functions.  Endorphin pathways have...
Source: Suboxone Talk Zone - August 15, 2018 Category: Addiction Authors: admin Tags: Addiction Buprenorphine pharmacology receptor actions Suboxone Withdrawal opioid tolerance stopping suboxone suboxone detox Suboxone taper tapering off buprenorphine Source Type: blogs

Tapering off Buprenorphine or Suboxone, Pt 2
In the last post we discussed some of the misconceptions about tapering off opioids.  Today we will discuss a couple basic principles, and then describe the approach I recommend for my patients tapering off buprenorphine. Opioids act at receptors that normally bind endorphins, which are released by neurons in response to a range of stimuli including trauma and rewarding behaviors such as eating a good meal or using addictive drugs.  Endorphin pathways elevate mood, reduce sensation of pain, and impact urine production, immune function, intestinal motility, and other bodily functions.  Endorphin pathways have...
Source: Suboxone Talk Zone - August 15, 2018 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine pharmacology receptor actions Suboxone Withdrawal opioid tolerance stopping suboxone suboxone detox Suboxone taper tapering off buprenorphine Source Type: blogs

Tapering Off Buprenorphine or Suboxone pt. 1
Many patients taking buprenorphine live in fear of a dark world around the corner where they will have to taper off the medication.  They see horror stories on YouTube posted by people who, for some reason, abruptly stopped the medication and kept a video log of their experiences.   My own patients sometimes ask, nervously, if I plan to retire some day.  Some have asked what they should do if I ever, say, drop dead. It needn’t be all that bad.  Yes, sudden discontinuation of a typical dose of buprenorphine will result in withdrawal symptoms.  But if you taper correctly, your body will sl...
Source: Suboxone Talk Zone - August 8, 2018 Category: Addiction Authors: admin Tags: Buprenorphine receptor actions Suboxone Withdrawal buprenorphine treatment opioid taper stopping suboxone Suboxone withdrawal Source Type: blogs

Tapering Off Buprenorphine or Suboxone pt. 1
Many patients taking buprenorphine live in fear of a dark world around the corner where they will have to taper off the medication.  They see horror stories on YouTube posted by people who, for some reason, abruptly stopped the medication and kept a video log of their experiences.   My own patients sometimes ask, nervously, if I plan to retire some day.  Some have asked what they should do if I ever, say, drop dead. It needn’t be all that bad.  Yes, sudden discontinuation of a typical dose of buprenorphine will result in withdrawal symptoms.  But if you taper correctly, your body will sl...
Source: Suboxone Talk Zone - August 8, 2018 Category: Addiction Authors: admin Tags: Buprenorphine receptor actions Suboxone Withdrawal buprenorphine treatment opioid taper stopping suboxone Suboxone withdrawal Source Type: blogs

Tapering Off Buprenorphine or Suboxone pt. 1
Many patients taking buprenorphine live in fear of a dark world around the corner where they will have to taper off the medication.  They see horror stories on YouTube posted by people who, for some reason, abruptly stopped the medication and kept a video log of their experiences.   My own patients sometimes ask, nervously, if I plan to retire some day.  Some have asked what they should do if I ever, say, drop dead. It needn’t be all that bad.  Yes, sudden discontinuation of a typical dose of buprenorphine will result in withdrawal symptoms.  But if you taper correctly, your body will sl...
Source: Suboxone Talk Zone - August 8, 2018 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Buprenorphine receptor actions Suboxone Withdrawal buprenorphine treatment opioid taper stopping suboxone Suboxone withdrawal Source Type: blogs

Addiction Treatment, Science, and Dead Rats
In my last post I teased that I would write about fake science.  I’ll try to make it interesting. The internet allows everyone to do research about symptoms and treatments for any condition. If not for need for prescriptions, people could act as their own doctors.  But a huge dose of caution is necessary before anyone takes that path. Realize first that doctors don’t treat themselves or even their family members.  The saying that ‘a person representing himself in court has a fool for a lawyer’ applies double in healthcare.  Treating someone close to one’s self introduces a ...
Source: Suboxone Talk Zone - May 23, 2018 Category: Addiction Authors: admin Tags: Education Pharma pharmacology Research treatment alcohol treatment fake science FDA approval nutritional supplements Source Type: blogs

