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Beyond the Prescription: Understanding Suboxone and Methadone

Screenshot of podcast hosts - Suboxone & Methadone in Opioid Addiction Treatment

Suboxone & Methadone: Unveiling the Truth in Opioid Addiction Treatment

Ever wondered what medical and addiction professionals think about Suboxone and methadone treatments? Are they the answer to opioid addiction or part of the problem? This episode takes a critical look at the challenges surrounding the use of Suboxone and methadone in addiction treatment. Join Waismann Method’s founder, Clare Waismann, M-RAS/SUDCC II, our medical director Michael H. Lowenstein, MPH, M.D., along with Domus Retreat‘s clinical director, David B. Livingston LMFT as they discuss the training deficiencies among health providers in prescribing these drugs and how these gaps impact patient care. Additionally, we shed light on the effectiveness of rapid detox. The goal is to dispel myths and bring awareness to effective treatment options, providing a comprehensive view for both patients and professionals in the field of addiction recovery.

With expert insights and real-life examples, this episode is a must-watch for anyone seeking a comprehensive understanding of opioid dependence recovery. Whether you’re a healthcare professional or someone touched by the opioid crisis, this discussion will offer valuable perspectives and essential knowledge.

Dwight Hurst, CMHC: And we are on with everybody. It’s always exciting now that, especially now that we’re doing that, we want to welcome everybody who is watching the video. If you’re hearing just the audio of this, I hope that you’ll investigate on our social media @opiates or go to opiates.com and there’s links to see us. You can see all our beautiful smiling faces as well. Want to welcome everybody back to Addiction Recovery and Mental Health, a podcast by Waismann Method Opioid Treatment Specialists and Rapid Detox Center. I’m your co-host, Dwight Hurst, and am, as always, joined by our wonderful panel of experts. First off, we’ve got Clare Waismann. Here is a substance use disorder certified counselor, registered addiction specialist. Or she’s had the passion and expertise for 30 years of of treatment in the field and is the founder of the Waismann Method. So hi Claire, thanks for being here. How are you? A pleasure. We’ve got Dr. Michael Lowenstein able to join us too, which is always exciting. Is here really the premier authority of the anesthesia assisted and rapid detoxification. And you you’ve pioneered so many advancements in that and such a great thing to have you in your expertise here as well. So thank you, Michael, for being here as well. And of course, and of course, we got our, our clinical pillar of, of therapy wisdom here, who I learned from every single time we do the broadcast. David Livingston, who shapes my own practice with my clients all the time, who is a master’s in psychotherapy and been such a key part of the clinical work in the Waismann Method and the Domus follow-up retreat as well. So thank you David.

David B. Livingston LMFT: Thank you Dwight.

Dwight Hurst, CMHC: We are covering something that is very near and dear to my heart as well, because I’ve just seen how impactful this can be in people’s lives when we’re talking about addiction. So today’s program is we’re calling it Beyond the Prescription. And we’re going to be talking about how do we understand all the ins and the outs of the use of Suboxone and methadone, and how that applies through detox? There’s so much talk about it. And I think there’s a lot of myths of things that get in the way of understanding the true nature and the true benefits and, and pros and cons and all of those things are real. But we have so many misconceptions out there that are on that too. So let’s dive into that and get into where, where do we want to start. Everybody, when we’re talking about the use of medical and medication interventions in addiction.

David B. Livingston LMFT: We’re talking about methadone and Suboxone in particular.

Dwight Hurst, CMHC: Sure.

David B. Livingston LMFT: And in terms of well, I’ll just jump in. I’d say one of the things that I see or have reported to me consistently is that patients don’t really know what they’re getting into. And while there’s especially with fentanyl all over the place now and so many medications being fentanyl, whether whether you think it is or not, and the extreme danger of that, there is some benefit in use to both methadone and Suboxone as treatments. So I mean, for starters, it inhibits or it decreases the risk of of death really. And there’s now you’ve got a psychiatrist with Suboxone. And often you’re usually you have methadone clinics giving out the methadone. But what I see is a real deficit in terms of education. So in both cases you’re on an opioid and sooner or later they’re and usually the arc is it’s usually okay for a while. And then it tends to level off and then it tends to go down. The other side is what I hear and see reported to me all the time. So opioids are going to suppress your emotions. They’re going to they’re going to suppress. If they can suppress pain, eventually they suppress everything else. And a lot of people don’t know they’re depressants. So over time it will shut you down. Okay. There’s also other physiological problems with it, as Dr. Lowenstein can talk about. So and it’s very, very subtle and gradual.

