Your life was probably challenging. Maybe there was trauma. Maybe there was abandonment. Maybe there was unhealthy peers, poor social support, marginalized communities. Maybe you were experiencing all that. Work on the mental health stuff. Work on the past. Create some concrete goals for the present that’ll help shape your future. Hey everybody, welcome back to the channel. This is Dr. B and the topic considered today is how not to get off subutex for success. In other words, what you shouldn’t do to get off subutex thinking that you will succeed and be

 

well off. So let’s get started. And today again, I have Parham Namatola with us. And hi Parham, say hello. How’s it going everyone? One thing I want to say that we’re going to try and do this format more often. And what I mean by this format, I want to answer a question from a viewer. And unfortunately, I was not able to get her name when I took this picture. But here’s what she writes. Let’s get started. It says, tripod for terrible withdrawals. Nothing works. I’m afraid of being on Subutex the

 

rest of my life. Is there any other type of help? So I think what she’s trying to say here is she wants to now get off Subutex. She’s horrified of being on this stuff for the rest of her life. I think she’s saying that pot’s been helping in her coming off Subutex. Then finally, she’s asking, what are some other ways? That’s what I take the question to be. It was a viewer. They put it on the channel. For some reason, I took a picture where I can’t see all of it. So I want to respond to that because I think it’s important. I recently did a piece on a response to Vice’s piece on marijuana

 

as a way to get off of opiates. And I think I was somewhat critical of that piece for many, many, many reasons. And I think this viewer is now again, I don’t know anything about her, how long she’s been on Subutex, what’s her dose, how rapidly she’s coming off of it. But she’s trying, she’s horrified of this idea of being on Subutex for the rest of her life. Is there any other way? And what are my thoughts? Number one, medically and clinically, there are multiple nuances that you need to consider when it’s time to taper. You have to look at the individual,

 

the dose they’re on, how long they’re in it. And here’s the key part that’s very relevant to what Powerhome does as a psychologist. How is the rest of your life going? Where’s your neural networks at now? Where’s your focus at now? What is your coping mechanism? Keep that in mind. You have to look at all of these things, including how fast you’re going to taper. Number two, there are also other medical ways that can assist in tapering off of buprenorphine products.

 

And I don’t want to get into that into this video. But all I’ve said is, yes, there are other ways besides marijuana. Two, you have to look at the patient, the whole patient, the rate of taper, the amount they’re on, how long they’ve been in it. And I think most importantly, what have you done for the length of time, whether it’s six months, a year, two, three, four years, that you’ve been on Subutex? Now I’m going to get to the main point I want to make.

 

What you need to do in the most general sense while you’re on Subutex or buprenorphine is live. I look at this medication, a critical medication, as taming cravings and withdrawals, which go on more than a few weeks or more than a few months. These are neural networks that have been set in, oftentimes from childhood, that created a response to coping that you went to the drugs. It’s a marathon, not a sprint. And you need to engage

 

in healthy activity, coping mechanisms, and come to the realization of the fact that reality is frightening. And when you can deal with that in a healthy way, now you can talk about tapering, whichever method you use. And when you get to that, depending on who you are, it needs to be done the right way. And I’m discouraging her from using marijuana as a taper if it’s causing her problems, simply because to me, this seems potentially, I know nothing about this person and I’m not giving

 

medical advice, potentially she’s got this sort of fear and she has this kind of paranoia. Oh my God, I’m not giving medical advice. Potentially, she’s got this sort of fear and she has this kind of paranoia. Oh my God, I’m on Subutex. And I want to leave it to two more thoughts. One, assume that you were a very bad opiate addict and you had to be on buprenorphine for the rest of your life in some theoretical world. When you look at something clinically, it’s a risk benefit analysis. Whether I have a cane, I’m taking blood pressure medication, or if I had to be on some small dose of buprenorphine for the rest of my life, is that not better than the alternative if I’m living a productive, healthy

 

life? And so that’s the other piece of this. And the main thing I want to say to her, use the opportunity of the buprenorphine product that is filling those receptors and start building the other networks that give you coping mechanism and ability to live in a positive, growth-oriented, healthy life. And that is the best way for you to start coming off Suboxone. And one last piece here, even though it’s silly. No, I don’t get paid big bucks by the drug companies. In fact,

 

if I was really a smart guy, I would join the kratom industry or the marijuana industry and probably make 10 times more. So I’m not trying to keep anyone on Suboxone and it doesn’t matter the pennies on the dollar that I get. Live a good life while you’re on this medication and the possibility and potential of coming off of it at the right time in the right place will present itself in the most natural way. Mental health while you’re on this medication. Parham, that’s my take on this. Yeah, no, it’s wonderful. I always learn so much

 

from you, Doc. I really mean that. And I want to kind of echo some of these sentiments. And Doc was saying, if you ever disagree with me, you can share it too. But fortunately or unfortunately, we rarely ever disagree. But I will say this as a clinician that works with individuals who are on medication-assisted treatment. And this conversation comes up a lot. They’ll come up and say, I don’t know if I want to be on this med for the rest of my life, or I don’t know if I’m even feeling any better. I don’t know if X, Y, and Z, and I want to get off. So the first and foremost, that’s a, you know, medical question with the, with the provider, with the, with the specific directions to go, to go that direction when it comes to tapering off medication, that’s number one. But number two,

 

I agree with what doc said. The more your life is a life that you’re engaged in, involved in, accomplished goals, proud of, reestablished relationships, for that person, it’s easier to make medication changes than for the person who is completely like a raw nerve that hasn’t accomplished any of that stuff. Raw nerve. It really, really is. And the part of it that I think is really important is this, is individuals say, I don’t know if I feel any better when I’m on this medication or this and that. It’s not, I mean, that might be a potential benefit of the medication, but the main thing is take away the cravings and the urges and the when I’m on this medication or this and that. It’s not, I mean, that might be a potential benefit of the medication, but the main thing is take away

 

the cravings and the urges and the repeating of the past behavior, which leads to illicit drug use, dangerous situations, dangerous people, dangerous places, health implications, financial consequences, legal consequences, like that’s the main thing. Now, here’s the thing, if you say, well, I’m off that stuff and I’m taking the Suboxone, but my life isn’t getting that much better, that’s what we always go back say, well, I’m off that stuff and I’m taking the Suboxone, but my life isn’t getting that much better. That’s what we always go back to is because prior to the Suboxone and prior to the opiate use, your life was probably challenging. Hence why opiates did magic for you. Maybe there was trauma. Maybe there was abandonment. Maybe there was unhealthy peers,

 

poor social support, marginalized communities. Maybe you were experiencing all that. The opiates came in and relieved those symptomologies. Then it became a problem itself. And now you’re on the Suboxone with no more of the opiates of the illicit kind. And what’s happening now is like all that stuff you’ve experienced your whole life is right there with you. So that’s why using this medication to be able to now finally, for the first time, work on the mental health stuff, work on the past, create some concrete goals for the present that’ll help shape your future. Once you do all that kind of stuff, this medication becomes a bridge to take you from where you always want to go in life, but never could because of the addiction. And once you

 

get there, let that person decide if he or she wants to make changes in their medication. Well done. There’s so much you say on this topic at many, many levels, including the difficulty in finding providers that don’t stigmatize the medication and understand the nuances of when to take you off of it, how to take you off of it. But first and foremost, every provider needs to educate you on the truth, not what you want to believe, and then respect your autonomous decision making. And then, unless if you’re going to kill yourself

 

support that decision that’s it power home thank you for the input i hope what we gave you facilitates your recovery your decision making your advice you give to others we’ll see you next time don’t forget to like and subscribe peace