Dealing with patients who report increased cravings

It is our experience that cravings have more to do with a patient’s heightened anxiety or fear than they do with unsaturated receptor sites. Rather than agreeing with the request to increase the dose of buprenorphine, we try to explore the source of the anxiety and explore alternate approaches for dealing with it. Here, a peer support phone tree or the technique of mindful meditation can be very helpful. Rarely is an increase in dosage helpful; it only reinforces the addict’s belief that narcotics alone can make him or her whole and well.