David B. Livingston LMFT: This happens often over months and years. And so it’s hard to recognize. And so when people get off it they start to feel like themselves again. Their emotional life is less deadened because they’re off of the opioid. And and also with both medications, they tend to turn on people, meaning that for a while they’re tolerated well, then eventually they’re not tolerated well. And there’s there’s other effects, including dysregulated sleep. You know, your body learns to metabolize these things quicker and quicker. So there’s subtle withdrawals depending on, you know, unless you’re going up in dosage. So so it’s a it’s a mixed bag. And I think once someone is past the point in which they are feeling compulsively using it can also create the other side of it, which is what drives compulsivity is frustration and feeling trapped. So eventually it helps with that. Or initially, it helps with that, but eventually, it creates it because you’re trapped on it. You’re getting off the methadone, you’re getting up and going to the clinic, or even if you’re not is, you know, there’s a whole process that helps people feel frustrated and trapped, and it can increase compulsivity in different ways. And usually by the time we see somebody, they’re just sick of it and they’re like, I got to get off this stuff. So. So maybe that’s a jumping in point.

Dwight Hurst, CMHC: Yeah. And that that you hit that on the head where there’s a lack of understanding, as you put it, not knowing what they’re getting into. And unfortunately that often extends to treatment professionals. And sometimes some of that information is being given out erroneously by volunteers who are not necessarily even trained professionals who are talking about what they think should be done. And unfortunately, even prescribers sometimes are not versed in these things. And, Dr. Lowenstein, you can talk, obviously, to the training that’s necessary, as well as what these things are doing inside of us when we take them and how they’re helping and what we should be aware of. That’s that’s kind of broad. You can go wherever you want with that.

Michael H. Lowenstein, MPH, M.D.: Yeah. So I want to just step back to something David touched on. Is that right now the predominant drug out there is fentanyl that we’re treating. And the risk of overdose death is just enormous because we really don’t know what’s in the fentanyl. Um, it’s being, you know, there’s, um, xylazine. It’s just it’s just very, very dangerous. So I think, or medication-assisted treatment has a very important role. Um, you know, and that could be methadone, that could be Suboxone or buprenorphine, and that could be naltrexone, which is the pure opiate-blocking medication. So I think there’s definitely a place right now for all three of these, especially with the risks of fentanyl, I think, and David touched on this. One thing that’s really, really important is to determine what’s the need of the individual. So when you first meet this patient what do they need? Where are they now? Is are we just treating and preventing, you know, the use of fentanyl and overdose death? Um, what are their immediate needs. And then you can look at each of these different treatment options and. Figure out what best meets the need of the individual, you know? So are we just trying to stave? Are they in withdrawal? And we just need to stabilize it. And then going forward, do they want to use these drugs to detox? Is there a reason to be for a period of time, to be on a maintenance dose to stabilize the rest of their life and, you know, their environment and everything else? Um, so I think we really have to understand the individual.

Michael H. Lowenstein, MPH, M.D.: And then as David’s talked about, a lot of the patients that I treat have now been they’ve been on these meds for a period of time. They’re stabilized and they just no longer want to be on maintenance meds. They want to be opiate-free. You know, we often hear of methadone being the liquid handcuffs. So patients, they’ve been stabilized. They’re on it. They’ve tried to wean off on their own. They can’t tolerate the withdrawal. They can’t either. They’re just not achieving their goals. Um, so I end up meeting them and treating them because they just want to be off these medications at some point. So I think, um, and then the other thing is you touched on training. Um, when I see patients on Suboxone, a lot of them are on a much higher dose than was needed to treat their original opiate issue. Um, and, you know, my adage has always been start low and go slow. So you really want to when you’re initiating these treatments and patients, you really want to find the lowest effective dose to achieve your goals. And then, you know, like I said, have the discussion. Are we going to use Suboxone or methadone to wean or detox? Is it going to be a maintenance. So I think the most important thing is here is to really understand what each individual patient wants or needs at that time, and to really tailor the treatment to their their wants and needs.

