The fabricated and invalidated effectiveness of opioid substitute buprenorphine in protecting against high-risk use and overdose death, never supported by research evidence, further exposed in new study

by Clark Miller

Published March 30, 2024

Not from the start, not ever, was there a body of research evidence establishing nor even strongly suggestive of the possible effectiveness and safety of generalized use of opioid pain medications for chronic non-cancer pain, an entirely non-medical condition. Instead, all lines of relevant, longstanding  evidence indicated against their use. That of course was no barrier for America’s medical/research/media collusion and trusted institutions to fabricate rationalization for their runaway dispensing fueling what we know as the opioid epidemic. 

Substitute the term “SSRI antidepressants” for “opioid pain medications” and essentially the same is true, fueling a national epidemic of untreated depression, another entirely non-medical condition. 

Now substitute “opioid substitution therapy (OST)” , “buprenorphine and methadone”, or “medication for opioid use disorder (MOUD)”, or “MAT” for “opioid pain medications” and substitute “problem compulsive opioid misuse” or “opioid dependence” – also entirely non-medical conditions –  for “chronic non-cancer pain”, and the same is true, as we are reminded every day as lethality of the crisis mounts. 

As deaths mount, the collusion and institutions that brought you the opioid crisis and perpetuate it have doubled and tripled down on their lies and bad science, aided as in the COVID epidemic by a cowardly and compliant mass media.

Why would that surprise us? These are, after all, the same compromised, mendacious, maleficent institutions behaving according to character, on different days, with different medical cures for non-medical conditions. 

pictures of opioid overdose victims

Over the past 5 years or so in a hundred or so posts here, beginning with posts deconstructing those fabrications for example here, here , here, here, here, and here, here, here, and continuing, the claims of benefit from substitute opioids buprenorphine and methadone have been invalidated, consistent with a persistently worsening opioid epidemic the more they are made available. 

BELOW – NEW RESEARCH: Large study population started on buprenorphine in prison increases use of prescribed bupe post-release, with no overdose benefit 

Lethally confounded conclusions

Let’s review briefly why and how, predictably, medical dispensing of substitute opioids that are fueling the worsening crisis  became supported by fabrications. More deeply, the branding and deceptions creating a fabrication of effectiveness and safety have been driven by rapacious greed of the profiteers of pharmaceutical giants and treatment industries, also by the psychological needs of medical providers, having generated the runaway lethal crisis, to retake control to fix it, again by dispensing pills, coupled with profound deficits in capacity for clinical and ethical judgment, capacity for application of critical thought to evidence. 

But it took more than that, including the reckless neglect of what has had to be an overtly obvious confounding factor in all of the related research, obvious to any adult mind regarding the  research current, recent, and from the beginning, on problem opioid use and its “treatment” in the U.S., in the model system in France, elsewhere in Europe, everywhere.

medical professional holding naloxone

That confounding factor is the concurrent – over time and worsening of opioid epidemics – focus on, investment in, expansion of, and implementation of increasingly broad-based campaigns to train, provide, and use to save lives the potentially lethal opioid overdose reversing drug naloxone, “Narcan”. Its use to reduce incidence of lethal overdose has increased generally over time and differentially, of course, provision focused on those most at risk for lethal overdose. Those factors and others of course necessarily establish naloxone expansion and use as a confounding feature  generally precluding confident conclusions about possible beneficial treatment effects for substitute opioids. Simply put, reductions of opioid OD deaths due directly to reversals by use of naloxone cannot be attributed to beneficial effects of America’s gold standard treatments, do not represent such benefits, instead represent increasing high-risk opioid use in the lethal epidemic. 

As extensively documented and discussed in posts here, that confounding effect applies most clearly when the outcome measure for a study is incidence of lethal overdose. Increasingly, interpretations of non-lethal opioid overdoses are confounded as well, as distribution and use of naloxone expands to settings in which saves are not reported or collected – reversals by peers, community members, passersby, others in community settings.  

Fabricated conclusions effectively messaged

And it took more than that, to create messaging to a helpless public hoping for understanding and for truth to compel responsible institutions to provide effective, evidence-based responses. It took qualified-by-pretense, constructed “journalists” and “science writers” who do not remotely possess the capacity to understand, evaluate, or think critically about the relevant research, nor to contextualize it in the relevant fields of experimental design, statistical analysis, human development and behavior, human psychology.  Pretend writers who are profoundly incapable of that, that is to say, who are perfectly qualified for the instrumental roles they have played

Their compliant, useful work has not abated, instead heightened in importance as deaths mount. The same messages are coming from the same players, as here, where we are presented again with the truth-by-consesnsus that – 

The opioid overdose epidemic has burned through the U.S. for nearly 30 years. Yet for all that time, the country has had tools that are highly effective at preventing overdose deaths: methadone and buprenorphine.

These medicines are cheap and easy to distribute. People who take them use illicit drugs at far lower rates, and are at far lower risk of overdose or death.

new opening of Suboxone clinic

As established (follow the links above), those are lethal lies, the provision of addictive, diverted, misused opioids never having been supported as beneficial or safe, instead serving to enable illicit, high-risk use fueling an increasingly lethal epidemic. 

New research

adds one more piece, more evidence in the consistently falsifying body of accumulating evidence. 

Take a look. 

“Buprenorphine receipt” – the engagement of individuals post-release in medical care or treatment resulting in prescription of and receipt of buprenorphine (Suboxone) – increased dramatically after bupe had started to be made available to them while incarcerated, from 10.6 percent to 21.2 percent of releases. 

Despite that remarkable increase in use of American Medicine’s proven, gold standard addiction treatment medication, there were no differences, no reduction in combined lethal and non-lethal overdoses. 

But these predictable results are more troubling than that, 

and even more predictable. 

We know, can say with nearly 100 percent confidence, that the released individuals accessing treatment or at least prescribing services of a medical professional and using a pharmacy to obtain the bupe received, would have been much more likely to have been provided naloxone regularly and as needed, compared to others not engaging in those services. Why? Because that’s how naloxone policies, procedures, and practices have evolved over recent years, in desperate attempts to slow deaths. It would be egregiously unethical and indicated against clinically for those individuals to not experience efforts to equip them with Narcan. 

That means that reduced incidence of opioid deaths was strongly predicted with increased receipt of bupe post-incareration due independently to the factor of differential provision of naloxone alone, and almost certainly occurred. 

The lack of statistical findings of reduced overdose deaths is nevertheless predicable as well, based on the established role – here, here, and here, for example – of bupe serving as commodity, consumable, and currency in street economies of high-risk, lethal illicit opioid use, including as currency for fentanyl. That is, the supported interpretation for these predictable results is that differentially supported Narcan saves masked the expected increase in opioid overdoses associated with provision of bupe, currency on the street for fentanyl. 


All that was left was to spin the results into a protective lie. 

Main points 

 – “all cause mortality” is not a measure of opioid-related overdose and/or deaths and in any case, as discussed, that was predicted by differential provision of and access to naloxone

 – “not statistically significant” = no difference

 – “These results suggest that offering buprenorphine during incarceration might improve treatment receipt” – No, the results showed that starting treatment with bupe in prison dramatically increased use of treatment-supplied bupe post-release, a doubling in percent accessing it and the major, significant finding. 

 – The glaring, predictable result is the absence of any effects comprising benefit from access to American Medicine’s gold standard treatment while in prison and absence of reduced mortality post-release with continued use of the medical cure. 

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

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