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PostPosted: Tue Feb 22, 2011 1:53 pm 
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Suboxone has worked for me so far. Since starting, I haven't really even thought about using opiates.

Like I mentioned before, I just think the program and process are inherently flawed and this drug gets treated so differently than others just because it is scheduled.

My doctor is so paranoid about this drug that I really do not think he should be prescribing it, but then again, I also think all doctors should be able to prescribe it and then I wouldn't have this problem. My general doctor is great and very smart.

When a doctor tells me that he can stop giving me suboxone for any reason, I find that irresponsible and troubling to make the patient feel on edge all of the time. I am a drug addict. I understand that I need to be drug free, but to quit cold turkey on everything and only get prescribed help for the opiate abuse just seems unfair when a patient is initially starting the program.

I came to the doctor to stop opiates and as times has passed, I now realize that I do actually want to be 100 percent clean of all drugs. But to do this over night and risk being discharged for one mistake isn't really going to help most drug addicts. There needs to be a level of reason and trust involved. I feel like I am very close to having the strength to kick all habits, but only my opiate abuse is being treated by this doctor.

There is a lack of substance abuse therapists out here and my current one isn't that great.

I am just scared of being kicked off the program. He is the only doctor that has space within 50 miles of me. If he decided to not treat me, then I am looking at withdrawals and I think that is where this program becomes a problem. I just don't enjoy feeling scared or paranoid about not being able to get refills because I am having trouble staying clean from all drugs.

This doesn't mean I am not ready for Suboxone treatment; quite the contrary. I was and am 100 percent ready for it because it has stopped me from abusing opiates. But there is no drug I know of that can instantly stop me from smoking pot or taking a Xanax for a panic attack--neither of which is abuse. Despite that, I do want to stop using those drugs entirely, but I am not sure how to do that yet.

And that spells doom for me on the outset for treating my opiate abuse, and quite frankly, that stinks.

So, starting today, if the doctor still treats me when he will get another dirty drug test, hopefully that will be the final one. But the fear won't go away that for any reason, he could just stop.

And where does that leave me? Take a wild guess.


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PostPosted: Tue Feb 22, 2011 2:23 pm 
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I can certainly understand your concern. Thankfully I only had/have to deal with one drug type - that being opiates. I never had to worry about alcohol, pot, coke, benzos or anything of the sort. Perhaps I'm lucky. Certainly Suboxone will help with the opiates - and some claim it helps with alcohol as well. But my question for you would be, what are you doing to address the other addictions? In fact, perhaps that should be the question to your doctor. Perhaps if you do test positive for other drugs and your Suboxone doctor speaks with you about this, your statement should be "doc, please help me with these other drugs." Have you thought about that? Perhaps you should tell you doctor that you really do want to stop the other drugs but don't know how to. Tell him that there is no medication like Bup for pot or benzos. Perhaps you can turn it around and ask, "Is there a medication you can prescribe for me to help get me off of benzos or off of pot"? Ask him. If he says no, ask "Is there some other help that you can give me to get me off of benzos or off of pot?" Turn it around and ask him. This may show him several things. It may show him that you actually do want to stop these other drugs. It may also show him that its not just as easy as wanting to stop. If he sees that even he has nothing to offer you, that he may be underestimating how difficult it all can be.

I really do think it is a two way street. Certainly you need to take active steps to work your way off of these other drugs. If you are not doing anything to stop them, you are still part of the problem. You have to put in your half. However, you also may need and certainly deserve assistance. I certainly agree with you that because you are not clean of pot and benzos well lets have you relapse on opiates again as well - makes very little sense. Still, from your doctor's point of view, being on benzos while taking Bup can be dangerous. It can actually kill - and that is something that doctors don't take lightly. Your doctor also understands that many addicts replace one addiction with another. They may get their opiate use under control but then another addiction starts up in place of it. Certainly the goal should be to be drug free from all substances. Be a partner in doing that. Get your doctor and you to work together and be a team in doing this. If your doctor just expects you to do it on your own without any help or if you expect it just to somehow happen without your hard work, both of you are misguided. However, if you both work together to address these problems, your chance at success goes way up.


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PostPosted: Tue Feb 22, 2011 2:51 pm 
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Donh,

I love that response....put it back on the doctor...Yes, we have a part, we need to want it, but sometimes we may want it but not want it, too. For anyone who knows addiction this is how it somestimes goes....we begin to be willing, but the pull is so strong...we may not have enough tools, there may be a lot of stress currently, or some big loss, or whatever.
So I like that...put it on your doctor, who by the way in my opinion should NOT be threatening you. I feel very lucky. I've had two sub dr now and both are very reasonable, appear to understand addiction, altho my first dr wouldn't treat anyone with polysubstance abuse. Seriously? Probably 70% have poly substance abuse histories. That's ridiculous.

