{"id":177,"date":"2013-11-25T03:11:04","date_gmt":"2013-11-25T03:11:04","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=177"},"modified":"2017-08-21T13:05:31","modified_gmt":"2017-08-21T13:05:31","slug":"primary-care-corner-with-dr-geoff-modest-buprenorphine-saves-lives-but-some-risks","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2013\/11\/25\/primary-care-corner-with-dr-geoff-modest-buprenorphine-saves-lives-but-some-risks\/","title":{"rendered":"Primary care corner with Dr. Geoff Modest: Buprenorphine saves lives but some risks?"},"content":{"rendered":"<p>this article was in the ny times today, first page and long article. so, fyi. a few points. \u00a0http:\/\/nyti.ms\/1ag73KD<\/p>\n<p>&#8211;though milder and safer than other opioids (and counter to my initial training for suboxone prescribing), people can get high on subox, esp if relatively opiate-naive.<\/p>\n<p>&#8211;in terms of safety, since 2003 there have been 420 subox deaths in the US (vs 3625 methadone deaths, and lots more from oxycodone, etc as per my recent emails)<\/p>\n<p>&#8211;no surprisingly, some MD have been prescribing suboxone inappropriately (and many of them also have prescribed other opiates inappropriately)<\/p>\n<p>&#8211;(again different from my initial training), subox is sometimes being used by injection (the naloxone incorporated is supposed to create withdrawal when given IV and thereby make injecting the drug a strong deterrent. turns out that the level of naloxone may not be high enough, and some people who do get a naloxone reaction find it to be relatively mild and transient). not sure what the real data are here in terms of %&#8217;s, but per this article, it is being injected at times.<\/p>\n<p>so, my experience certainly confirms that suboxone (buprenorphine\/naloxone) is a commonly used street drug, mostly used to prevent withdrawal, though also perhaps for some opiate-naive patients to get high. i find that it is a really great drug for the majority of my patients on it, often a very complex panel of patients with an array of psychosocial\/behavioral problems. but more than 60% (my guess) do phenomenally well, function well, and really get their lives back. \u00a0this article tempers my enthusiasm a bit, but in perspective i really do find it a great drug for the majority of my opioid-addicted patients who want to\/are ready to quit the other opioids.<\/p>\n<p>geoff<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Buprenorphine in the new york times [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2013\/11\/25\/primary-care-corner-with-dr-geoff-modest-buprenorphine-saves-lives-but-some-risks\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-177","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/177","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=177"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/177\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=177"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=177"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=177"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}