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 Post subject: 100 patient cap
PostPosted: Sat Aug 27, 2011 3:32 pm 
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So I have read a few posts about the patient cap and what Dr. J has to say about it and have been thinking about this subject. First the cap was put in place by our lovely, knowledgeable federal government (do you hear a hint of sarcasm). Why, who really knows. I am sure it was full of good intentions and probably placed by beaurocrats who have no experience in addiction but feel they know better what a Dr. can and can not handle as far as patient load. Dr. J said that it keeps down the amount of patients the mills can see, and while I agree, I would also have to argue that without the cap the bad Dr.s would not be able to operate as they would be out of business. In my opinion the cap has allowed for bad Dr.s to prey on addicts and make a quick buck. It's the simple rule of supply and demand. There is a high demand for suboxone and since the good, knowledgeable Dr.s are most likely at there cap it leaves addicts with nowhere to turn but the bad Dr.s. If good Dr.s could accept more patients then more people would get a better quality of care. Would there still be some bad ones left? Absolutely, but i think it would cut out a majority of these Dr.s looking to make a quick buck. I was reading an older post last week by a woman who was angry at this situaition of unknowledgeable, uncaring Dr.s and what can be done about it. In my opinion getting the cap thrown out is the first and maybe most important step to solving this problem. I have also read suggestions that only addiction specialists/phsyciatrists should be able to prescribe this med. It's like someone wrote you do not go to a podiatrist for your heart meds, but it's not because the podiatrist cant prescribe the heart med it is because we can see a heart Dr. and choose to go to them (they have no cap), Infact Sub is the only drug I am aware of with this rule. How do we fix this? Again I am not sure, getting the government to listen and respond is by far not an easy task. I am going to research this further and let you know if I find something that will help get the message out there. This is my opinion on the matter and would love to hear yours! Please excuse my spelling and gramatical errors, I was typing this while holding my 10 month old and she seems to have a fasination for the keyboard.


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PostPosted: Sat Aug 27, 2011 3:52 pm 
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Holy Smokes, you did an amazing job for holding a ten month old in your hands while typing that......I wish I had some kind of good excuse for my crappy grammar!! :lol:

Breezy, I agree with everything you're saying, but I would like to add this.....I wish doctors would stop prescribing so many narcotic pain meds to so many people for any little ailment. It's the OxyContin's and Vicodin's and Dilaudid's that got us into trouble and are driving the need for Suboxone. I'd like to see some effort put into curbing those prescriptions.

I know there are a couple of doctors here in town that all you have to do is walk in and pay the fee, tell him you bonked your elbow or some crap like that and out you walk with 30 Hydrocodone and a couple of re-fills.

Even the legit doctors hand out Hydro's like it's nothing. A buddy of mine has an old ankle injury and instead of doing what his body is screaming at him to do, which is get off the damn thing, he goes to a legit doctor and gets Hydro's no problem at all?? Then he's up on his ankle because he can't feel the pain signals his body is sending him and he's buggering his ankle up worse, requiring more Hydro's. Thankfully, he knows my entire story and he was able to catch himself before an addiction settled in.

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PostPosted: Sat Aug 27, 2011 3:59 pm 
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Brezzy: The quick answer on how to "Fix" this is to contact your FEDERAL legislators - both House and Senate. They are the ones who have the ability to introduce legislation to make a change. Now, having said that, and while it is easy to contact your reps, it is a long, long process and very difficult to get something like this changed. It would be nearly impossible without a mass-scale, coordinated effort. I actually used to be a registered lobbyist on the state level and let me tell you, dealing with state legislators is difficult enough - Federal is off the charts difficult. For one thing, on the state level, it is feasible to actually go to your state capitol and attend, even speak at, a public hearing. Think about the difficulty and expense on the Federal level. How many of us can hop a plane and head to DC to lobby and attend a hearing to increase the doctor/patient cap for Bup?