So, I agree....put him to work! Ask him to help you....ask him for research on what's working for other drugs....the new gaba inhibitors etc...there is a lot going on for drug addiction all the time....make him get current in his research and reading. I also agree that you have your own part, too. But as trite as these sayings are sometimes, it takes what it takes...one thing at a time. You are dealing with a powerful addiction right now. Sometimes doctors expectations of us are due to just not really understanding addicton...and not that all treatment providers need to be in recovery but it def helps, especially situations like this.

I worked at a clinic who wouldn't let me have my patients on sub! I finally talked them into allowing it then they said part of the patients treatment plan needed to be that they would be working to taper off sub while in Treatment and within 3 months!!! I actually started laughing....everyone stared at me like I'd just smoked a joint I guess...but I finally convinced them that it was counterintuitive to recovery and they changed the policy. But, guess what they thought about methadone? They wouldn't take anyone on MMT. I couldn't budge their thinking on that one, despite literature and reports from DHS saying it was their #1 choice for the treatment of opiate addiction.

It takes time to change things....but I just really like Donh's idea...


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PostPosted: Tue Feb 22, 2011 4:16 pm 
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This doctor is questionable to say the least. I saw him in early January and told him that I was going to test positive for cocaine that I did on New Years Eve. It was a mindless error; and in less than a minute when I realized what I did I left, went home and called my girlfriend. I was so mad. I am forgetful. I sometimes forget I am even on Suboxone. It is no excuse, I wasn't happy with it, but I told the doctor.

He seemed appreciative of my honest and then handed me a refill.

But here is where it gets messed up. His office manager tells me that the doctor will be gone for several weeks and the earliest he could schedule me in would be Jan. 28. Fine, I said. The week of Jan. 28, she called me and said the doctor was not back from vacation yet and they needed to reschedule. He wasn't coming back until the third week of February! What kind of suboxone doctor is gone for almost 2 months? Well, it just so happened that in the third week of February I had my own vacation, so I scheduled to see him this past Monday.

While on vacation I call to get a refill because I was down to 4 packets. She puts me on hold for 5 minutes and then says "The doctor wants to know what you were doing for a few days in the final week of January when you ran out of Subs."

I replied that I never ran out. She then put me on hold.

She came back and said that I tested positive for cocaine on my last drug test and the doctor wants me to come in immediately and take two drug tests--one to test for subs and the other to test for all drugs. I was so angry. I told her that for one, I haven't used opiates since I started the program and that secondly, the dirty test should not be a surprise because I was upfront with the doctor. I also told her I was not in town and that I had an appt for Monday. But she demanded I come in for a drug test right away. I couldn't go.

So, on Friday night they call me and she says I have been discharged from the program for a positive drug test with cocaine. I couldn't believe it. Here I am with just 4 strips left and he was kicking me out for a drug test I informed him about with honesty. I felt betrayed and the accusatory office manager was driving me mad on the phone. Yes, I did lose my temper with her. The doctor never once got on the phone with me. All of this was given to me over the phone by his office manager in an office that has ZERO privacy because patients wait in the same room as the main phones.

I begged for her to put herself in my shoes, but a non addict will never understand. I told her that I was being honest and that I swear on everything and everyone I love that opiates are not in my system and that there must be some misunderstanding. I told her I needed an advocate, that I felt gained up on and the doctor was acting inappropriately. She said all she could do is talk to him again on Monday and see if he would keep my appointment. I also told her that my insurance is not covering these drug tests and they each cost me several hundred dollars a piece!!! I cannot afford these drug tests.

So, over that weekend I cut up my remaining strips into slivers and began the process of planning of how I was going to handle the WDs and being off subs. I was scared shitless and angry. But there was also a part of me that kind of wants to be off this already, but I think it is clear that it might be a little too early.

On Monday, she calls me and says the doctor will see me. I get over there and he comes in the room and says "How are you doing?" with a wide smile. I said, "sir, what is going on?"

He told me that he discharged me from the program for cocaine use.

I told him, doctor, I was honest with you and said that I used cocaine. Why is this a surprise to you? When I came in for that first visit, you told me that this program is based on trust, so I have given you that trust. I am a drug addict. I need help. I am seeing a counselor. I have not touched opiates.


He looks in my folder and says, this is a misunderstanding and that I was right in that I told him upfront about the cocaine use. This is when he went on to say that the DEA would like to stop this program, and that there is so much oversight that if I lose one packet they can trace it to him and me, and that he doesn't have to treat me and that he could get in trouble if he continues to treat me while I have dirty tests.

What is troubling to me is, if I tell him I won't pass the test, then why the heck is he testing me so there is a record of that in his folder? Why not wait a few days to test when the cocaine is out of my system so that he can see that his priority that I stay off opiates has been followed.

It was a sucky week, an unprofessional situation and it has instilled this awful paranoia and fear in me about this program.

At any time he could be done with me and I am left to either relapse or suffer through whatever level of withdrawal the demons are going to pass over me. How is that care? How is that going to work for any addict?

If honesty is a big part of the program, then let me be honest. He gave me a script and tested me with two different tests and on I went. Before I left, I told him again that this test will be positive for Xanax and marijuana. I am praying that no other drug shows up because I don't trust any of these drugs and when they leave my system.

