Blame Suboxone!

First Posted 3/24/2014

I recently came across the blog of a person who has dedicated his life to trashing buprenorphine treatment.  I won’t provide the name or link, as I don’t want to waste my own ‘page rank’ on supporting his misplaced anger.  But I suspect many readers of my blog have stumbled across that one as well, given the similarity of our keywords.    His blog doesn’t contain personal comments, I suppose because there are only so many ways to say ‘darn that Suboxone’.  Instead he auto-posts stories from across the country from newsfeeds, with keyword combinations of ‘Suboxone’ or ‘buprenorphine’ plus ‘robbery’, or ‘death’, or ‘overdose’, or ‘real bad person.’  I made the last one up, but you get the idea.

The person lost his son several years ago, a tragedy that would usually keep me from adding my own commentary.  But in the several years since his son’s death, he has written a number of diatribes on other anti-buprenorphine web sites.  In other words, he has contributed to the deaths of enough young people that by now, counterpoints are long overdue.

In his ‘about me’ section, he writes that his son took Suboxone for about 18 months, and died over two years after stopping buprenorphine/Suboxone.  He explains, in twisted logic, how the death is not the fault of his son’s drug addiction, or the drug dealers, or easy prescribing of prescription opioids or diversion of opioid agonists, or poppy policy in Afghanistan… but because of Suboxone.

Opioid Withdrawal Treatments

A post on the Forum asked about the best remedies for opioid withdrawal.   I will review the medications and other treatments for opioid withdrawal that I have heard discussed by physicians or by people on the internet.  Hopefully readers will leave comments about medications or approaches that they have found useful.  Likewise, if you are a physician, please weigh in with the approaches that you have found to be useful.

For readers, it is very important to understand a couple things about this post.  First, the medications listed here are not FDA approved for treating opioid withdrawal.  They have not been systematically tested for that purpose. Most of the medications that I will list are available only by prescription— and must be taken ONLY by prescription.  They all have interactions with other medications, and they all have toxicity in certain doses, and in people with certain conditions.  Do NOT take them other than through guidance by your doctor.  This post is intended to spark discussion with your doctor— and to help doctors learn about approaches that they have not heard about elsewhere.

I will encourage doctors or other contributors to this post to avoid discussion specific dosages.  These medications must be prescribed by physicians who understand them, or who know how to become knowledgeable about them.

Suboxone Side Effects

I’ve received questions over the years from people claiming a range of symptoms from Suboxone or buprenorphine, from back or muscle pain to fatigue, depression, or irritability. I didn’t invent Suboxone, so I don’t take it personally when people blame commonly-occurring symptoms on the drug. But I get bored by the non-scientific thinking behind such claims— that since they started buprenorphine at some point in the past ten years, every symptom or illness that comes along must somehow be related to buprenorphine. No matter, apparently, that people who DIDN’T start buprenorphine often develop the same symptoms. And no matter that they themselves have done a number of things over the past few years BESIDES start buprenorphine. But over and over, people insist that they know, without a doubt, that buprenorphine has to be the problem.

I also get frustrated answering questions about these symptoms when people who complain about them are closed off to other explanations. When I point out that many non-buprenorphine patients have the same complaints, my comments provoke anger. Sometimes I’m accused of having a vested interest to keep people on buprenorphine (I don’t-beyond wanting to provide good medical care).

I have a long waiting list of patients and buprenorphine is only a small part of my practice, so I have no reason to compel use of buprenorphine. But I don’t like the risk that my own patients, or others, might be swayed by faulty logic and fret over problems that have no logical basis.