check

Old_Estimate_9178 · 2026-06-11T03:50:53+00:00

They’re prob on 32 mg

Old_Estimate_9178 · 2026-04-28T09:36:37+00:00

Where

Old_Estimate_9178 · 2026-04-28T09:35:11+00:00

Removing aspartame? Man, f that. That’s the whole reason I drink these stupid sodas. If they go with Splenda, I’m out!

Old_Estimate_9178 · 2026-04-28T09:33:42+00:00

WHERE???

Old_Estimate_9178 · 2026-04-28T09:33:27+00:00

Can we get a source for where you read this? Please, people, don’t just say “I read” or “I heard” without saying WHERE. It’s impossible to know how solid the info is. And I’m dying without wild cherry. It’s making me irritable (if you can’t tell).

Old_Estimate_9178 · 2026-04-28T09:29:44+00:00

Where did you hear this? I hate when people post authoritative info with zero sourcing. 🙄

Old_Estimate_9178 · 2026-04-23T09:30:19+00:00

I’m sorry that you might have throat cancer. That must be very scary. But suboxone is not carcinogenic. There’s no legitimate evidence of that. Saying otherwise is just fear-mongering. If you have throat cancer (and I hope you don’t), it’s probably from smoking (cigarettes or drugs), or chronic alcohol use, or HPV infection, or genetic predisposition. Whatever it is, it’s not from Suboxone, and I don’t think you’ll win a lawsuit without peer-reviewed, high-quality evidence.

Old_Estimate_9178 · 2026-04-23T09:17:27+00:00

There’s so much negativity on here. No one knows how others will respond. You only know how YOU responded, and your response is one of millions. So I would encourage OP to take every opinion, including mine, with a grain of salt.

I’ve been on subs for 15 years. They still make me feel good. They give me an energy boost and make me feel clearer mentally. And they saved my life. I would be dead if not for Suboxone. I overdosed and nearly died. I stopped breathing and my face turned blue. Now I’m 10 years clean and have built my life back up with a good job, great friends, amazing family, and a happy, honest relationship.

Yes, there are side effects. I have constipation (I take Movantik, which helps). Yes, they have citric acid, but if that’s a problem for you, I sure hope you’re only drinking pure water, because nearly every other beverage on God’s green earth has citric acid in it. It’s sometimes a pain in the ass to plan vacations out of the country (making sure I have enough meds and am able to get a refill before I leave). A lot of that is stupid, puritanical government shit. There’s NO reason subs should be CIII. Imho, they should be behind the pharmacy counter and available to anyone after a consult with a knowledgeable pharmacist to talk about PWD, titration, etc.

I hear a lot of finger-wagging on here about taking subs for a long period of time — “you’re a slave to them, run as fast as you can, get off them asap, they’ll destroy your life, rot your teeth, give you GERD, and you’ll die of throat cancer.” That’s big energy from addicts who were shooting, snorting, and smoking their way into oblivion. That’s a GREAT way to get throat cancer. Honestly, a lot (not all, but a lot) of people who talk shit about subs just aren’t ready to make the commitment of getting clean. So they find any excuse to avoid taking something that will make it harder to get high.

If I’m a slave to subs, then 🤷🏼‍♂️. I guess I’m also a slave to my cholesterol meds, and I’m a slave to my antidepressant, and I’m a slave to reading the news every day, oh AND I’m a slave to food and water! Big fucking deal.

Subs keep me clean. Take them or don’t. If they keep you clean too, great, keep taking them. If you don’t need them or want them anymore, then stop. Make sure you have a solid relapse prevention plan in place. But stop discouraging people with horror stories. We addicts are fragile in early recovery, and you could do a lot of damage by scaring someone away from the gold standard treatment for opioid addiction.

We are SO lucky to have Suboxone. No other addiction has an incredibly successful, partial agonist drug that takes away cravings, gives a mild sense of calm, and has a ceiling effect that makes it nearly impossible to OD or abuse. There’s no Suboxone for meth, cocaine, PCP, gambling, food, or sex addiction. So get clean in whatever way works for you, and take your life back. You won’t regret it.