Addiction Treatment, Science, and Dead Rats
In my last post I teased that I would write about fake science.  I’ll try to make it interesting. The internet allows everyone to do research about symptoms and treatments for any condition. If not for need for prescriptions, people could act as their own doctors.  But a huge dose of caution is necessary before anyone takes that path. Realize first that doctors don’t treat themselves or even their family members.  The saying that ‘a person representing himself in court has a fool for a lawyer’ applies double in healthcare.  Treating someone close to one’s self introduces a ...
Source: Suboxone Talk Zone - May 23, 2018 Category: Addiction Authors: admin Tags: Education Pharma pharmacology Research treatment alcohol treatment fake science FDA approval nutritional supplements Source Type: blogs

Addiction Treatment 'Science' and Dead Rats
In my last post I teased that I would write about fake science.  I’ll try to make it interesting. The internet allows everyone to do research about symptoms and treatments for any condition. If not for need for prescriptions, people could act as their own doctors.  But a huge dose of caution is necessary before anyone takes that path. Realize first that doctors don’t treat themselves or even their family members.  The saying that ‘a person representing himself in court has a fool for a lawyer’ applies double in healthcare.  Treating someone close to one’s self introduces a ...
Source: Suboxone Talk Zone - May 23, 2018 Category: Addiction Authors: admin Tags: Education Pharma pharmacology Research treatment alcohol treatment fake science FDA approval nutritional supplements Source Type: blogs

Addiction Treatment ‘Science’ and Dead Rats
In my last post I teased that I would write about fake science.  I’ll try to make it interesting. The internet allows everyone to do research about symptoms and treatments for any condition. If not for need for prescriptions, people could act as their own doctors.  But a huge dose of caution is necessary before anyone takes that path. Realize first that doctors don’t treat themselves or even their family members.  The saying that ‘a person representing himself in court has a fool for a lawyer’ applies double in healthcare.  Treating someone close to one’s self introduces a ...
Source: Suboxone Talk Zone - May 23, 2018 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Education Pharma pharmacology Research treatment alcohol treatment fake science FDA approval nutritional supplements Source Type: blogs

Buprenorphine, Not Subbies
I’ve been writing longer and longer posts on SuboxForum so maybe I need to write more here.  This blog archives twelve years of frustration over the ignorance toward buprenorphine, at least until I ran out of steam a year ago.  I grew used doctors refusing to treat people addicted to heroin and other opioids.  I became used to the growth of abstinence-based treatment programs, even as relapse rates and deaths continued to rise.  It isn’t all bad news; I enjoyed the past couple meetings of AATOD, where people openly spoke about medication-assisted treatments without hushed voices.  ...
Source: Suboxone Talk Zone - April 9, 2018 Category: Addiction Authors: admin Tags: Addiction Buprenorphine recovery Suboxone treatment addiction treatment stigma subs Source Type: blogs

Buprenorphine, Not Subbies
I’ve been writing longer and longer posts on SuboxForum so maybe I need to write more here.  This blog archives twelve years of frustration over the ignorance toward buprenorphine, at least until I ran out of steam a year ago.  I grew used doctors refusing to treat people addicted to heroin and other opioids.  I became used to the growth of abstinence-based treatment programs, even as relapse rates and deaths continued to rise.  It isn’t all bad news; I enjoyed the past couple meetings of AATOD, where people openly spoke about medication-assisted treatments without hushed voices.  ...
Source: Suboxone Talk Zone - April 9, 2018 Category: Addiction Authors: admin Tags: Addiction Buprenorphine recovery Suboxone treatment addiction treatment stigma subs Source Type: blogs

