Blog Archive

There is growing evidence that ketamine can be useful in treating excessive drinking.  Most people who drink too much and would like to reduce it took a long time to get that way.  Many are stuck in a pattern of attempting abstinence alternating with binging.  Ketamine may help to oppose...

To understand the answer to this question one must understand the difference between addiction and dependence.  It is certainly true that people are dependent on suboxone, especially if using it to treat addiction.  That is because addiction to opioids results in dependence.  If you don't take the suboxone for a...

In my practice, I have observed that it is fairly common for people on suboxone to use cocaine.  One might ask whether using cocaine has an effect on recovery from opioid addiction. Here I am not referring to the obvious risks of using any street drugs, rather, I am asking...

During the infusion itself many people experience a kind of transcendent stat.  The antidepressant effects are almost immediate.  There is some evidence that patients must achieve what is called a dissociative state in which they have a kind of out of body experience in order to get the full antidepressant...

Ketamine infusion can be done in the doctor's office with basic monitoring equipment.  An IV is started and ketamine is infused over a period of about 40 minutes in a quiet environment.  The patient remains conscious and able to converse.  Blood pressure, heart rate, ECG, and oxygen saturation are monitored. ...

Ketamine infusion is effective for what is known as treatment resistant depression (TRD).  Treatment resistant depression is defined as depression which has not responded to the usual treatment consisting of selective serotonin reuptake inhibitors (SSRIs) along with talk therapy.  In the past, when depression persisted despite an adequate trial of...

Ketamine is an anesthetic drug which has been used to provide anesthesia for surgery and to treat depression since the 1950s.  When used for surgery it is given in high enough dose to cause unconsciousness, profound amnesia and pain control.  When treating depression, it is given in a very low...

Suppose you have been taking suboxone for several months, and you decide that you don't need it anymore.  You feel ok for the first day, though you will likely develop cravings for opioids.  Then one of your old buddies gives you a call, and he is still taking street drugs,...

Most people worry about withdrawal, but the problem is more complicated.  It is well known that stopping buprenorphine is risky because relapse into opioid addiction is common.  The risk of overdose during suboxone withdrawal is higher than usual because the buprenorphine is still in your system, so it blocks other...

The COVID-19 pandemic has triggered dramatic changes throughout everyday life — and in the medical community as well. Not only are providers across the country postponing elective procedures, but many are also encouraging people to avoid in-office appointments to reduce their risk of exposure to this highly contagious coronavirus.But what...

Yes. But it takes time and care.  Like any other opioid, discontinuing Suboxone causes withdrawal.  Suboxone stays in your system for a relatively long time, so withdrawal is not as fast or severe as with fentanyl, heroin, or oxycodone.  Withdrawal symptoms are generally milder, but also longer lasting.  Reducing your...

There are two phases in treatment with buprenorphine, called induction and maintenance.  The induction phase is the beginning of treatment, the transition from other opioids.  This must be done with care, because of the particular characteristics of buprenorphine.  Of course one goal is to avoid withdrawal, but that is not...

Until buprenorphine was developed, people with opioid addiction had only one option to treat their problem which was to take methadone prescribed at drug treatment clinics.  Methadone has several disadvantages.  First, it fully activates the mu receptors, even though for various reasons people don't usually experience the same level of...

The buprenorphine helps you to stop taking dangerous drugs like heroin, fentanyl, or oxycodone without having withdrawal, and at the same time you feel normal, not high.  Taking buprenorphine helps you get rid of craving for drugs of addiction, and it is much safer at the same time.  It allows...

Buprenorphine, the active ingredient in Suboxone, is different from other opioids in a number of important ways.  All opioids work on receptors in the brain called mu receptors (along with a number of other effects, but the mu receptors in the brain are the important ones in opioid effects involved...

Suboxone is the best known brand name for a combination of buprenorphine and naloxone, which are medications used to treat opioid addiction, also known, more euphemistically, as Opioid Use Disorder  Buprenorphine is the main ingredient of suboxone.  Buprenorphine is an opioid, like heroin, oxycodone, or methadone, but with important differences. ...