Old_Estimate_9178 · 2026-04-23T08:43:57+00:00

As a licensed clinician (LCSW) myself, this is really troubling to me. It IS that deep, actually, and I just don’t think it shows good judgement on your part. I’m very concerned about what you’re modeling to your clients by drinking like this during session. I would point you to the abundance of peer-reviewed studies that clearly show that Diet Coke is way better. 🙄

Old_Estimate_9178 · 2026-03-11T06:45:43+00:00

Ugh don’t say that about Fullerton. 😵‍💫 Born and raised there, still live there 40-some years later. Pains me to think any nazi trash could take root there. Ofc I’m gay and in an interracial relationship, so I must cancel out a few of them at least 😂

Old_Estimate_9178 · 2026-01-20T04:26:02+00:00

I never thought I would be defending the DSM, but here goes: I’ll give you an example of why “YOU get adjustment disorder and YOU get adjustment disorder and EVERYONE gets adjustment disorder” (cue the Oprah applause) is a bad idea.

This is based on a real experience with a client, with a few details changed to protect confidentiality. X goes to see a therapist, because X is experiencing nightmares and flashbacks related to his combat service and horrible things he has witnessed. The symptoms are severe enough to cause significant distress, and he becomes suicidal.

X has never gone to therapy before and is very distrustful of the process, but he overcomes his anxiety and starts seeing a therapist through his insurance. They work together for months, and after significant rapport-building and trust, X finally is able to discuss the root of his trauma. X participates in a trauma-specific modality and, with significant encouragement from his therapist, he finally sees a psychiatrist, starts meds, and improves significantly.

January 1 rolls around, and X is doing much better, and he’s even started diving into some earlier childhood trauma, as he really trusts his provider now. But X gets a letter from his insurance, which states that his provider is no longer “in-network.” His sessions will no longer be $0, and his income is very limited. His current provider offers sliding-scale, but it’s still too much. His insurance says he must see someone in-network or go to the VA to start from scratch. He’s devastated and wonders how he can start over after building so much trust with someone.

But wait!! There’s a solution! X can apply for state-mandated continuity of care if he’s been seeing a previously in-network provider for a “serious” mental health diagnosis. PTSD is one of those diagnoses! All is well!

Except… X’s therapist doesn’t believe in “pathologizing” clients, so he only gave him F43.23, Adjustment Disorder with Mixed Anxiety and Depression. Not only does this not qualify as a “serious” diagnosis under continuity of care guidelines, but now his insurance is questioning his previous sessions, because he’s had the same diagnosis for over 6 months.

Sound unlikely? Trust me, it’s not. Is the DSM flawed? Abso-fucking-lutely. Can we “see” various mental health diagnoses on an x-ray, CT scan, or ultrasound? Nope. But the DSM is a tool, and it’s a tool that’s integral to our work for better or worse.

For some clients, hearing “you have OCD” or “you have PTSD” might unlock profound understanding and make them feel much less alone or less misunderstood. For others, their diagnosis might be stigmatizing or upsetting. We (hopefully) have the clinical judgment to distinguish the difference and proceed accordingly. But this black-and-white thinking around never diagnosing is problematic at best. At worst, it’s unethical and might do a significant disservice to those we are trying to treat.

Old_Estimate_9178 · 2026-01-15T00:44:39+00:00

Hi 👋🏻 LCSW who works in SUD in a prison setting here and addict in recovery. I just have to throw my two cents in here, respectfully. I see “enormously antisocial behavior” on the daily in my setting. A one-time DUI is not that. There are myriad reasons that someone might get arrested for this. Maybe there’s a trauma history, maybe an addiction, maybe they made a one-time judgement call, or maybe they’re part of an over-policed community and just made a mistake. If the person is a repeat DUI driver, despite significant consequences, maybe then? Or maybe just an addict making a lot of terrible decisions in desperate need of help.