Buprenorphine, Not Subbies
I’ve been writing longer and longer posts on SuboxForum so maybe I need to write more here.  This blog archives twelve years of frustration over the ignorance toward buprenorphine, at least until I ran out of steam a year ago.  I grew used doctors refusing to treat people addicted to heroin and other opioids.  I became used to the growth of abstinence-based treatment programs, even as relapse rates and deaths continued to rise.  It isn’t all bad news; I enjoyed the past couple meetings of AATOD, where people openly spoke about medication-assisted treatments without hushed voices.  ...
Source: Suboxone Talk Zone - April 9, 2018 Category: Addiction Authors: admin Tags: Addiction Buprenorphine recovery Suboxone treatment addiction treatment stigma subs Source Type: blogs

Help for Heroin Addiction
A couple comments for regular readers…  first, watch for an upcoming change to a new name.  For years I’ve debated whether to adopt a name centered on ‘buprenorphine’, rather than the more-recognizable ‘Suboxone’.  I believe that time has come.   Second, I’m going to ‘reset’ with some introductory comments about the proper approach to treating heroin addiction, intended for those who are seeking help – starting with this post. I’m addicted to heroin.  Which treatment should I use? I’ve treated heroin addiction in a range ...
Source: Suboxone Talk Zone - March 27, 2018 Category: Addiction Authors: admin Tags: Addiction Clean Enough treatment addiction treatment Buprenorphine heroin addiction medication assisted treatment Methadone Source Type: blogs

Help for Heroin Addiction
A couple comments for regular readers…  first, watch for an upcoming change to a new name.  For years I’ve debated whether to adopt a name centered on ‘buprenorphine’, rather than the more-recognizable ‘Suboxone’.  I believe that time has come.   Second, I’m going to ‘reset’ with some introductory comments about the proper approach to treating heroin addiction, intended for those who are seeking help – starting with this post. I’m addicted to heroin.  Which treatment should I use? I’ve treated heroin addiction in a range ...
Source: Suboxone Talk Zone - March 27, 2018 Category: Addiction Authors: admin Tags: Addiction Clean Enough treatment addiction treatment Buprenorphine heroin addiction medication assisted treatment Methadone Source Type: blogs

Help for Heroin Addiction
A couple comments for regular readers…  first, watch for an upcoming change to a new name.  For years I’ve debated whether to adopt a name centered on ‘buprenorphine’, rather than the more-recognizable ‘Suboxone’.  I believe that time has come.   Second, I’m going to ‘reset’ with some introductory comments about the proper approach to treating heroin addiction, intended for those who are seeking help – starting with this post. I’m addicted to heroin.  Which treatment should I use? I’ve treated heroin addiction in a range...
Source: Suboxone Talk Zone - March 27, 2018 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Clean Enough treatment addiction treatment Buprenorphine heroin addiction medication assisted treatment Methadone Source Type: blogs

The Other Opioid Crisis: Hospital Shortages Lead To Patient Pain, Medical Error
I came across this public-accesss story, and wanted to share the perspective: Pauline Bartolone, Kaiser Health News Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups. The shortage, though more significant in some places than others, has left many hospitals and surgical centers scrambling to find enough injectable morphine, Dilaudid and fentanyl — drugs given to patients undergoing surgery, fighting cancer or suffering traumat...
Source: Suboxone Talk Zone - March 26, 2018 Category: Addiction Authors: admin Tags: Acute Pain Anesthesia Public policy surgery Chronic pain opioid addiction Source Type: blogs

The Other Opioid Crisis: Hospital Shortages Lead To Patient Pain, Medical Error
I came across this public-accesss story, and wanted to share the perspective: Pauline Bartolone, Kaiser Health News Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups. The shortage, though more significant in some places than others, has left many hospitals and surgical centers scrambling to find enough injectable morphine, Dilaudid and fentanyl — drugs given to patients undergoing surgery, fighting cancer or suffering traumat...
Source: Suboxone Talk Zone - March 26, 2018 Category: Addiction Authors: admin Tags: Acute Pain Anesthesia Public policy surgery Chronic pain opioid addiction Source Type: blogs

