Initiating buprenorphine treatment during short‐term inpatient ‘detoxification’

A new study on initiation of buprenorphine maintenance was just published. The press release describes the intervention as an alternative to “revolving door” detox and relapse cycles: “patients who start long-term buprenorphine treatment at a detox program, instead of going through detox and getting a referral for such treatment at discharge, are less likely to … Continue reading Initiating buprenorphine treatment during short‐term inpatient ‘detoxification’

Is calling addiction a disease harmful?

In recent years there’s been a lot of attention and energy devoted to reclassifying addiction from a disease to something else–a “disease” of despair, a lack of social connection, a product of injustice and hardship, a product of deprived environments, a learning disorder, etc. Now, there’s a recent study getting attention that suggests teaching clients … Continue reading Is calling addiction a disease harmful?

Follow up – Responses to charges against Invidior

So . . . a week and a half ago, Indivior, the manufacturer of Suboxone, was charged with conspiracy, health care fraud, mail fraud and wire fraud. Prosecutors said: Indivior misled doctors and government health programs into believing that the drug, Suboxone Film, was safer and less likely to be abused than rivals, the Justice … Continue reading Follow up – Responses to charges against Invidior

Three noteworthy medication assisted treatment (MAT) studies

There have been a few noteworthy medication assisted treatment (MAT) studies published recently. Two studies evaluated the comparative effectiveness of extended-release naltrexone (Vivitrol) versus buprenorphine-naloxone (Suboxone). Anticipation of these studies has been heightened by questions about Vivitrol’s effectiveness and marketing. Study 1 The first of these was published in JAMA in October and summarized their … Continue reading Three noteworthy medication assisted treatment (MAT) studies

A closer look at the evidence

Someone sent this document today and highlighted this statement, “The evidence of the effectiveness of MAT is overwhelmingly positive. 115, 116, 117” That statement provides 3 sources: 115 Addiction Treatment Forum. MAT with Methadone or Burprenorphine: Assessing the Evidence for Effectiveness. February 10, 2014. http://atforum.com/2014/02/mat-with-methadone-orbuprenorphine-assessing-the-evidence-for-effectiveness/. Accessed October 31, 2016. 116 Fullerton CA, Kim M, Thomas CP, … Continue reading A closer look at the evidence

Another buprenorphine retention finding

There has been a lot of discussion about the use of buprenorphine to treat addiction and prevent overdose. I’ve pointed out that weak retention rates weaken this rationale. One common response is that the treatment system and recovering community reinforce stigma associated with maintenance medications and undermine outcomes, including retention. This makes retention findings from other … Continue reading Another buprenorphine retention finding

A closer look at the evidence (Part 1)

You may have heard that the unlikely crew of Newt Gingrich, Patrick Kennedy & Van Jones have taken interest in addressing the opioid crisis. More allies is a great thing. They strongly advocate for medication-assisted treatment as the standard of care: Medication assisted treatment, or MAT, is the use of FDA-approved medicine in concert with behavioral … Continue reading A closer look at the evidence (Part 1)

Is rehab “outdated, expensive and deadly”?

This article, calling rehab “outdated, expensive and deadly” is wrong about some important things and right about some important things. What it gets wrong On medication assisted treatment (MAT): It overstates the effectiveness of buprenorphine. If the medication “eliminates” and is so “effective”, you think they’d have better outcomes than this (Which is not an outlier … Continue reading Is rehab “outdated, expensive and deadly”?