So how does something like this get done then? Well, typically you go to your national association or representative. If it was a firearms issue we would go to the NRA. If it was an airplane issue we would go to the AOPA (Aircraft Owners and Pilots Association), if it was something to do with a new heart drug or regulation dealing with heart disease we would go to the AHA (American Heart Association). One of the big problems we have is we don't really have an organization who will advocate and lobby on our behalf. The closest thing perhaps might be The National Alliance of Advocates for Buprenorphine Treatment (NAABT). But they really don't have the resources and are not nearly powerful enough. Another option would be for the drug manufacturer itself to lobby and get this done. After all, it would very likely mean increased sales for them. Yet, they don't seem to either have the resources or want to put forth the money and effort do get something like this done.

It is a really, really, really long and hard thing to get a change like this done. Certainly if legislation should ever get introduced, each and every single one of us would have to really burn up the telephone lines calling legislators and getting their support. Because, there likely will be those on their "other side" who will testify against it. Those who don't think Bup is a good idea - or it threatens their method of practice (IE: Traditional AODA treatment, 12-step, etc.). The Dr. Drew's of the world would likely testify how this is a bad idea. See the problem?

If you really do want to at least try, the single best thing anyone reading this can do is contact their Federal representative and senator. That would be your best move. Hope that gives you a bit more info.


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PostPosted: Sat Aug 27, 2011 4:11 pm 
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I'm having a deja vu. Didn't we talk about this back when Dr. J brought this up on his blog? I also think there's an old thread out there about how we all should be contacting our federal elected officials. (I'm just too busy at the moment to look it up.) But I second everything Don said. And it's great to see you again, Don. You've been missed.

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PostPosted: Sat Aug 27, 2011 5:52 pm 
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Romeo, I absolutely agree with you as well, pain pills are way over prescribed.

Dohn and Hat, I should have been more clear, I completely agree with what you both say and know that is the way to go about it, however like you said its easier said then done. Getting something done in the federal govt is near impossible without someone very powerful and rich or maybe even a celebrity. I have had some issues in my kids school and went thru the proper channels and couldn't even get that fixed. So what I mean when I say what can we really do, I mean because we have no power and it is extremely frustrating. So I am just not sure there is any feasible answer to this but I am quite sure it is a huge problem. Unfortunately I do not think there are too many elected officials who even care about us addicts let alone willing to advocate for change.


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PostPosted: Sat Aug 27, 2011 6:07 pm 
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Aha, I'm not crazy. Well, I probably am, but not in this case. I found that old thread.
http://suboxforum.com/viewtopic.php?t=1648.

No one seemed too interested then, which is a shame. Maybe this time we can raise awareness among us well as NAABT. We have to start somewhere, right?

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PostPosted: Mon Aug 29, 2011 1:51 am 
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Hat, thanks for the link to the other post. I liked your letter, the only thing I would add is how the cap allows bad Dr.s to get patients, since the good Dr.s are at capacity. If the good drs could see more patients. Not only would it give addicts more access to Sub but also give them acces to a quality sub doc and also causing the bad drs to lose business, possibly shutting them down. I am thinking of writing a letter similar to yours and sending to as many sub drs as I can, inviting them and there patients to write to there Senator and congressman.

Also I wonder if it is possible to pick a specific date and ask everyone to mail out there letters on the same day, I have seen this before with other causes. That way it isn't just one random letter here and there. There is power in numbers. Please let me know what you all think of this idea and if would be willing to write a letter. Beside your own congressman and senators, I think we should include the sponsors of the bill. Please excuse any errors, I am extremely tired while writing this and am having a hard time finding the right words.


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PostPosted: Mon Aug 29, 2011 6:08 am 
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I think that's a good idea, breezy. Also, we should probably find out which committee first had the DATA 2000 act and go directly to that committee and its chair. If the chair refuses to bring up new legislation, then it's a waste of time anyway. So maybe not only writing to our senators (I say we pick one or the other - my senators are MUCH more open than my congressman), but perhaps members of the committee that would get that kind of bill IF it were to be introduced. The other thing that ought to go along with this campaign should be a bunch of op-ed letters.

And now I'm going to say the same as breezy did - it's early and I'm tired so I hope this makes sense. :|

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