The Other Opioid Crisis: Hospital Shortages Lead To Patient Pain, Medical Error
I came across this public-accesss story, and wanted to share the perspective: Pauline Bartolone, Kaiser Health News Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups. The shortage, though more significant in some places than others, has left many hospitals and surgical centers scrambling to find enough injectable morphine, Dilaudid and fentanyl — drugs given to patients undergoing surgery, fighting cancer or suffering traumat...
Source: Suboxone Talk Zone - March 26, 2018 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Acute Pain Anesthesia Public policy surgery Chronic pain opioid addiction Source Type: blogs

Missing the Point of Buprenorphine Treatment
A forum reader wrote about concerns over a partner on buprenorphine.  Her concerns pointed out a common misperception about the goals of treatment of opioid use disorder using buprenorphine, or using methadone for that matter. Her question, amended for privacy: I married the love of my life.  He is still he love of my life but has been an addict for 15 of them. Our children have been greatly affected by his addiction.  He made promise after promise that he was clean, and I dove back in with complete faith time after time only to get burned. His addiction started with recreational pills increasing over time, ...
Source: Suboxone Talk Zone - June 17, 2017 Category: Addiction Authors: admin Tags: Addiction Buprenorphine Suboxone treatment buprenorphine treatment opioid taper rapid detox Suboxone taper Source Type: blogs

Missing the Point of Buprenorphine Treatment
A forum reader wrote about concerns over a partner on buprenorphine.  Her concerns pointed out a common misperception about the goals of treatment of opioid use disorder using buprenorphine, or using methadone for that matter. Her question, amended for privacy: I married the love of my life.  He is still he love of my life but has been an addict for 15 of them. Our children have been greatly affected by his addiction.  He made promise after promise that he was clean, and I dove back in with complete faith time after time only to get burned. His addiction started with recreational pills increasing over time, ...
Source: Suboxone Talk Zone - June 17, 2017 Category: Addiction Authors: admin Tags: Addiction Buprenorphine Suboxone treatment buprenorphine treatment opioid taper rapid detox Suboxone taper Source Type: blogs

Missing the Point of Buprenorphine Treatment
A forum reader wrote about concerns over a partner on buprenorphine.  Her concerns pointed out a common misperception about the goals of treatment of opioid use disorder using buprenorphine, or using methadone for that matter. Her question, amended for privacy: I married the love of my life.  He is still he love of my life but has been an addict for 15 of them. Our children have been greatly affected by his addiction.  He made promise after promise that he was clean, and I dove back in with complete faith time after time only to get burned. His addiction started with recreational pills increasing over time, ...
Source: Suboxone Talk Zone - June 17, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Suboxone treatment buprenorphine treatment opioid taper rapid detox Suboxone taper Source Type: blogs

Brandeis and CDC Wrong on Buprenorphine PDMP Data
I’ll share an interesting story about the data used for the prescription drug database in Wisconsin and other states.  I’ve been holding back on writing about this issue in hopes that the reason for the story would be corrected, and I would have no story to tell.  But that hasn’t happened. A new law in Wisconsin requires all prescribers to check the prescription drug database when prescribing any controlled substance.  I’m surprised that no privacy advocates have complained about the database, which tells prescribers about the controlled substances used by their patients over the past...
Source: Suboxone Talk Zone - April 28, 2017 Category: Addiction Authors: admin Tags: Addiction Buprenorphine pharmacology Public policy risks Brandeis University CDC drug database PDMP Source Type: blogs