Dwight Hurst, CMHC: Do you feel like then is it important to have a sort of a. And maybe you can correct me if this term isn’t a good one, but kind of an exit strategy from day one, or at least knowing what the goals are that would lead to cessation of the use of the medication.

Michael H. Lowenstein, MPH, M.D.: Yeah, I think that’s important. With any treatment plan, you want to you want to figure out what the immediate needs are. The patients need to fully understand what they’re getting into. Right. The majority of patients are not aware of what it’s, you know, Suboxone or buprenorphine. It binds tighter to the opiate receptor than any other medication, any other opioid. And as a result, it’s probably the hardest to get off of. Um, so there’s and I think that’s the providers need to understand what they’re really prescribing as well. But I think the patients do need to be educated up front and, and at least to let them express what their short term and long term goals are. And a lot of these patients, this is not their first rodeo, right. This has been a revolving door, which is kind of the definition of addiction. Um, so they a lot of times they know what they want or what they need, and it’s up to us as providers is to help them achieve those goals.

Dwight Hurst, CMHC: Yeah. Treating people as individuals is something that obviously is one of our deep values on this, on this podcast and in the in the Waismann Method program at large. And sometimes I have found that while it’s good to be aware of misconceptions people may have, it’s also good to listen to my patients and say, tell me what you know and teach me about your experience as well. So I have noticed there is sometimes a rise in anxiety as people get close to that point of completely going off, even if they have, as one prescriber told me once, that he had patients who had such a low dose that it probably wasn’t even. And it had been a while since initial sobriety that it probably wasn’t even doing much anymore. But the anxiety spike of, okay, we’re going to get rid of this now, sometimes for some patients is is very difficult. Is that something you’ve any of you observed as well? Maybe you’re better at teaching it again.

Michael H. Lowenstein, MPH, M.D.: So yes. And I think that’s the importance of like with our treatment, the importance of the aftercare. So I educate the patients and say you’ve got two issues here. You’ve got the fact that you’re opioid dependent and you need a medical detox to treat the opiate dependence. But I tell the patients everybody uses drugs for a reason. So once the opiates are out of the picture and you’ve been successfully detoxed, in our case, we transitioned patients to naltrexone, you know, to block the receptors and reduce cravings and reduce the risk of relapse. But then you have to address all the other underlying issues. So I think if you have that discussion with them up front, why both are important. We got to detox you first medically and then we have the Domus aftercare that where you can start to address all those other things. And yeah, a lot of people, a lot of people have been detoxed before they were started on Suboxone too early and had a horrible precipitated withdrawal. So they all come from a place where there’s reasons why they’ve stayed on the drugs, and a lot of times it’s just the anxiety and fear of what they’re going to face afterwards, or they’ve had detoxes that were just miserable and they just stay on the drugs just because they don’t want to experience that again.

Dwight Hurst, CMHC: Hmm. Interesting.

David B. Livingston LMFT: Right? That, that ultimately, you know, as Dr. Lowenstein saying in, in the treatment, you establish a new way forward ultimately so people will feel trapped, even in things they don’t necessarily recognize or minimize, whether it’s poor sleep, whether it’s just the drug itself, which is why you’ve got to get them off the drug. And usually they come in when they’re sick of it and it’s they can recognize and feel that it’s it’s its own trap. Now it’s no longer a way forward. And they need a different way forward. So they have to get detoxed. And then you address each of the issues in their life situationally, whether it’s anxiety, depression, you know, troubles at work, troubles in their relationships, other issues. And as you begin to address these, it’s really what a treatment is and show them possible ways to move forward. Just the feeling of seeing a different way forward is unbelievably therapeutic. It brings down compulsivity because it it limits the amount of frustration and feeling of being trapped and in multiple ways, because these things go on in everybody’s lives. It isn’t that there aren’t competing needs and conflicts that have to get worked out. They do. But really treatment is about working those things out. And as that happens, people feel a sense of agency again. They feel and there’s a sense of a treatment taking hold because they feel their lives moving forward in a way that they’re they’re wanting. So just to add to what Dr. Lowenstein was saying.

