Posts

December 18, 2014

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12:33 PM | A Message of Hope at Christmas – We Do Recover!!
I have heard various statistics about rates of recovery of the years, especially in AA. Some of the figures were depressing low and often go unchallenged which can be demotivating for those seeking recovery. Why AAs in particular spread distorted statistics which suggest hardly any one recovers is open to question? Out of all the […]
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3:16 AM | The Opioid Dependence Big Picture
First Posted 1/16/2014 Below, internet colleague Paul Dessauer shares his extensive knowledge of opioids in comments about my naltrexone post. His comments were particularly interesting in that they provide evidence that at least someone is aware of the big picture about addiction to heroin and pain pills. In my post about naltrexone, I described how some people […]

December 16, 2014

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10:00 PM | Hot Flashes from Suboxone and Buprenorphine Treatment
First Posted 1/13/2014 A viewer on YouTube commented on my video about hot flashes  from Suboxone, but I don’t know if that is because the symptoms dissipate, or if people learn to deal with the symptoms.  I suspect that both are true.  But for some people, the sweating and heat are no small matter: Here […]

December 15, 2014

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6:36 AM | Treatment for Elderly with Breast Cancer May Not Be as Effective
A new analysis has found that while clinical trial data support omitting radiation treatments in elderly women with early stage breast cancer, nearly two-thirds of these women continue to receive it. The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society. Results published in 2004 from a large, randomized […] The post Treatment for Elderly with Breast Cancer May Not Be as Effective appeared first on Wiley Asia Blog.

Palta, M., Palta, P., Bhavsar, N., Horton, J. & Blitzblau, R. (2014). The use of adjuvant radiotherapy in elderly patients with early-stage breast cancer: Changes in practice patterns after publication of Cancer and Leukemia Group B 9343, Cancer, DOI: 10.1002/cncr.28937

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6:36 AM | Treatment for Elderly with Breast Cancer May Not Be as Effective
claimtoken-548f952b76556 A new analysis has found that while clinical trial data support omitting radiation treatments in elderly women with early stage breast cancer, nearly two-thirds of these women continue to receive it. The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society. Results published in 2004 from a large, […] The post Treatment for Elderly with Breast Cancer May Not Be as Effective appeared first on Wiley Asia Blog.

Palta, M., Palta, P., Bhavsar, N., Horton, J. & Blitzblau, R. (2014). The use of adjuvant radiotherapy in elderly patients with early-stage breast cancer: Changes in practice patterns after publication of Cancer and Leukemia Group B 9343, Cancer, DOI: 10.1002/cncr.28937

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December 13, 2014

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6:45 PM | Making Connections: Peer Support and Eating Disorder Recovery
I feel like a broken record when I say that we continue to lack an evidence-base for most “alternative” forms of support for eating disorders. As I’ve noted in prior posts, just because something is not evidence based does not mean it does not work for anyone; often, an evidence base is established when researchers can secure enough funding to run a randomized-controlled trial (RCT) that would act as evidence. Even when an RCT has been run, it is hard to say that one form of […]
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3:33 PM | Short Term Suboxone
Firsted Posted 1/8/2014 I received an email today containing an angry comment about Suboxone/buprenorphine that I’ve read a number of times before on forums about addiction.  The essence of the comment was that Suboxone has caused tons of problems, including diversion, people stuck on the medication, and buprenorphine abuse. He wrote that the reason for […]

December 11, 2014

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11:11 PM | Does Suboxone Stop Working Over Time?
First Posted 12/31/2013 Buprenorphine is relatively unique among opioids in having a ‘ceiling’ to mu opioid effects.  There are other known molecules that act as partial agonists at mu opioid receptors, but buprenorphine is the most useful, at this point, because of other traits of the molecule– such as having few side effects from actions […]

December 10, 2014

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12:35 AM | Listen: Dr. Christopher Labos and I on the Rise of Integrative Medicine
This month, Within Reason tackles a scientific topic, so I can publicize it here! Woohoo! Would you like a side of magic with your chemo? Disproven folk remedies used to be the domain of snake oil salesmen; now, they are being integrated into university health centres. Jonathan speaks to Dr. Christopher Labos, a public science educator and … Continue reading →