Brandeis and CDC Wrong on Buprenorphine PDMP Data
I’ll share an interesting story about the data used for the prescription drug database in Wisconsin and other states.  I’ve been holding back on writing about this issue in hopes that the reason for the story would be corrected, and I would have no story to tell.  But that hasn’t happened. A new law in Wisconsin requires all prescribers to check the prescription drug database when prescribing any controlled substance.  I’m surprised that no privacy advocates have complained about the database, which tells prescribers about the controlled substances used by their patients over the past...
Source: Suboxone Talk Zone - April 28, 2017 Category: Addiction Authors: admin Tags: Addiction Buprenorphine pharmacology Public policy risks Brandeis University CDC drug database PDMP Source Type: blogs

Brandeis and CDC Wrong on Buprenorphine PDMP Data
I’ll share an interesting story about the data used for the prescription drug database in Wisconsin and other states.  I’ve been holding back on writing about this issue in hopes that the reason for the story would be corrected, and I would have no story to tell.  But that hasn’t happened. A new law in Wisconsin requires all prescribers to check the prescription drug database when prescribing any controlled substance.  I’m surprised that no privacy advocates have complained about the database, which tells prescribers about the controlled substances used by their patients over the past...
Source: Suboxone Talk Zone - April 28, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine pharmacology Public policy risks Brandeis University CDC drug database PDMP Source Type: blogs

Is Suboxone Potent?
We get about 5000 readers of SuboxForum per day who ask question, provide answers, or share their experiences with buprenorphine medications. If you’re a patient on buprenorphine, consider joining us. It is free, and you’ll find help for starting buprenorphine, tapering off the medication, and everything in between.  Or if you’re a buprenorphine prescriber consider joining to see what patients are doing and thinking, and to help answer their questions! Yesterday someone wrote about the high potency of buprenorphine. He also wrote that it is hard to get off buprenorphine medications. I ended up writin...
Source: Suboxone Talk Zone - April 27, 2017 Category: Addiction Authors: admin Tags: Addiction Source Type: blogs

Is Suboxone Potent?
We get about 5000 readers of SuboxForum per day who ask question, provide answers, or share their experiences with buprenorphine medications. If you’re a patient on buprenorphine, consider joining us. It is free, and you’ll find help for starting buprenorphine, tapering off the medication, and everything in between.  Or if you’re a buprenorphine prescriber consider joining to see what patients are doing and thinking, and to help answer their questions! Yesterday someone wrote about the high potency of buprenorphine. He also wrote that it is hard to get off buprenorphine medications. I ended up writin...
Source: Suboxone Talk Zone - April 27, 2017 Category: Addiction Authors: admin Tags: Addiction Source Type: blogs

Is Suboxone Potent?
We get about 5000 readers of SuboxForum per day who ask question, provide answers, or share their experiences with buprenorphine medications. If you’re a patient on buprenorphine, consider joining us. It is free, and you’ll find help for starting buprenorphine, tapering off the medication, and everything in between.  Or if you’re a buprenorphine prescriber consider joining to see what patients are doing and thinking, and to help answer their questions! Yesterday someone wrote about the high potency of buprenorphine. He also wrote that it is hard to get off buprenorphine medications. I ended up writin...
Source: Suboxone Talk Zone - April 27, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Source Type: blogs

Ten Gripes of Buprenorphine Doctors
I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from the latter group comes across this page, I’ll list a few things to do or to avoid when caring for someone on buprenorphine (e.g. Suboxone). 1. Buprenorphine does NOT treat acute pain, so don’t assume that it will. Patients are fully tolerant to the mu-opioid effects of buprenorphine, so they...
Source: Suboxone Talk Zone - March 25, 2017 Category: Addiction Authors: admin Tags: Acute Pain Addiction Buprenorphine Chronic pain Suboxone surgery buprenorphine stigma Source Type: blogs