Dwight Hurst, CMHC: Real education and empowerment is really key to what I’m hearing is that people know, and then we give them a little bit of that, just not just knowledge, but guidance and then trust also, and which it strikes me like so many times, there’s so many things that this is really what we talk about in medical treatment for anything. Right? Is that that’s what you want is to be related to in that way of being educated and empowered with your own health as a patient of any type of medical intervention? Um, what would we say about some of the myths or misconceptions that are out there in regards to medication-assisted treatment?

Dwight Hurst, CMHC: You want to jump in, Clare?

Clare Waismann, M-RAS/SUDCC II: I’m sorry I got disconnected for a second.

Dwight Hurst, CMHC: Okay. Yeah. You’re good. I just I just put out there the idea of myths and misconceptions that sometimes get in the way of people’s either engagement at all, or how they engage with medication-assisted recovery.

Clare Waismann, M-RAS/SUDCC II: I think when you talk about anxiety, I think a great part of the anxiety is because they have been told so many times that addiction is a chronic disease, that they will be in some kind of drug the rest of their lives. Um, most people that call us, you know, say, I can’t even believe this. I was told that I need to be on methadone or Suboxone the rest of my life, and I think that that’s a very, um, hard statement that creates hopelessness. You know, as David is saying after a while on these medications, patients tend to live a life that is without ups and downs. So, you know, like they describe so many times, a decade passes by them and they don’t even know where he went. So it’s a life of doubt, the natural euphoria that makes life worth living. So as much again as is. These drugs are really important for some patients at some instants of their lives where, um, they could be at such high risk. I think giving them the information and the ability to come off these drugs is not just the right thing to do, but is the humane thing to do, because it gives them hope. It gives them a way out. Yeah.

Dwight Hurst, CMHC: Well. And sometimes it’s funny where there’s almost a shame association sometimes with just like there’s with anything with addiction. Right. There can be a shame association. One of the big misconceptions I hear is the old, and I think of it as just really old school, thinking that if you’re using a medication to treat your addiction, then it’s not real recovery, whatever that means, right? Is that something that you see people still falling into that these days? I’m sure that’s come up. Having operated a detox chemically assisted detox for so long that you must have seen that. I guess I’m hoping. I hope it was more in the past than it is now. But do we still see that popping up?

Clare Waismann, M-RAS/SUDCC II: I think the goal here, um, Michael, David, is to give the patient the best quality of life. Um, right. And for long term, regardless, you know, of what they have to take. I mean, we take medications for so many different medical issues so we can have a good quality of life. Um. From even mental health issues. Depression, you know, why would this be a different case?

Michael H. Lowenstein, MPH, M.D.: And I think from a medical standpoint, um, opiates affect so many different body systems physiologically, right? It affects hormone production. It affects your gut, it affects your sleep, it affects your neurotransmitters. Um, so I think Claire’s right there because you want to give, tell people that we’re going to get rid of the opiates, even a maintenance drug, to just let your physiology find its new normal. And, you know, some people say that, you know, detoxed. And we’re going to reestablish your pre-addiction state. But I kind of my argument to that is well whatever was going on pre-addiction was what led to addiction. Right. So there was something that was not balanced. So I actually tell patients let’s find a new normal. Let’s you know get you off the opiates, let your body, you know, good nutrition and sleep and exercise and mental health to address those issues. And let’s find a new, healthy normal where your neurotransmitters will rebalance, you’ll produce hormones again, you’ll produce new healthy receptors and let your body actually find a new physiologic normal and a new mental health balance where you can go forward without the need for drugs. So, um. I think that’s really that’s what I, you know, that’s how I present this to patients that, you know, let’s get you away from the past and let’s find you a new, healthy, normal. You know, just physiologically, we all age and, you know, our normal is different for everybody. So let’s make sure that that new normal is good. I mean, that’s the whole push behind, you know, regenerative medicine or, you know, trying to just create a new healthy balance throughout the physiology.

