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Buprenorphine and buprenorphine/naloxone intoxication in children - how strong is the risk?
Authors: Soyka M Abstract Opioid maintenance therapy with methadone or buprenorphine is an established and first-line treatment for opioid dependence. Risk of diversion and toxicity of opioid prescription drugs, including buprenorphine, causes significant concerns. This is particularly the case in the United States, where the number of related emergency visits is increasing, especially in children. A systematic literature research (Medline, Pubmed) was performed to assess the risk associated with buprenorphine. The search, which was not limited to particular publication years, was performed with the key words bupre...
Source: Current Drug Abuse Reviews - November 14, 2014 Category: Addiction Tags: Curr Drug Abuse Rev Source Type: research

Search About Suboxone
Discussions are divided into categories and cover a wide range of topics, including patients’ personal experiences during pregnancy and childbirth, surgery, and buprenorphine induction and withdrawal.  We try to prevent discussions from degenerating into […]
Source: Suboxone Talk Zone - August 13, 2013 Category: Addiction Authors: J T Junig Tags: Addiction Buprenorphine Education Suboxone Suboxone Forum buprenorphine and pregnancy how to stop buprenorphine Suboxone and surgery suboxone information suboxone risks Suboxone withdrawal 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 buprenorphine.  And...
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

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

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 a certain b...
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

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 thought that some of the people pointing ...
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

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

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, but now he i...
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

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 slowly reset your toleranc...
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

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, but now he i...
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

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

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 slowly reset your toleranc...
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