Ten Gripes of Buprenorphine Doctors
I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from the latter group comes across this page, I’ll list a few things to do or to avoid when caring for someone on buprenorphine (e.g. Suboxone). 1. Buprenorphine does NOT treat acute pain, so don’t assume that it will. Patients are fully tolerant to the mu-opioid effects of buprenorphine, so they...
Source: Suboxone Talk Zone - March 25, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Acute Pain Addiction Buprenorphine Chronic pain Suboxone surgery buprenorphine stigma Source Type: blogs

Where ’s the Buprenorphine asked Mr. Obvious? Thanks, CDC!
A quick note tonight, hopefully with a longer post to follow this weekend… I’ve been frustrated by the people behind the Wisconsin PDMP, or Prescription Drug Monitoring Program, for their mistakes related to buprenorphine. Whoever came up with the numbers made a rookie error when calculating the equivalent morphine dose of patients taking buprenorphine products. The error is easy to notice by anyone who works with the drug, but apparently difficult to grasp by anyone with the power to correct the database figures. Those people include, by the way, the folks at Brandeis University who give the numbers to Wiscon...
Source: Suboxone Talk Zone - March 22, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Benzos Buprenorphine pharmacology Public policy risks benzodiazepines CDC PDMP Source Type: blogs

Buprenorphine Overdose After Naltrexone Treatment
Naltrexone induces mu-receptor hypersensitivity.  Buprenorphine’s protective ‘ceiling effect’ may not prevent overdose in patients with this ‘reverse tolerance’. A new patient described his recent history of respiratory failure several days into buprenorphine treatment.  He was told by his doctors that he experienced an allergic reaction to Suboxone. The rarity of buprenorphine or naloxone allergy led me to look deeper into his history, and my conclusion differs from what he was told by his last treatment team. The patient, a man in his mid-50s, has a history of significant opioid us...
Source: Suboxone Talk Zone - February 15, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Buprenorphine Induction pharmacology receptor actions side effects Suboxone tolerance buprenorphine induction buprenorphine overdose naltrexone treatment Suboxone after vivitrol Suboxone allergy Source Type: blogs

Opioid Induced Hyperalgesia Prevented by Buprenorphine?
“Buprenorphine is a kappa receptor antagonist. For these reasons, buprenorphine might be unique in its ability to treat chronic pain and possibly OIH.” The opioid crisis has been fueled by the use of opioids to treat chronic pain.  Practice patterns have changed, but doctors are still criticized for their roles in the overuse of opioids.  I’ve sat through community ‘heroin forums’ (sometimes on stage) as sheriffs, politicians, and ‘recovered addicts’ firmly pointed fingers at health professionals.  I, meanwhile, kept my finger under the table, but had the t...
Source: Suboxone Talk Zone - February 5, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Acute Pain Buprenorphine Chronic pain Suboxone treatment buprenorphine treats chronic pain chronic pain treatment opioid induced hyperalgesia opioid pain relief pain vs. addiction Source Type: blogs

Benzos and Buprenorphine
The high safety of buprenorphine, except when combined with a benzodiazepine, has been twisted in comments about the drug (and in the minds of regulators) to buprenorphine being uniquely dangerous when combined with benzodiazepines, which is not true. I’ve heard more and more from insurers, regulators, and well-meaning agencies about the dangers of combining buprenorphine and benzodiazepines.   Some insurers protest paying for buprenorphine if patients are taking benzodiazepines.  Medicaid recently sent a letter that described a ‘severe risk’ of using benzodiazepines in patients on buprenor...
Source: Suboxone Talk Zone - January 27, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Benzos Buprenorphine pharmacology risks Suboxone tolerance buprenorphine and benzodiazepines suboxone overdose xanax and suboxone Source Type: blogs

Cannabinoid Hyperemesis: How Rare?
Marijuana might cause pain and vomiting in the people who value the drug the most. Doctors should learn more about cannabinoid hyperemesis syndrome. (adsbygoogle = window.adsbygoogle || []).push({}); Source: Cannabinoid Hyperemesis: How Rare? (Source: Suboxone Talk Zone)
Source: Suboxone Talk Zone - January 4, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Source Type: blogs