Dwight Hurst, CMHC: You make a really good point that this is a this is a tool and a toolbox. And there’s so many other things that it’s it’s almost an overfocus on the presence of the substances to say, you know, oh, is this just a replacement or something? It’s like, no, that’s just a part of a treatment, not a treatment in and of itself. So, David, you were going to say something.

David B. Livingston LMFT: To that point that it’s it’s a coping mechanism, you know, I mean, initially, I think the medicinal use of opioids was for and as it’s now being really laid out, is for acute short-term pain because it’s effective and that is a medicinal use for it. And so and because it allows people to cope and get through that period, okay. Until there’s a different way for it, until the pain abates enough, until there is some sense that you can manage and get through it. And but that is the whole idea of a treatment is that as you lay out the things that are inhibiting you from feeling good and feeling, you know, a sense of your life moving forward, and it can be chronic anxiety, which will inhibit you because people want to feel okay or even good. Right? So so you have to take each of these things as they exist. And so it takes a while to begin to sort of really ferret out what those are and address them. So one of the things that we do is besides, you know, I address those as much as I can in our process and then really try to establish some sort of sense of what has to get dealt with moving forward. So they have so the patients have some feeling for, okay, we I’ve gotten this done, I’ve gotten a sense of what I need to address. And then here’s a way forward to do that.

Dwight Hurst, CMHC: I’m you. What do you think are some of the things that people should be aware of as they are approaching this as an element of their treatment? Um, obviously they want to consult with medical, but, but. I guess what I’m hearing from from everybody in Dr. Lowenstein. You’re saying that this may or may not. It’s not a one size fits all, I guess, is what I’m saying. And how do people decide what role that this plays in their treatment?

Clare Waismann, M-RAS/SUDCC II: I think there is no one size fits all when you’re talking about human beings. We are all so different with so different needs. And I think also that in the addiction field, this is the biggest flaw, is thinking that, you know, we’re treating addiction and everybody needs the same treatment and we’ll get the same result and people. Feel unseen. Unheard. Lost. Hopeless. Um. I think.

Dwight Hurst, CMHC: We’ve had a little interruption in the internet connection with Clare there. Would anybody like to make something? I’m assuming we’re reconnecting. But while we’re waiting, would you guys like to jump in?

Michael H. Lowenstein, MPH, M.D.: Yeah. So I think we did. You know that.

Dwight Hurst, CMHC: Maybe.

Michael H. Lowenstein, MPH, M.D.: There is no one size fits all of Claire’s back.

Dwight Hurst, CMHC: Sorry, guys on.

Clare Waismann, M-RAS/SUDCC II: The internet.

Dwight Hurst, CMHC: Today. Everyone is just disagreeing with you when you came up. No, I’m just kidding. Everybody was. We were. We were echoing in agreement that. Yes, not there is not a one size fits all, but go ahead, Claire.

Clare Waismann, M-RAS/SUDCC II: And I think the expectations as well, I think it’s really, as Dr. Lowenstein was saying before, when people believe if they go to a rapid detoxification, that they are going to find, you know, they’re going to go back to pre addiction state, I think is a cruel and unrealistic expectation. That is, you know, we’ll just let the patient down. And in the same way when somebody enters rehab and their promise oh your son is going to be nicer better more effective more productive. You can’t make these statements for patients. You know what patient will achieve. You know, what patient’s goals are is you know, so relative to their needs at that time on their lives, whatever was ten years ago, it might be not that important right now.

