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In your pt example why are you tapering if the patient is stable, as you said?

What study showed evidence of pain relief from anti depressants? The last Cochrane review showed very little benefit other than duloxetine for Fibromyalgia.

If a patient has been stable on a dose, why are we tapering them? It’s our bodies and why are you all doing this to people? Who benefits from this? Why does ECHO want to cause HARM? This isn’t harm reduction this is directly causing HARM.

The 2016 CDC guidelines have sadly been grossly misinterpreted. They were written NOT by one single Drs input, that speciaizes in pain. But guess who played s key role?! Andrew Kolodsny who had a hugggge profit to be made by pushing Bup!! Bup IS NOT a pain reliever! These sad misunderstandings have caused ppl with intractable pain turn to the streets, or worse, committing suicide. Wonder why prescribing is down, but od deaths have risen? Its that simple. Illicit Fentanyl is found in the majority of those od deaths. When will patients be heard and given back some quality of life?

The updated ORT removed the sexual abuse question. Please stop asking your your patience this question.

I recently suffered a fracture of the greater trochanter and the ER physician gave me a tiny amount of the lowest dose Vicodin and told me to ask my Suboxone doctor to prescribe something stronger. When I did my doctor told me I would have to come in and be seen in person even knowing that I would have to take a bus several miles on crutches to do so. Why do doctors treat patients with a history of addiction so horribly when they know that failing to treat pain adequately can result in something far greater than if they did. It almost seems like they would rather you go and buy street drugs then then treat your pain adequately

I recently suffered a fracture of the greater trochanter and the ER physician gave me a tiny amount of the lowest dose Vicodin and told me to ask my Suboxone doctor to prescribe something stronger. When I did my doctor told me I would have to come in and be seen in person even knowing that I would have to take a bus several miles on crutches to do so. Why do doctors treat patients with a history of addiction so horribly when they know that failing to treat pain adequately can result in something far greater than if they did. It almost seems like they would rather you go and buy street drugs then then treat your pain adequately

Thank You. Informative, easy to listen to and realistic.

More safer...yes, indeed...

People need to unewrstand that u cant just stop.poof and thats it. Opioids have a extremley unplesant and painfulll withdrawal. Most opioid dependant people consider thwmsels as clean if they just could stop using the illegal stuff. And for that they need methadone or bupernorphine

This is old info. You have to wait 3-4 days after last fentanyl use to even think about taking suboxne unless you are microdosing it and weening the fent. over the course of a week or two. Macrodosing wont work with fentanyl unless you wait the 3-4 days.

Who ever is looking to get on suboxone from fentynal do not do this. Take a tiny piece and then do a little bit of drugs and then repeat for a couple days and then your fine. Do not take a shit ton at once you will have precipitated withdrawals

Would there be a way I could reach out to you? I need your help please get back to me

if you ain`t got chronic pain , you ain`t responsiable ! put on a Dr, thats been in an accident & has multipul pins, screw s ,& plates !

perfect ,thank you so much

I've done the bernese method with fentanyl at least 5 times already and it's the best way to bridge the way to subs comfortably not only that it helped me get off subs.. I can say fentanyl helped me get off subs.. not proud of it but it does work if u stop fent and subs after the bernese method

Brilliant

great video

loved your video❤ but can you make it shorter in future

You didnt talk about benzimidazoles, like isonitazine, etazine etc. Could you make a video about that? So scary how illicit labs are creating this next level of synthetic opioids on their own

Oh My God💛!!! The secret to success > P r o m o s m!

Once again… You didn’t mention at all how to properly dose the medication. There isn’t enough information on this. The recovery community is left to fend for themselves for information regarding Buprenorphine on drug forums and sites like Reddit. A lot of doctors also improperly demonstrate how to take the medication and this cause increases in side effects, withdrawal and ultimately patients dropping out of treatment and going back to their DOC. This needs to be changed and I really hope the medical field has someone step up and lead proper technique and teaching to patients and doctors alike. The drug companies don’t seem to care either. Good day

You didn’t mention at all how to properly dose the medication. There isn’t enough information on this. The recovery community is left to fend for themselves for information regarding Buprenorphine on drug forums and sites like Reddit. A lot of doctors also improperly demonstrate how to take the medication and this cause increases in side effects, withdrawal and ultimately patients dropping out of treatment and going back to their DOC. This needs to be changed and I really hope the medical field has someone step up and lead proper technique and teaching to patients and doctors alike. The drug companies don’t seem to care either. Good day

Great overview, thank you!