Cannabinoid Hyperemesis: How Rare?
I recently read a CBS news story about CHS, or Cannabinoid Hyperemesis Syndrome, describing a 100% increase in cases in Colorado since the legalization of marijuana there.  A search for ‘THC’ and ‘CHS’ pulls stories from a range of sources including High Times, Wikipedia, Fusion.net, and Current Psychiatry.  A broader search reveals articles calling the disorder ‘fake news‘. Most articles about CHS describe the condition as ‘rare’, but becoming less rare as the legalization movement takes root and grows (like a weed).  The syndrome occurs in heavy, long-time us...
Source: Suboxone Talk Zone - January 4, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Acute Pain Chronic pain pharmacology receptor actions abdominal pain and THC cannabinoid hyperemesis syndrome CHS marijuana nausea and THC Source Type: blogs

Make Sleep Meds Work For You
I’ve been busier than I like, and haven’t had as much time for posting.  But I spend a lot of time answering emails from my patients, and some of my responses may be useful for others.  Below I’ll share my answer to a patient who has been unable to get quality sleep.  Next week I’ll find another answer to share with readers. This patient asked whether her insurance would cover Lunesta.  She wrote at 2 AM that she is up most of the night tossing and turning. She now takes 10 mg of Ambien, and wrote that it ‘stopped working’.  She doesn’t think 20 mg of Ambie...
Source: Suboxone Talk Zone - November 27, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: pharmacology Research ambien best sleep medication insomnia treatments lunesta sleep medication no working sleeping pills Source Type: blogs

Congress Acts on Opioid Dependence (ugh)
I won’t weigh in on the upcoming election, for fear of being barraged with insulting tweets by one candidate or ‘offed’ by the other.  But the current opioid dependence crisis provides a great chance to learn whether you stand on the side of ‘limited government’ or the alternative. The TREAT Act takes 5 minutes to read, that would have increased the cap on buprenorphine patients.  President Obama undermined the TREAT Act by announcing his own plans to raise the cap soon after the TREAT Act was presented in the Senate.  After 7 years without mentioning heroin or opioid addiction,...
Source: Suboxone Talk Zone - July 21, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Public policy Suboxone treatment buprenorphine cap nurse practitioners prescribe suboxone opioid legislation Source Type: blogs

This Suboxone Doesn ’t Work!
Today on SuboxForum people were writing about their experiences with different buprenorphine formulations.  Doctors occasionally have patients who prefer brand medications over generics, but buprenorphine patients push brand-loyalty to a different level.  The current thread includes references to povidone and crospovidone, compounds included in most medications to improve bioavailability.  Some forum members suggested that their buprenorphine product wasn’t working because of the presence of crospovidone or povidone.  Others shared their experiences with different formulations of buprenorphine and...
Source: Suboxone Talk Zone - June 16, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine pharmacology Psychodynamics side effects Suboxone Withdrawal exipient opioid dependence povidone zubsolv Source Type: blogs

This Suboxone Doesn’t Work!
Today on SuboxForum people were writing about their experiences with different buprenorphine formulations.  Doctors occasionally have patients who prefer brand medications over generics, but buprenorphine patients push brand-loyalty to a different level.  The current thread includes references to povidone and crospovidone, compounds included in most medications to improve bioavailability.  Some forum members suggested that their buprenorphine product wasn’t working because of the presence of crospovidone or povidone.  Others shared their experiences with different formulations of buprenorphine and...
Source: Suboxone Talk Zone - June 16, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine pharmacology Psychodynamics side effects Suboxone Withdrawal exipient opioid dependence povidone zubsolv Source Type: blogs