Dwight Hurst, CMHC: And it strikes me too that going back to that, as you say, pre addiction stage number one, it’s an unrealistic expectation to think we’re going to go back and it’s just going to be just like on the other hand too. It also wouldn’t be good if we could right. If we could deliver on that. There was a as we’ve been it’s been coming up in this discussion. There were reasons. It reminds me of a dynamic I see a lot when people will let down their guard and they will become vulnerable to those around them. They’ll tell their family, I’m depressed, I’m suicidal, I’m anxious. I have this addiction. Something happens to where now people know. Unfortunately, you sometimes hear from family members, well-intentioned. They’ll say things like, boy, I just want my happy kid – spouse, parent, whatever. I just want that happy person back that happy-go-lucky. And unfortunately, what the person can hear with that is it’s like, oh, well, you’re now broken, you know? And what I really wish was that you were still hiding all these things that were making you miserable. And so not only is it an unrealistic expectation, it’s a very it would be toxic if we could do it if everybody. If that makes sense. What I’m saying, why would we want to go back to that, the thing that put me on that path?

David B. Livingston LMFT: Well, that’s it. Because whatever put them on that path meant that they didn’t see a different way forward, and they began to use an opioid to, to cope. So, you know, in the beginning you just meet people where they’re at. So I don’t feel good. When am I going to feel better? Well, okay. So how are you sleeping? Well, I’m not sleeping well okay. So let’s address your sleep. Okay. What else is going on? I’m anxious. Okay, well, let’s get you sleeping better, because that will contribute to your anxiety once you’re sleeping well. And and we help them get sleeping better. Usually, their anxiety goes down. And then you got to start exercising and moving around. That tends to bring anxiety down significantly again. So there’s a process. And what happens with addiction is there’s no there’s no parsing the needs and then breaking them down and then really laying out a step by step way forward. And I would say that one of the things that we do well here is we have a real sense of a process, and it’s really how we approach it. And because of that, it’s, you know, we’re not just giving anecdotal ideas, you just got to do this or that. It’s that’s not what a treatment is. A treatment really is a ability to break things down until there is, you know, if you’re not sleeping well, let’s figure out why, okay. And then you’ve got to solve that because nothing people don’t feel better until they’re sleeping well enough. So you go step at a time and you solve these problems. And then there’s also an idea because this this is huge in the treatment of addiction, is that people begin to feel like they can think again, that they’re not just stuck and they have problem-solving. They can solve these problems step by step. And it reestablishes a sense of growth again, which is really what that is. And then they feel a sense of hope. They feel a sense of their agency back. All of that inhibits any potential relapse.

Dwight Hurst, CMHC: And the hope then hope is huge. I always kind of close the my little my little tag. Line when we finish these episodes always has to do with looking for hope, right? Because that is also it’s also empowering. And this is where people even start to embrace the idea that I could be healthier mentally than I maybe have been in a long, long time. Aside, even aside from if the addiction is a symptom of that lack of health and lack of psychological, you know, well-being, that I can actually not. It’s not like I’m trying to get back to where I was and hang on white knuckling what’s going on. I can actually be happier and healthier because I know how and I’m empowered to manage my health. And that’s a goal, right? That’s the real goal.

Clare Waismann, M-RAS/SUDCC II: Well, that’s it. To the, you know, the reason why we’re here today, talking about Suboxone and methadone, it’s for me. I always think that instead of maintenance drugs that let’s maintain you where you are, it could be a supportive drug. Let’s support you while you’re trying to find, you know, a better solution, a healthier solution, a happier solution. So I think the language we use, it’s also quite hopeless, you know, maintenance drugs for the rest of your life instead of supportive drugs at the moment you need. And then there is a medical way out.

Dwight Hurst, CMHC: And knowing the difference between those types of drugs, right?

David B. Livingston LMFT: There’s almost no other field.

David B. Livingston LMFT: In psychology or medicine that I know of that approaches things that way. It’s as if you’re stuck and this is it. And we’re just going to keep you here in this place. There’s no educational process. There’s it’s, um, it’s not good enough, I guess is the best way to put it. And, um, and I really think getting stopping the idea of a revolving door really is the establishment of continually feeling like things are getting better, you know, through breaking things down and figuring out what’s inhibiting that and then what’s going to allow that, the needs to get met again in a different way, in a healthy way.

Dwight Hurst, CMHC: Dr. Lowenstein, you were going to say something. No, I was.

Michael H. Lowenstein, MPH, M.D.: Just going to say maybe.

Dwight Hurst, CMHC: You just looked wise there.