In Tennessee if I are in chronic pain sufferer with mri showing u r in chronic pain and test positive for THC from trying medical marijuana in a legal state they take your meds away. They sentence you to LIFE IN PAIN. That is a violation of the EIGTH AMeNDMENT!!!! Stop mistreating Wilkes in pain!!!!!!!!!

Detox is not treatment. Detox can actually worsen outcome and lead to overdose. Treatment is MAT, for a chronic relapsing illness

Great lecture thanks’

I have question on if subcutaneous is covered by insurance?

Wonderful! Thankyou so much for the topic- understudied including dose equivalent conversion and supportive meds. I hope this is a point of current research.

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Cock and ball torture From Wikipedia, the free encyclopedia at en.wikipedia.org Cock and ball torture (CBT) is a sexual activity involving application of pain or constriction to the male genitals. This may involve directly painful activities, such as genital piercing, wax play, genital spanking, squeezing, ball-busting, genital flogging, urethral play, tickle torture, erotic electrostimulation or even kicking. The recipient of such activities may receive direct physical pleasure via masochism, or knowledge that the play is pleasing to a sadistic dominant. Image: Electrostimulation applied on a penis Contents: Section 1: In Pornography Section 2: Ball stretcher Section 3: Parachute Section 4: Humbler Section 5: Testicle cuff Section 1: In pornography In addition to it’s occasional role in BDSM pornography, Tamakeri (literally Ball kicking) is a separate genre in Japan. One notable actress in tamakeri is Erika Nagai who typically uses her martial arts skills to knee or kick men in the testicles. Section 2: Ball stretcher A ball stretcher is a sex toy that is fastened around a man in order to elongate the scrotum and provide a feeling of weight pulling the testicles away from the body. While leather stretchers are most common, other models are made of steel rings that are fastened with screws causing additional mildly uncomfortable weight to the wearer. The length of the stretcher may vary from 1-4 inches, and the steel models can weigh as much as five pounds. Section 3: Parachute A Parachute is a small collar, usually made from leather, which fastens around the scrotum, and from which weights can be hung. Conical in shape, three or four short chains hanging beneath, to which weights can be attached. Used as part of cock and ball torture within a BDSM relationship, the parachute provides a constant drag, and squeezing effects on the man’s testicles. Moderate weights of 3-5 kg can be suspended, especially during bondage. Smaller weights can be used when the man is free to move, when the swinging effect of the weight can restrict sudden movements, as well as providing a visual stimulus for the dominant partner. Section 4: Humbler A humbler is a BDSM physical restraint device used to restrict the movement of a submissive male participant in a BDSM scene. The humbler consists of a testicle cuff device which clamps around the base of the scrotum, mounted in the center of a bar that passes behind the thighs at the base of the buttocks. This forces the wearer to keep his legs forward, as any attempt to to straighten the legs slightly pulls directly on the scrotum, causing from considerable discomfort to extreme pain. Section 5: Testicle cuff A testicle cuff is a ring-shaped device around the scrotum between the body and the testicles which when closed does not allow the testicles to slide through it. A common type has two connected cuffs, one around the scrotum and the other around the base of the penis. They are just one of many devices to restrain the male genitalia. A standard padlock may also be locked around the scrotum; without the key it cannot be removed. Some passive men enjoy the feeling of being "owned", while dominant individuals enjoy the sense of "owning" their partners. Requiring such a man wear testicle cuffs symbolizes that his sexual organs belong to his partner, who may be either male or female. There is a level of humiliation involved, by which they find sexual arousal. The cuffs may even form part of a sexual fetish of the wearer or his partner. However, these are extreme uses of testicle cuffs. More conventionally, the device pulls down the testicles and keeps them there during stimulation, which has a number of benefits: Making the penis appear longer. Pulling the testicles down and away from the base of the penis stretches the skin over the base of the penis and pubic bone, exposing the additional inch or so of penile shaft that is normally hidden from view. Improving sexual arousal. While some men may be aroused by the feeling of being "owned", the physical feeling of stretching the ligaments that suspend the testicles has an effect similar to the more common practice of stretching one's legs and pointing the toes. Preventing the testicles from lifting up so far that they become lodged under the skin immediately adjacent to the base of the penis, a condition which can be very uncomfortable, especially if the testicle is then squashed by the slap of skin during thrusting in sexual intercourse. Delaying or intensifying ejaculation by preventing the testicles from rising normally to the "point of no return". It is much harder to reach an orgasm.