Obama ’s Lousy Suboxone Offer
I was reading more about Obama’s executive order over at Dr. Burson’s blog.  I guess she is a ‘competitor’ in the blogging world, but I have to admit that her blog has a lot more detail about the issue than I do.  If you haven’t been there yet, check it out.  Keep coming back here too of course! She wrote recently about the rules that would be required by the Feds, in order for them t o allow us the ‘right’ to treat people with buprenorphine.   I wrote to Dr. Burson after reading her post that she is providing the facts, and I can’t help but provide t...
Source: Suboxone Talk Zone - May 16, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Public policy Suboxone treatment heroin addiction obama suboxone treatment Suboxone treatment cap TREAT Act Source Type: blogs

Obama’s Lousy Suboxone Offer
I was reading more about Obama’s executive order over at Dr. Burson’s blog.  I guess she is a ‘competitor’ in the blogging world, but I have to admit that her blog has a lot more detail about the issue than I do.  If you haven’t been there yet, check it out.  Keep coming back here too of course! She wrote recently about the rules that would be required by the Feds, in order for them t o allow us the ‘right’ to treat people with buprenorphine.   I wrote to Dr. Burson after reading her post that she is providing the facts, and I can’t help but provide t...
Source: Suboxone Talk Zone - May 16, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Public policy Suboxone treatment heroin addiction obama suboxone treatment Suboxone treatment cap TREAT Act Source Type: blogs

Obama and the TREAT Act
I just read an article in the Daily Beast that reads like a better version of something I would write about the value of medication-assisted treatment of opioid dependence.  I appreciate Christopher Moraff telling a story that has been untold far too long, and I hope the story raises questions across the country. But I have something else on my mind that deserves a story of its own.  I am just a small-town psychiatrist in the Midwest, of course, and so I could be missing something.  I watch Veep and House of Cards, but I assume that the political games in those shows are grossly exaggerated.  I’ll...
Source: Suboxone Talk Zone - May 12, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Legal Public policy Suboxone treatment heroin addiction Obama patient cap TREAT Act Source Type: blogs

Prince Missed Suboxone Lifeboat by 12 Hours
One of the links from this page connects to the ‘OD Report‘.  I set up the connection to highlight the epidemic of overdose deaths, not to sensationalize the issue.  But the Prince story is sensational and tragic at the same time. And the connection to buprenorphine only magnifies the tragic circumstances that are wrapped around the use of a potentially-life-saving medication. I read some time ago about Prince’s chronic pain problems, primarily involving his hips and secondary to years of dancing in high-heeled shoes.  Shortly after his death, TMZ reported that Prince’s plane made an ...
Source: Suboxone Talk Zone - May 6, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Chronic pain Suboxone andrew kornfeld Dr. Kornfeld Prince overdose Recovery Without Walls suboxone treatment Source Type: blogs

Counseling Schmounseling
I just noticed a couple of my recent posts….  these people have it wrong, and that person has it wrong.  One of these days I really need to print something positive and uplifting.  But not today. Excuse the self-flattery, but I like to think of myself as a physician scientist.  That concept motivated my PhD work, and cost me friend after friend in the years that followed!  A physician scientist isn’t all that difficult to be from an educational standpoint, especially in the age of the internet.  The one thing that is necessary is the willingness, or need, to question every assumpt...
Source: Suboxone Talk Zone - May 3, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Public policy Research Suboxone treatment addiction counseling heroin addiction medication assisted treatment Methadone opioid dependence Source Type: blogs

Addiction Treatment Has it ALL WRONG
Today on SuboxForum members discussed how long they have been treated with buprenorphine medications.  Most agreed that buprenorphine turned their lives around, and most are afraid they will eventually be pushed off the medication.  Most buprenorphine patients described a reprieve from a horrible illness when they discovered buprenorphine.  But most have new fears that they never anticipated– that their physician will die or retire, that politicians will place arbitrary limits on buprenorphine treatment, or that insurers will limit coverage for the medication that saved there lives. I joined the discus...
Source: Suboxone Talk Zone - May 1, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine recovery Suboxone Suboxone Forum addiction counseling character defects heroin addiction Vivitrol Source Type: blogs