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 writing mo...
Source: Suboxone Talk Zone - April 26, 2017 Category: Addiction Authors: admin Tags: Addiction Source Type: blogs
In pain? Many doctors say opioids are not the answer - Salon.com
Those of you who have experienced pain, especially gnawing, chronic pain, know that it affects your happiness, outlook and ability to function.In the past couple of years, the treatment of chronic pain has undergone an earthshaking transformation as opioid addiction continues to claim — and ruin — lives.Many primary care doctors no longer liberally prescribe opioid painkillers such as oxycodone, fentanyl and hydrocodone for back pain, migraines and other chronic conditions. Instead, they are increasingly turning to alternative medications and non-drug options such as acupuncture and physical therapy."Most primary ...
Source: Psychology of Pain - April 16, 2017 Category: Anesthesiology Source Type: blogs
McCaskill Opens Investigation into Opioid Manufacturers
Senator Claire McCaskill, Ranking Member of the Senate’s Homeland Security and Governmental Affairs Committee, has launched a wide-ranging investigation into the business practices of the manufacturers of America’s top five prescription opioid products (based on 2015 sales). The investigation is slated to explore whether pharmaceutical manufacturers have contributed to the opioid epidemic with which America is currently dealing.
Senator McCaskill sent letters to Purdue, Janssen (parent company: Johnson & Johnson), Insys, Mylan, and Depomed, asking for information related to the sale, marketing, and education strat...
Source: Policy and Medicine - April 13, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Treating pain after opioid addiction: A personal story
Follow me on Twitter @Peter_Grinspoon
As a primary care physician at Massachusetts General Hospital (MGH), I am profoundly grateful for my 10 years in recovery from opiate addiction. As detailed in my memoir Free Refills, I fell into an all too common trap for physicians, succumbing to stress and ready access to medications, and became utterly and completely addicted to the painkillers Percocet and Vicodin. After an unspeakably stressful visit in my office by the State Police and the DEA, three felony charges, being fingerprinted, two years of probation, 90 days in rehab, and losing my medical license for three years, I fi...
Source: Harvard Health Blog - April 7, 2017 Category: Consumer Health News Authors: Peter Grinspoon, M.D. Tags: Addiction Drugs and Supplements Managing your health care Pain Management Source Type: blogs
If you have low back pain try these steps first
Low back pain, the scourge of mankind: it is the second leading cause of disability here in the United States, and the fourth worldwide. It’s also one of the top five medical problems for which people see doctors. Almost every day that I see patients, I see someone with back pain. It’s one of the top reasons for lost wages due to missed work, as well as for healthcare dollars spent, hence, a very expensive problem.
Looking at two kinds of back pain
Let’s talk about the most common forms of back pain: acute (which lasts less than four weeks) and subacute (which lasts four to 12 weeks). Most of these cases (approximate...
Source: Harvard Health Blog - April 3, 2017 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Back Pain Managing your health care Pain Management Source Type: blogs
A Nation in Pain
This past week, Governor John Kasich of Ohio issued an executive order limiting the amount of opioids doctors and dentists can prescribe to no more than a 7 day supply. Failure to comply could result in disciplinary action, including loss of license. Exceptions exist only for patients with cancer or those enrolled in hospice programs. For all the rest, it represents a hard full stop. No longer will the chronic pain sufferer, the woman status post lumbar back fusion x 3, be able to get a prescription for a month's supply of oxycodone with 3 refills.On the surface this appears to be a reasonable initiativ...
Source: Buckeye Surgeon - April 2, 2017 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
How the opioid epidemic became America ’s worst drug crisis ever, in 15 maps and charts - Vox
With all the other news going on, it can be easy to lose track of this fact. But it's true: In 2015, more than 52,000 people died of drug overdoses, nearly two-thirds of which were linked to opioids like Percocet, OxyContin, heroin, and fentanyl. That's more drug overdose deaths than any other period in US history — even more than past heroin epidemics, the crack epidemic, or the recent meth epidemic. And the preliminary data we have from 2016 suggests that the epidemic may have gotten worse since 2015.This situation did not develop overnight, but it has quickly become one of the biggest public health crises faci...