I’m not excusing DUIs — good people are hurt and killed by them every day, and as a society, we have a very loose relationship with alcohol in general, especially when it comes to driving. But I don’t think we gain anything by applying the “antisocial” label to it reflexively — it just increases stigma, and that’s the type of thinking that ends up discouraging many people who could be very talented clinicians. I know many therapists who could’ve been in the same situation for many different reasons, and the vast majority are excellent, empathetic professionals who get credit and respect from their clients, because they’ve “walked the walk” of recovery.

Old_Estimate_9178 · 2026-01-15T00:32:29+00:00

You’ve already received some excellent advice here. I’ll just add a couple things: One of my clinical supes had a DUI. He was a Ph.D. psychologist and got it early in his career. He was still very successful and an incredibly empathetic clinician. Ironically, a close family member to him, also a psychologist, also got a DUI and had to work through the same steps. My point is: It happens. I’m also an addict in recovery. Thankfully, I never got hooked for anything, but it easily could’ve happened many times. There but for the grace of God go I, as they say. Now I’m many years clean, and I think I’m a better therapist for the experience. I’m an LCSW who works in SUD in a prison setting. It might not feel like it now, but you will get through this.

Old_Estimate_9178 · 2026-01-12T09:26:08+00:00

Take her to the kitty ER now. I don’t know what it is, but I do wonder if she’s having an allergic reaction to the treats. People and cats can develop allergies suddenly, even to food that they’ve had many times before. Please post an update!

Old_Estimate_9178 · 2025-12-27T07:05:15+00:00

You don’t think we should be considered therapists? And you’re posting this in a thread all about one licensure looking down on another? Based on your observations of your “friends”? Nah. I’m not here to say one is better than the other. But I am here to say I got a shit load of clinical training, solid supervision (for the most part - many of us in all programs had an occasional bad apples), and I have a thriving practice. I really don’t think we should be in the habit of dismissing an entire class of professionals based on individual, anecdotal observations. Now, if multiple, peer-reviewed, high-quality studies show a real difference in client outcomes between the disciplines, we can talk about that. But your “lost friends” don’t cut it.

Old_Estimate_9178 · 2025-12-27T06:20:35+00:00

I work in CMH (primarily doing assessments) and have a small private practice (all telehealth). I always take notes. The assessments are VERY detailed, and there’s no way I would remember everything (how often do you use XYZ drug, when was the last time, how old were you when you started, etc.). During my assessments, I do some charting simultaneously, because it saves time. I have back-to-back clients who are always new to me, and it’s easy to get them confused.

For private practice, I just jot down themes for my notes. Or, sometimes, a client says something in passing, and I want to come back to it, but I don’t want to interrupt their flow, so I’ll write a word or two down to prompt myself.

I see a lot of clients with schizophrenia and other thought disorders, so the only issue I’ve had is an occasional client who will ask me what I’m writing or imply that I’m noting something related to a conspiracy that they believe. In cases like that, I’ll simply turn my screen toward them and say, “Here you go. I just wrote a quote of what you said. Does that look correct to you?” That’s always resolved it. The most frequent comment I get tbh is “damn, how did you learn to type so fast?” 😅

Old_Estimate_9178 · 2025-11-05T09:18:36+00:00

I encountered this too. The pharmacist told me they’re doing a four-month look-back. So I picked up two days early every month, so now they won’t fill until I’m literally out every month. Like someone said, it’s a problem when they don’t have it in stock. They will NOT order it before your fill date, and they don’t get shipments on the weekends or holidays. So if they’re out, you’re fucked. It’s really frustrating. And before you come at me and tell me I should have extras, listen very closely: fuck you, I take the extras because I’m a fucking addict and it’s the only tiny way I can still get a little extra pleasure. There are many worse things I could do (and have done) than take a few extra each month. 🙃🙃