December 09, 2014

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5:28 AM | Toward Understanding Ibogaine
First Posted 12/30/2013 Paul Dessauer, Outreach Coordinator at WASUA, the Western Australian Substance Users’ Association, often adds insight to issues that come up on my blog.  He shared a few comments in response to my post about ibogaine, and at my request gave permission to post his remarks here. His comments include a summary of […]

December 08, 2014

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5:11 AM | Opioid Dependence Treatment with Ibogaine
First Posted 12/28/2013 I’ve always assumed that stories about ibogaine curing opioid dependence were fabricated or exaggerated.  But I’ve read more about ibogaine since the drug popped up on an episode of Homeland.  The scene made me wonder how and when the hoopla over ibogaine began, and why it ended.  After all, people treat addiction with […]

December 05, 2014

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1:27 PM | Treating Severe Anorexia Nervosa in the Community
Can treatment for severe anorexia nervosa be delivered safely in a community setting? According to a recent paper by Calum Munro and colleagues (2014, open access), the answer is yes. In 2001, a systematic review by Meads, Gold, and Burls found that inpatient treatment is not more or less effective than outpatient treatment for individuals with AN. Of course there will always be patients who will require inpatient care, but given the high cost, lack of clear efficacy, and known risks, it is […]

December 04, 2014

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7:00 PM | Health Privacy at the Pharmacy
First Posted 12/20/2013 In the middle of an already-hectic schedule, my office received a call from a pharmacist at Roundy’s Pharmacy, Sheboygan WI saying that he couldn’t fill a script for oxycodone without the patient’s ICD-9 number.  The ICD-9 is soon to be replaced by ICD-10, a system that applies numbers to every medical illness […]
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11:45 AM | How to Find a Therapist You Love
When I was struggling with my eating disorder, I’d have particularly awful days. Often, it involved me crying into my carpet and wishing I didn’t exist. In those moments, when life was heavy and pressing, I was willing to reach out for help, but I didn’t know where to begin. My eating disorder was a […]

December 03, 2014

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10:27 PM | Can New York City Fix Its Mental Health Treatment Problem?
New York City Mayor Bill de Blasio believes he can fix New York City’s terrible problem within its criminal justice system and its poor treatment (and mistreatment) of people with mental illness. He’s putting some much-needed money where his mouth is — $130 million, to be specific. The money will be used to help begin […]
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1:30 PM | Learning More About Animal Abuse
New research investigates the effects of abuse on domestic dogs.Photo: GeorgeMPhotography / ShutterstockThe paper, by Franklin D. McMillan (Best Friends Animal Society) et al, looks at the behaviour profiles of 69 dogs with a very strong suspicion of abuse, and compares them to 5,239 pet dogs. The abused dogs scored significantly higher on various problem behaviours including aggression and fear to unfamiliar people and dogs, attachment problems, attention-seeking, and repetitive […]

McMillan, F., Duffy, D., Zawistowski, S. & Serpell, J. (2014). Behavioral and Psychological Characteristics of Canine Victims of Abuse, Journal of Applied Animal Welfare Science, 18 (1) 92-111. DOI: 10.1080/10888705.2014.962230

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November 30, 2014

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11:45 AM | What I Wish People Knew about Depression
Someone recently asked me to write on what I wish people knew about depression, in light of Robin William’s suicide. Here’s my response. I wish people knew that depression is complex, that it is a physiological condition with psychological and spiritual components, and therefore can’t be forced into any neat and tidy box, that healing […]

November 29, 2014

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7:45 AM | This Month in Blastocystis Research (NOV 2014): Blasting Blastocystis Edition
The 'This Month' post is triggered by a paper emerging in the journal Gut Pathogens describing a clinical pilot study on the efficacy of triple antibiotic therapy in Blastocystis positive IBS patients. The article is free for download here. The triple therapy consisted of fourteen days of diloxanide furoate 500 mg thrice daily, trimethoprim/sulfamethoxazole (cotrimoxazole) 160/80 mg twice daily, and secnidazole 400 mg thrice daily. Six of ten patients achieved eradication. […]

