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PostPosted: Sat May 03, 2014 3:41 pm 
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I want to get off methadone and switch for a brief period of time to Suboxone, ultimately to get off both. I have Kaiser insurance and my doctor said that they could admit me to the hospital for three days for the induction.

However, after leaving her office I started thinking about it and asking questions of my friends. I heard through the rumor mill that Kaiser requires FIVE DAYS of no methadone dosing before administering Suboxone.

What I assume that means is that I go for five days on my own with no methadone and then check into the hospital and am monitored, and when I reach a viable level of withdrawal (presumably 26 on the COWS chart), I would be given Sub.

This concerns me! I have concerns about making it for five days with no methadone.

Has anyone heard that this is Kaiser's policy?

Any input would be appreciated.

Many thanks.

Mari


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PostPosted: Sat May 03, 2014 4:35 pm 
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Someone might contradict me but I have not heard of this policy via a specific insurer, I don't know that that is even possible though stranger things have been 'on the books.'

What I do know is that the transition from methadone specifically requires more time than other opioids when converting to buprenorphine to avoid precipitated withdrawal.

72 hours is the minimum for decent transitions, typically, and often people are still not scoring high enough on the COWS scale even at that point.

The COWS scale isn't meant to be a headache or punishment, it is really what is most effective in helping to determine level of opioid withdrawal and thus provide as seamless as possible a transition to the partial-agonist buprenorphine.

More concerning than that, and I'm not going to go into a lot of detail here, is that you plan to make the switch to buprenorphine for a short time? That is your prerogative, totally, but I didn't see a mention of what your aftercare plan is and within what modality you plan to keep your addiction in remission.

Time on methadone/buprenorphine and 'being sick of being on medication' alone does not effectively keep people from eventual return to active opioid use, I hope you know that and have a regimented plan in place.

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PostPosted: Sat May 03, 2014 5:53 pm 
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Hi, Twin. Thanks for your response. I do have an after-care program that I am formulating in my mind, which involves one-on-one counseling as well as attending 12-Step meetings (AA, since I don't care for NA meetings), as well as journaling. I am well aware of the dangers of relapse. I just don't want to get on bupe for a prolonged period of time and have another monkey on my back that I would have to deal with intensively. That's my reason for only being willing to be on it briefly (less than a month). As far as I'm concerned, I know I will ALWAYS have this opiate addiction staring me in the face every day of my life and will do whatever is humanly possible to deal with it, as mentioned above, meetings, etc.

Thanks again.

Mari


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PostPosted: Sat May 03, 2014 6:34 pm 
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Hi Mari, I have kaiser as well. Although I wasn't on methadone, I've talked to many people during the classes that were and basically it was a case by case call as to how long. I guess people metabolize drugs differently. But I know that my psych and his nurse were incredibly kind and answered every question I had(have), call or email them, it will ease your mind. Good luck and I'm so glad that you are taking charge of your life, cc


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