I want to be 100 percent clean. But my substance abuse therapy is not doing crap for me and neither is this doctor. I don't know what else to do. There isn't another sub doctor within 50 miles of me, and I am not even sure those that far away have space.

Maybe the WDs aren't that bad for me and the experience would be bearable. But then there's the will power I must find to stay clean---and see how I am writing this as if I am already out of the program? That is what this doctor has done to me this past week.

I blame myself for the dirty tests. I am an addict and need more help. But I have not touched a damn opiate since I started, and he has to see that as a reason to continue working with me. If not, he's not a care physician and he shouldn't be a doctor prescribing this complex drug to very complex and damaged individuals.

But I am thankful that he admitted the error and filled out another script. I am going to try to save some for situations such as this past week.


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PostPosted: Wed Feb 23, 2011 7:43 am 
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Wow - that's a really lousy situation. Don offered some great advice in suggesting you turn to the doctor for help. That's exactly what such a doctor should be doing. I hope that works. If i were in your shoes I would be constantly afraid of being dropped from the program, too. I would suggest you keep looking for another doctor. Drive an hour if you have to. It's worth it. If you have to go off suddenly, not only will you have withdrawals, but you're at risk of relapse and we all know that can be fatal. I wish you the best. Oh and in trying to find a doctor, often psychiatrists have the waiver to prescribe sub, yet they don't really "advertise" it. Maybe start making some cold calls to psychiatrists? It's worth a try. Best of luck to you. And hang in there.

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PostPosted: Wed Feb 23, 2011 9:11 am 
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That's just such crap....I know there are so many sub dr. out there doing the same thing....threatening, not really understanding addiction, setting off a kind of fatalistic idea that the DEA wants to shut down the program....I do not know if that is true and I am not sure why with methadone being around as long as it has been and being used to treat opiate addiction, that now with a new and much improved medication, in my opinion, that there is all of this craziness....the fears of diversion are real yes but why does that mean we live on the edge here...methadone is diverted all the time but no one says that program will shut down. I've not heard that anyway. I do know DEA has made recent changes and I've heard they want more lab testing with patients....but I have a new sub dr and he has not required me to do any testing at this time....and I've just transferred to him. I told him I was willing to do them and wanted to do them for accountability even though i don't have any extra money for them...and he was very easy going about it. So, I hear about huge changes from DEA from one doctor, and then another doctor its life as usual....nothing new.
What I think is that it depends on the FEARS these doctors have and their interpretations sometimes. My old sub dr. def had more fear than the new one.

After reading your update I realize my response to you was very simplistic...I cannot imagine what you are going through but I can imagine the fear of w/d, the anger at feeling ganged up on, the unprofessional behavior and the lack of confidentiality. It pisses me off to no end.

As a group we need to gather information and work hard to keep Subuxone around....I for one am sick of hearing that it might go away....that is alarmist thinking but even my doctor couldn't answer that question...I'd encourage people to write to senators, read up on NIDA website, keep educating ourselves and fight back. It def feels like something is going on.

I'm glad you got your Rx and wanting to "save" some is understandable...and feeling the need to get off is also understandable. I don't want to be forced off either and you said it yourself...it may not be the right time for you yet. But i hear you begging the doctor for help and feeling like he is not paying attention. Just crap.


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PostPosted: Wed Feb 23, 2011 9:31 am 
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I don't blame you for being frustrated. I agree that your doctor is paranoid and he needs to take a breather. I don't know if he can get in trouble for continuing to treat you when you are having positive urine screens. My last sub doctor prescribed marijuana. Several sub docs prescribe xanax. So the marijuana and the xanax to me aren't necessarily such a big deal that he would get in trouble. The cocaine on the other hand I can understand his concern.

With that being said, you aren't going to change your doctor's paranoia so you have to deal with what has been put in front of you. I definitely think being honest with this guy is essential because he will clearly kick you out otherwise. However, I also think he WON'T continue to prescribe if you keep having dirty tests. If it were me, I am not sure I would go into this NEXT appointment and ask him for help with it because I am not sure if he would respond well to that. I might go to him and tell him you were able to stay clean this past month but you feel like you are still teetering and you don't feel confident and is there anything he can suggest because you really don't want to get kicked out of your sub program. I guess that's kind of the same thing except we now know you already took the drug tests that will be positive.

Outside of that, keep watching for new doctors in your area. This poor guy probably feels really pressured since he is the only one in the area too. He probably feels like a lone wolf with the spotlight on him. He also probably still prescribes for others just like he has for you knowing that he will still prescribe because he doesn't WANT to just cut you off but yet he is then fearful he may lose his DEA# for it. His whole practice would go under. I understand their fear to some extent. He probably doesn't even realize how much pressure and stress he then places on you and probably doesn't understand that it is making things worse for you.

Good luck.

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PostPosted: Sun Jul 31, 2011 2:34 pm 
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Thanks for sharing your thoughts and ideas on this one. Please keep posting about such articles as they really spread useful information. Thanks for this particular sharing. I hope it stays updated, take care.

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