Michael H. Lowenstein, MPH, M.D.: Earlier about when you, you know, when patients initially or when they initiate Suboxone or methadone is to have a plan and, you know, it’s set realistic expectations. And I think this is just so as Clare says, these drugs are supportive and allow you to kind of figure out other things. So now that the patients have been detoxed, it’s it’s very similar going forward. You have to have a plan and you have to have realistic expectations, and there’s going to be ups and downs. So I think this is just the next phase in, you know, the drugs the medications played their role. And now that you’re detoxing off it, I think, you know, part of the importance of an aftercare and like David had spoken about, is we really need to figure out what’s going on. Now. We’ve eliminated the drugs and just really have a plan going forward, because we’re not going to fix this overnight. And in a couple of days we can rapidly detox people and treat their opiate dependence very quickly, safely, and comfortably. But now going forward, they’re going to have to address all the underlying issues which got them to where they were. Um, and just for them to understand that, you know, this is the first step and this is what you’re going to need going forward. And I think that’s really helpful for them to have that time period where you can establish these kind of goals and expectations in a very supportive environment and realizing that this is not going to, you know, we’re not going to fix this in a day, but at least you’re pointed in the right direction.

Dwight Hurst, CMHC: Absolutely. Well, as we have progressed through the discussion here and in the interest of our time in the program, as we’re getting close to wrapping up, I want to throw it out there. What else would we want to say about this? Does anyone else have anything you’d want to make sure we get out there for people to hear

Clare Waismann, M-RAS/SUDCC II: I think it’s important for patients on Suboxone and methadone to say that there is no judgment on what they’re taking, but there is a way out if they decide to, you know, to find another way that is not maintenance drugs. I think information should be provided for them, that this is not a chronic disease. That once an addict, is not always an addict. I think those are judgmental. Those are harmful concepts. When we didn’t understand how the brain works and what substance use did to our bodies. But we have come a long way where we understand, where we can treat, where we can reverse, and we can support patients to live a healthier and happier life.

Dwight Hurst, CMHC: Absolutely. Well said. David, I stepped on you there. Go ahead.

David B. Livingston LMFT: No, I said the same thing you did. I liked what Clare had to say. You’re not going to get a lot of this perspective. I think really it’s Dr. Lowenstein said very well in the beginning that use of Suboxone and methadone is really to limit risk and the risk is real. And there’s a benefit to that for people who are very vulnerable. And so it isn’t to disparage the use of keeping people healthy and alive. There’s a real need for that. And. However, eventually, the same thing that’s helped you in the beginning when you were vulnerable can actually it will actually deaden your emotional life. It will limit how you feel. It has other physical, physiological repercussions, especially methadone. But ultimately it will it will shut you down. It’s just the nature of it over time. And it’s a hard way to live for very long. And I don’t think that there’s much education on that fact, because initially the whole goal is to make sure people are safe. And again, there’s an understanding. I understand why, but because of that, there’s very little talk about what the other side of it is. I imagine because they don’t want to scare people off. It’s probably also some financial incentive as well. But both are true. And I think ultimately people do deserve to be educated fully.

Dwight Hurst, CMHC: Well, much, much information of much use as always, that has been shared today. I hope that everybody out there listening is that you’re able to think of this, to apply this in your life, in the life of those that you’re supporting and with and hopefully even in your professional life. If we have professionals who tune into the program as well. I want to thank everybody today for sharing and being here and everyone out there as well, want you to know that we love and appreciate you for watching, for listening. If you would like to learn more about what we do with Waismann Method, please go to our website at opiates.com. We also would love to get feedback. We love to hear your questions and things that you’d like us to address on the show, that have to do with your experiences or things that that you would like to hear addressed. And you can email us at info@opiates.com or hit us up anywhere on our social media. I think we’re at opiates on all platforms, right? As far as I know. Um, and so I’ll just say now, on behalf of Clare Waismann, David Livingston and Dr. Michael Lowenstein, I’m Dwight Hearst and want to tell everybody to keep asking questions, because if you ask questions, you’re going to find answers. And whenever you find answers, you can find hope. Thanks again. We’ll be back with you again soon.