November 19, 2014

12:41 AM | Suboxone Not on the Affordable Care Act FAQ
First Posted 9/15/2013 I’ve written the first two parts of a three-part column about unintended consequences.  Part one described why discounts demanded from insurers for front-line services (e.g. office visits) create challenges for independent primary care practices that don’t have other sources of revenue, particularly revenue from procedures.  Part two explained why physicians employed by […]

November 17, 2014

2:27 PM | Why the military can’t get suicide prevention right
Last Friday, the Inspector General of the Department of Defense released a report called the Suicide Event Report Data Quality Assessment. I had no idea what the assessment was about but I am devoted to suicide prevention and intrigued by data so I gave the 100-page report a read. When an active service member commits […]
5:20 AM | New Bupe News Section
Wanted to take a second or two to point out a new section to the blog, called ‘Bupe News’.  You’ll see the link at the tope of the page, along with an ever-growing list of links.  The point, of course, is to keep y’all reading, since Google knows EVERYTHING, including how many seconds each and […]

November 13, 2014

12:37 AM | Suboxone Abuse Pt I
First Posted 8/11/2013 We’ve all read articles about the epidemic of opioid dependence during the past ten years.  We’ve heard the concern over pain medications being overly-prescribed by some physicians.  Some of us older docs even remember the claims, by the Joint Commission on Hospital Accreditation and other medical watchdogs, that physicians were undertreating pain and […]

November 07, 2014

9:32 PM | Who Pays For Health Care? (Hint: We ALL Do)
First Published 4/20/2013 I realize that practice patterns differ between practices, even those treating the same condition (opioid dependence) with the same medication (buprenorphine).  Differing patient characteristics result in different regional standards of care, for example.  And some areas have access to services (e.g. group treatments or laboratory testing) that may not be as available […]

November 03, 2014

8:24 PM | An Interview with the ATTC
For those who missed it, I recently provided some opinions about buprenorphine treatment for The Bridge, a journal produced by the Addiction Technology Transfer Center Network.  The discussion was published in The Bridge Volume 4, Issue 3, and is copied below. Question 1. The introduction to buprenorphine treatment in the U.S. has occurred through a […]

November 02, 2014

2:30 AM | Suboxone as Problem, Suboxone as Solution
Originally Posted 3/14/2013 A local District Attorney wrote to me last week to express his concern about the increased diversion of buprenorphine.  I often sense an undercurrent of tension when I cross paths with attorneys, aware of the different attitudes that we hold that arise from our different roles in society. The DA wrote about the […]

October 30, 2014

3:09 AM | Crazy Week for Suboxone
Originally Posted 3/3/2013 What a crazy week for buprenorphine.  I’ve written about the FDA slapping the face of Reckitt Benckiser by denying their Citizens’ Petition.  Adding insult to injury, the FDA then approved two generic formulations of Suboxone tabs (actually, the correct name is buprenorphine/naloxone combination tabs).  Stock in RB dropped about 5%, but shares regained most of […]
2:53 AM | Reckitt Benckiser Citizen Petition for Suboxone: DENIED
Posted 2/23/2013 For those who missed my explanation, I’m adding these old posts to reconstruct the archive.  The site’s database was damaged by something, somehow… New posts coming soon. Find a copy of the response here, or at this

October 26, 2014

10:52 PM | Suboxone Maker’s Petition Denied by FDA
Originally Posted 2/23/2013 I’ve written in detail about the bold move by Reckitt-Benckiser, maker of Suboxone, that few people outside the company saw coming.  In brief, the company has been cruising across the Atlantic for the past ten years, fueled by stellar growth of its flagship medication, even as the expiration of the patent on Suboxone loomed ahead […]

October 24, 2014

10:30 PM | Wasting Resources on Suboxone
Originally posted 1/26/2013 Readers of this blog know that I have often questioned whether there is any clinical difference between Suboxone and generic buprenorphine.  Naloxone is an opioid-blocking chemical added to buprenorphine, supposedly in order to reduce intravenous diversion of the medication.  The combination of buprenorphine plus naloxone is branded as Suboxone. I’ve pointed out over […]
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