Author: TeeJay

Posted: Sat Nov 03, 2012 11:05 pm

I dunno if the blame lies squarely on RB for this. IMO it extends to the medical culture as a whole.

Doctors want to feel like what they’re prescribing is doing the patients good … because it makes them feel better as doctors to think the new medication they’re prescribing is an advancement on the previous medication. While many are very open minded, scientific folk who weigh up the evidence, they’re also human and are open to human failings.

Another thing is that for the most part they’re really BUSY. So if there’s this assumption being thrown around that buprenorphine withdrawals are milder than other opioids because it’s a partial agonist, they may consider that to be a logical statement and run with it. If I had no practical experience with bupe withdrawal, I’d consider it to be logical. Most wouldn’t even have the time to question it and research it. And even if they did, there’s fuck all evidence even now into its withdrawal intensity… So if you could on the one hand be cynical and question this assumption that’s floating around and question whether this drug you’ve been prescribing the last 5-10 years has actually done your many patients harm… or you could run with the assumption and still feel good about yourself as a doctor, feel like you’re doing your patients good. I mean, they’re clean and employed and their family loves them again? Seeing buprenorphine transition their crippled addict patient into a respectable member of society might make a doctor feel pretty chuffed.

It seems the medical world is really quick to trumpet the benefits of a new treatment, and much slower to acknowledge potential pitfalls when they emerge. Anti-depressant withdrawal syndrome is something that comes to mind. There was a shitload of evidence for acute withdrawal symptoms emerging before they actually acknowledged it.