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Been on sub for 5 years. It’s a bandaid. It’s puts the inevitable withdraw symptoms on pause but they will always be waiting. Being on sub is not a good time. They lock on your receptors so strong so nothing else can get through so there is no high no pleasure, fine but that also includes natural chemicals we produce like dopamine and serotonin. Sure I don’t feel sick and weak and tired but I also have no ambition, no joy or happiness in things I used to like. I’m stuck in an endless mild depression. To get off you really need to ween for about a year otherwise the withdraw symptoms are too intense. Suboxone is a huge money maker and doctors that care about their patients should work on a plan to ween off not a plan to take for the rest of your life. Most doctors have no idea what the absence of pleasure in your life can cause real physical pain.

What is wrong with taking low dose of a weak opioid for incurable chronic pain?

This guy is reciting his textbook. Of course Suboxone damages organs. Gastric motility is slowed causing a lack of passing regular bowel movements which causes problems in many different organs. How can you bring a child into this world that has to go through withdraws and you aren’t willing to go through those withdraws yourself? I will agree with him about the public relations issues.

I have been on subox for over a year. I have to disagree with him about no physical consequences. It releases histamines in some causing skin issues,all OPIODS can . The brain cannot rewire to normal dopamine production ( the natural happines reward) while on any OPIODS.. Male sex drive is affected on any opioid! Urine retention is common for many. I believe long term use will hurt the liver , kidney and teeth and bones. My humble educated opinion as a researcher and bup maintenance patient. Yes it worked miracles, but to hope to be free of it eventual. Surprised by his opinion here. God bless my friends!

Great Doctor, if there was more addiction Dr’s with this mentality and approach we would have more addicts staying sober or at least more getting treatment.

doctor explains this excellent , subooxone causes dependence , not addiction

I disagree that there are no negative effects of suboxone. it has an effect on your biochemistry. and it is addictive. try taking it and then quitting. im a fan of suboxone for recovery but to say it is 100% safe is just not correct. I agree that it's better then relapsing.

Im on this i have started on 20 mg iv been reducing since september now its feb 2019 im on 8mg doing well with my opiate addiction recovery

This stuff saved my life.. Thanks to everyone who help make this!...

I applaud this guy for being pro sub for recovery. But I don’t like his opinion on stopping completely. It seems very negative. There can be life after sub use but it takes work. I’m an addict clean for 5 years now. It is not easy but it’s doable. I think the thing this dude is trying to make known is if you do have to be on replacement therapy for life so be it. Don’t ruin your life trying to be clean of everything if in fact you would be better off with sub. Obviously clean is the best way but don’t best yourself up if you have to be on sub for life. Only you know the truth.

I completely forgot about the cravings it was amazing. Being sick from that withdrawal is the worst thing ive ever gone through. Well the suboxone alleviated all that. It lasts much longer too. The staying power is twice that of the Vicodin. Much better

I took hydrocodone for 20 years. Never thought id get past the withdrawal. Well I did. It saved my life.

Dr. Mariani, Thank you for these videos!

He seems like such a great Doctor.

I'm going to say this on every video. This guy is good.

This guy is good. I wish he was my doc.

Buprenorphine IS a powerful drug, but it saves lives.

He has an excellent was of explaining what he is presenting. His delivery is excellent and he really paints a picture for you.

Concur with Timothy Liverights comment. Also noted the apparent disapproving microexpressions when discussing other drugs potentially used. Notice how he shakes his head "no" when asking about prior psychiatric treatments or admissions. Bulk of the questions were closed ended. Some folks might wonder what the patient is thinking.

Pretty much how I conduct initial interviews although I was struck by the interviewer's facial posture of looking at the patient in a sideways position. Seemed a pinch off-putting or a suggestion of his discomfort.

Everyone has different situations. Mine comes from a injury back 8 years ago. I broke my back, severe nerve damage couldn't walk. Dr gave me pain meds I was 41 and in my life I didn't ever take pain meds,,never. Not in my teens,20's ect. After being prescribed pain meds for a year I was sent to a pain management clinic. That's when I made the descision not to go to clinic to be prescribed more pain meds instead I went to a suboxone clinic. The Buph actually helped my nerve pain better than any pain pill ever did. Now my dilemma,,even thou it helps I have depression,dizzy spells, and the cost leaves me month to month broke. I'm supposed to be on 2 8mg a day but instead take 1. If I quit taking my nerve pain increases if I do take I feel better but want off worried about long term effect.I'm thankful I didn't go to clinic in many ways. I feel trapped damned if you take damned if you don't.

Thanks for this video. Excellent description of what is needed for substance abuse disorders. Real science-based medicines that work! Love the term "Medications for Addiction Treatment" - That's the best description of MAT. Naltrexone for alcohol treatment, when used as a targeted medication, is ground-breaking (The Sinclair Method/TSM). This documentary is an intro to the method. tubitv.com/movies/326586/one_little_pill - The many TSM videos on RUclips are compelling 'anecdotal' evidence that Pavlov was spot on, even in humans. Dr Roy Eskapa's book describing TSM and the clinical trials is a must read.

As an MAT provider always looking for persuasive communication ideas, I found this wonderfully concise, sincere, and wonderfully persuasive. Great job!!!

Sherry I am so proud of you! I remember you from your early recovery days in Cambridge. Keep going one day at a time. (Bud)

I think it's dangerous to talk about a "blocking dose" since it encourages a patient to test it. You can always take enough to feel it which risks overdose.

Well make all these doctors keep the ones who want to stay on? on? I take 2 and half mgs. for 11 years now and im straight, I believe im ready to start getting off though? but i'll worry about that when i can't get anymore.

I think it's also important to note that people can overdose even on the XR of Naltrexone, which wasn't clearly stated on the 3 videos. The blockade could be overcome with increased amounts of opioids. Good video overall, keep them coming!

It is good to be optimistic but you and I can not make a change until patient want a change. This the way I see these patient with addiction as their families and friends wants them to be in treatment but ? are they really interested in treatment.

Thanks for the explanation, I was scared to start it, now my thoughts are clear!

Excellent supportive discussion of a common problem in recovery

Sadly many members of our society Stigmatize treatment of addiction with medication. Some people are able to get off their anti hypertensive medications. Some people need medication for all their lives. As a physician who treats hypertension and addiction I have had patient stay on medication and do well and patients stop medications and do well. Most however remain on medication. Why ? Because medications work!! We are living longer despite rising rates of obesity and heart disease Why? Medication! Why are we dying from substance abuse? Lack of good medication that help treat addiction! The Kakko trial in Sweden in 2003 clearly shows that those who take medication are less likely to DIE than those who stop medication! Please do not stigmatize those who are living a productive life while taking medication. Their life might depend on it!!

As a former psychiatric nurse for nearly 30 years in the largest free standing psychiatric hospital in the east coast, this Physician is excellent. He is compassionate, knowledgeable and invested in the treatment of this woman. Awesome video!

I couldn't be any prouder of the 2015-16 Yale Addiction Psychiatry and Medicine fellows. Very, very strong work to help stem the US opioid crisis.