Kratom: Curse or Cure?

Recently, the US FDA issued a public health advisory warning the public not to use kratom, a substance purported to treat pain and opioid withdrawal. They give the following arguments: 1) There is no reliable evidence that kratom effectively treats opioid withdrawal; 2) use of kratom can lead to death; and 3) it can worsen… Continue reading Kratom: Curse or Cure?

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Benzodiazepines: Another Face of the Crisis

A little-commented on aspect of the opioid epidemic is the polypharmaceutical nature of the overdoses. For many deaths, it isn't just morphine or oxycodone found in the drug toxicology report. There can be antidepressants, stimulants, alcohol, and perhaps of most concern, benzodiazepines. If you think opioids are overprescribed, then benzodiazepines, or benzos, are on a… Continue reading Benzodiazepines: Another Face of the Crisis

A Drug for a Drug

It is perhaps ironic that the opioid epidemic that everyone is worried about is something that we have the most ability to address. The main pharmacological treatment (i.e., treating with drugs) for opioid addiction is known as Medication-Assisted Treatment or MAT. The rationale for MAT is use other opioids to reduce cravings, highs, and withdrawal from… Continue reading A Drug for a Drug

What’s this brain reward system you keep talking about?

Mesolimbic pathway by User:Slashme; Patrick J. Lynch; User:Fvasconcellos licensed under CC BY-SA 4.0 In my last post, I talked about the hijacking of the brain's reward system and the role it plays in addiction. I need to expand on that, because this is a lot more complicated than it looks. It is fascinating from a Stoic viewpoint: How much… Continue reading What’s this brain reward system you keep talking about?

On Opioids

Vicodin, Lortab, Oxycontin, morphine... They are the source of all relief and of all ills. Of course, I exaggerate, but judging by the discourse around opioid deaths, we appear to be in a life-or-death struggle with these classes of medications. I would not presume to tell someone whether they should take opioids for pain or… Continue reading On Opioids