Nagel R, Bielefeldt-Ohmann H & Traub R (2014). Clinical pilot study: efficacy of triple antibiotic therapy in Blastocystis positive irritable bowel syndrome patients., Gut pathogens, 6 34. PMID: http://www.ncbi.nlm.nih.gov/pubmed/25349629

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4:07 AM | Bangor to Maine: Too Much Suboxone Treatment!
First Posted 11/26/2013 As I read about the moratorium on buprenorphine treatment programs in Bangor, Maine, I thought about the scene from the movie Titanic where the people who found safety in lifeboats struggled to keep those in the water from climbing aboard. The Bangor city council recently voted to impose a moratorium on expanding buprenorphine treatment […]

November 27, 2014

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12:36 AM | Buprenorphine Diversion: Beyond a Superficial Understanding
First Posted 11/19/2013 In ‘Addiction Treatment with a Dark Side’, Deborah Sontag of the New York Times shared her observations of the clinical use of buprenorphine for treating opioid dependence, warts and all.  Readers of the Talk Zone know my bias—that buprenorphine/Suboxone is one of the only effective treatments for opioid dependence, and many patients […]

November 26, 2014

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4:06 PM | Treatment Resistance in Eating Disorders
Clinicians treating patients with eating disorders find the challenge great with many treatment-resistant cases.To some extent, this is true of any clinical disorder. Outpatient treatment rolls and inpatient samples are over-represented by those failing to respond to initial interventions.A medical example is helpful here. Endocrinologists specializing in diabetes see more complicated cases where glucose control is difficult and diabetic complications are common.Diabetics with easy glucose […]
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12:40 AM | Killing the Suboxone Gift Horse with Naltrexone
First Posted 11/14/2013 I received an email update today with important news from the world of psychiatry and addiction.  The email highlighted a study from the October issue of Jama Psychiatry, entitled ‘A Randomized, Double-blind Evaluation of Buprenorphine Taper Duration in Primary Prescription Opioid Abusers’.  The study compared relapse rates in opioid addicts who were tapered […]

November 24, 2014

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7:12 PM | 5 Sneaky Signs of Depression You May Be Overlooking
Things have changed a lot in the past 30 years when it comes to our ideas about depression. In the 1980s and even the 1990s, people often still saw it as a moral weakness, a sign of being “crazy,” or as something to be dismissed completely. Today most people not only know someone who has […]
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6:47 PM | We Are Capable Of Far More Than The Limitations Most People Accept
Do you have bipolar disorder or know somebody who does? What would change if you could learn how to turn depression and mania on and off whenever you wanted to? The entire way we look at bipolar disorder would change in profound ways. Some of them are beyond most people’s imagination, but a simple illustration […]
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6:15 PM | Pregnant Taking Suboxone: Should Social Services be Involved?
First Posted 11/4/2013 I recently saw a new patient who described treating her own opioid dependence with diverted Suboxone.  She sheepishly described reading everything she could find about buprenorphine and meticulously using half of her friend’s medication to avoid other opioids, without fail, for four years. She would likely be treating herself now, if she […]
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11:45 AM | How to Deal with Invasive Thoughts
I’m no stranger to nasty thoughts. I recognize when they’re present so innately that it’s safe to say it almost hurts. In my almost nine years of living with schizophrenia I’ve had to battle my fair share of these thoughts and I’ve gotten so good at it that I can almost see them coming from […]
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11:30 AM | Cracked Science Video 4: Irreproducible
We often hear the science corrects itself in the long run, but how efficient is this mechanism? Jonathan Jarry reports that reproducibility in the scientific literature is not always a given. (Des sous-titres en français seront bientôt disponibles!) Just so you are not too demoralized, the landscape may be changing: http://www.nature.com/news/journals-u… http://www.nature.com/news/metascienc… Continue reading →
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