Source: Psychology of Pain - March 30, 2017 Category: Anesthesiology Source Type: blogs
Long-term use of opioids may depend on the doctor who prescribes them
You may have heard of the phrase “primum non nocere” — the Latin phrase that doctors are supposed to follow that instructs them to “first, do no harm.” Doctors also have an important ethical obligation to alleviate pain. But what happens when these two mandates collide? That, unfortunately, is the case with opioid pain relievers: powerful medicines like oxycodone, hydrocodone, and hydromorphone. These medications are potent pain relievers, but this relief comes at a serious, and sometimes deadly, cost.
The United States is now in the era of an “opioid epidemic” in which deaths from opi...
Source: Harvard Health Blog - March 27, 2017 Category: Consumer Health News Authors: Scott Weiner, M.D. Tags: Addiction Drugs and Supplements Pain Management 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
My mother isn ’t a drug-seeking patient. She’s in pain.
The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She’d come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she’d come by taxi. The veins in her arms were small, threadlike and collapsed, like those of a ninety-year-old or a recreational drug user.
Her medical file was huge, with reports from her primary-care physician, from local hospitals and the gastroenterology department of a highly regarded teach...
Source: Kevin, M.D. - Medical Weblog - March 15, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/christina-phillips" rel="tag" > Christina Phillips < /a > Tags: Patient Pain management Source Type: blogs
Is a new class of painkillers on the horizon? | Science | AAAS
Scientists are chasing a new lead on a class of drugs that may one day fight both pain and opioid addiction. It ' s still early days, but researchers report that they ' ve discovered a new small molecule that binds selectively to a long-targeted enzyme, halting its role in pain and addiction while not interfering with enzymes critical to healthy cell function. The newly discovered compound isn ' t likely to become a medicine any time soon. But it could jumpstart the search for other binders that could do the job.Pain and addiction have many biochemical roots, which makes it difficult to treat them without affecting other c...
Source: Psychology of Pain - February 28, 2017 Category: Anesthesiology Source Type: blogs
A primary care doctor delves into the opioid epidemic
Our nephew Christopher died of a heroin overdose in October 2013.1 It had started with pain pills and experimentation, and was fueled by deep grief.2 He was charismatic, lovable, a favorite uncle, and a hero to all the children in his life. His death too young was a huge loss to our family. I have always felt that I didn’t do enough to help prevent it, and perhaps, in a way, even contributed.
Good intentions with unintended consequences
My medical training took me through several big-city hospitals where addiction and its consequences were commonplace. Throughout all of it, great emphasis was placed on recognizing &#...
Source: Harvard Health Blog - February 20, 2017 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Addiction Behavioral Health 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 use over t...
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
Drug Wholesalers to Pay $36 Million Over West Virginia Pill Mill Claims
Two prescription drug wholesalers – AmerisourceBergen Corp. and Cardinal Health Inc. – will pay $16 million and $20 million, respectively, to resolve West Virginia’s claims relating to their distribution of controlled substances in the state, according to Governor Earl Ray Tomblin. The settlement – in which neither company admitted to any wrongdoing – is believed to be the largest pharmaceutical settlement in state history, after lawsuits dragged on for more than four years in Boone County Circuit Court and spanned the terms of two attorneys general.
In 2012, McGraw filed lawsuits against Cardinal Health, Ameris...
Source: Policy and Medicine - February 12, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Bad HIT in pharmacy: Hospital to pay half million dollar fine after pharmacist's drug theft
This is an example where bad health IT in an " infrastructure " system (as opposed to a clinician-facing system) led to a quite unfortunate outcome for the community.Bad Health IT ( " BHIT " ) is defined as IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes cognitive overload, slows rather than facilitates users, lacks appropriate alerts, creates the need for hypervigilance (i.e., towards avoiding IT-related mishaps) that increases stress, is l...
Source: Health Care Renewal - February 12, 2017 Category: Health Management Tags: Abington Memorial Hospital bad health IT bad phamacy IT DEA healthcare IT risks US Attorney ' s Office Source Type: blogs