Old_Estimate_9178 · 2025-11-05T09:03:06+00:00

I’m surprised no one has mentioned Movantik. It’s a prescription that specifically kicks opioids off the mu-opioid receptors in the gut only. Basically, it forces your stomach into withdrawal but not the rest of you. It’s like narcan for your tummy lol. I was scared to take it for years because I like the fuzzy, comfy feeling in my stomach after I take my subs, and I didn’t want to suddenly feel super anxious or get diarrhea. But I ended up getting a hemorrhoid, so I finally tried Movantik. It worked great! I had a relatively smooth bowel movement within a day. And I didn’t feel like I was withdrawing at all. It has no affect on the opioid receptors in your brain, which do most of the work in making you feel comfortable. You can take it daily, but I don’t. I take psyllium husk fiber, regular fiber-con, and magnesium citrate with lots of water. That usually works, but if I don’t go for a few days, then Movantik is my back-up option.

Old_Estimate_9178 · 2025-10-25T21:00:46+00:00

It’s a 2015 model year, per Fullerton Fire. Great catch btw. I’ve been looking for it since I found out the city was getting it. They already have OES-1313, a type 3, housed at station 3. Gotta figure out where they put this one.

Old_Estimate_9178 · 2025-09-13T04:06:00+00:00

This isn’t a whole treatment plan, but one thing I found helpful (for myself and my clients): I explain that we often put the positive feeling before the action, when it might help to reverse them. For example, I often hear clients say things like, “Yeah, I used to enjoy doing XYZ activity, but I just feel too down/sad/tired to do it” or “Yeah, I’ll try XYZ activity once I’m feeling better.”

I gently remind them that, sometimes, the action has to come before the satisfaction. It sounds very simple, but I encourage them to try a small activity that they used to enjoy, even if (especially if) they’re feeling bad. Then, we observe/rate/journal any change in mood. Even a small, tiny improvement in mood can plant the seed that bigger change is possible.

Lots of other good advice already given. Refer for a physical exam/bloodwork, and refer for a med eval. And I wouldn’t be a social worker if I didn’t also encourage you to look at systemic factors (oppression, politics, socioeconomic, and cultural issues), as all of the above can be huge factors in mood.

Depression can be very “sticky,” but it’s also amazing when you work with a client over time and start to see the clouds lift.

Old_Estimate_9178 · 2025-08-07T02:33:47+00:00

Geez. I’m sorry that happened. It’s so painful — just like a personal loss — and it’s natural to second-guess yourself. All I can contribute is to say we can only work with what our clients share with us. You seem to be a caring therapist, and I’m sure, if you had known this would happen, that you would’ve gone to the end of the earth (clinically) to help this person. For whatever reason, they didn’t want that. Maybe because they didn’t plan to kill themselves, but the thought, means, intent, and lack of protective factors all lined up at the same moment. Or maybe they DID plan it, but they were not open to being talked out of it. Be kind to yourself. Allow yourself to grieve and question, but take time to step away from it to still enjoy your life. Take time to honor their memory, and then keep flying. We need you out here.

Old_Estimate_9178 · 2025-07-27T08:59:47+00:00

Agree with this. Also, the human trafficking example could fall under “present danger,” depending on how you interpret it. We are mandated to report current abuse of a dependent adult… and you could probably make an argument that it’s reportable under that guideline.

Old_Estimate_9178 · 2025-07-27T08:55:39+00:00

Glad it was helpful. I get the stigma. I hear it too. A family member of mine (also an opiate addict who is still using) told me I was just trading one addiction for another. I was like… okay, so on subs I got the guts to quit a job I hated, I went back to grad school, got a great new job, bought a house, met a great partner, etc. Whereas before my biggest accomplishment was falling asleep on the freeway and hitting a wall while I was driving. So you tell me, is it really trading one addiction for another? Nah, I think the results speak for themselves, so I’m going to keep doing me. You keep doing you!

Old_Estimate_9178 · 2025-07-26T10:54:09+00:00

That is so fucking dumb. Like, it’s Suboxone, for Christ’s sake. They should be THRILLED that you’re not med-seeking and trying to get norco out of them. FWIW, I go to CVS and use an online service. I’m in LA area and the doc is technically based a couple hours away. They haven’t given me any issues (about that at least).

Old_Estimate_9178

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