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 Post subject: Cash only clinics
PostPosted: Sun Jul 30, 2017 12:51 am 
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Hey everyone,

I have insurance but can't get an appt at any places that take insurance. I was able to get an appt at a cash only place on Tuesday for $250 cash.

I've never been through this process before and am a little worried about spending the money and not getting a script. It's causing me a lot of anxiety.

Can someone with experience tell me how this process works at a cash only place?

Also I've been off heroin for about 3 days now and have been using kratom to survive with wd's, Will this create any problem getting a script?

Thank you


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 Post subject: Re: Cash only clinics
PostPosted: Sun Jul 30, 2017 7:27 am 
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Hey Pooper lol!

Well in my area it used to be pretty much cash only clinics but now almost everything is insurance. U still have the option to pay cash but for some reason they've raised the prices outrageously to deter them. For instance, a neighbor clinic of mine was always $400 a month. Now that they're taking Medicaid their price went from $400 to $500! I know this because I called and asked a few months ago. My clinic started out cash only when I first started there and it's $350 a month. It's still the same but now they accept insurance also.

I can't tell ya exactly what to expect because from my experience, each clinic has their typical way of doing things. For example, my doctor does in office induction. Not all doctors do that. My doctor doesn't allow his patients to take much of any medication especially benzodiazepines but others don't have a problem with it so there's differences sometimes.

As far as being off heroin for 3 days, awesome job! I don't think the kratom will mess with ur induction but I'm not totally positive about that. Hopefully someone who does can chime in. I do know that kratom is not a good idea. It's addictive plus it's very unreliable because it can contain contamination that will make u very sick. The even worse thing about the contaminants is u can have a perfectly ok dose one second and the next will make u sick. Please be careful with kratom.

When is ur appointment? What I'd do if I were worried about when u will be getting a script or when ur going to do ur induction.... call them and ask them everything u need to know. Ask them when ur induction will be and if ur getting ur script ur first appointment. Just any question that's bothering u or making u wonder, ask that question. Ur paying them and u deserve to know and have peace of mind with all this. Trust me, I hear the receptionist at my clinic answer the phone and explain everything in detail alllll the time. Questions are perfectly ok to ask.

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Jennifer


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 Post subject: Re: Cash only clinics
PostPosted: Sun Jul 30, 2017 8:25 am 
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Jennifer has made some really good points here. One is that you shouldn't be worried to call the doctor's office before your visit to get a rundown on all of their policies in place. As a potential client and future patient, it's your responsibility to find out and follow all of the rules.

I would highly encourage you to discontinue any further kratom use. It is increasingly being checked for on UA's as a "drug of abuse" and even though it might be rare, their have been documented cases of kratom that was mixed with scheduled narcotics or other contaminants. If you really want to start on the road to sobriety, I would leave kratom in the rear view mirror.

It's great that you've been off of heroin for 3 days. If you were going to an inpatient facility they might make you wait 24 hours before induction with the buprenorphine. They need to know that you are in withdrawal before they can give you the medicine because if you take it too soon, you could have "precipitated withdrawal" and get really sick. So do not use any H before you go to your appointment. I know it's tough. We've all been there, believe it!!

I can't tell you too much more about what to expect because I don't know what kind of doctor you're going to be seeing. Like Jenn said, some doctors have a certain way of doing things. They allow some things, including medications, that other doctors won't. You may have an on-site induction in the doctor's office or they may send you home with a small script and some directions.

As a suggestion, if they send you home to take the suboxone on your own, come back here and let us know. We need to know a little bit more about you and your habit before we can properly advise you about how much of a dose to take and when. Good luck.

- OM

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 Post subject: Re: Cash only clinics
PostPosted: Sun Jul 30, 2017 6:30 pm 
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Welcome PD,

The cash thing I can't speak on as my place takes insurance. But I will give you fair warning about switching from H & Kratom over to Suboxone. Your tolerance is very high if you are taking a large amount. Sometimes, Methadone is a better choice to switch to. Then later it's possible to taper and begin Suboxone.

If you are intent on going through with it then check the COWS scale. Meaning, you MUST be in moderate to severe withdrawal for the Buprenorphine to take over your MU receptors. Heroin is a hard one to dislodge so you'll need the largest legal dose they can give you. But if you're successful then my hat is off to you and a life of good recovery is straight ahead. You will feel like death warmed over beforehand though.

We've just read stories here about members having trouble coming off H. How large is your habit? Do you inject or snort it? I just want to give you a heads up that the road ahead may not be comfortable for awhile. Once you've settled down on Suboxone everything will work out.

Sorry for the downer reply and feel free to ignore it and take others advice. I was not on H and only did Hydrocodone so my opinion is not based on personal experience. If someone else posts who came off of heroin then please listen to them, not me. Or if you're lucky, one of our resident doctors will give you a clearer picture of what to expect.

Welcome to our forum and we all wish you a decent transition over to Buprenorphine and recovery.

rule

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 Post subject: Re: Cash only clinics
PostPosted: Sun Jul 30, 2017 7:08 pm 
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Most of my addiction was to pain medicine but I finally went in for inpatient detox after a short battle with snorting heroin. I know firsthand at what to expect. That's why I want to make such a big point about being in moderate to severe withdrawal before you start the suboxone. You DO NOT want to have precipitated withdrawal switching from heroin (or any narcotic) to suboxone. I saw that happen and the person got sicker than a dog.

If you continue to use kratom or heroin they may push back the time of your induction. Obviously you don't want that so your best bet is to remain clean until your appointment. Depending on the setting they may give you comfort meds to help out with certain WD symptoms. Make sure to let the suboxone tablet completely dissolve and swish around the remaining saliva for a good 10 to 15 minutes before you swallow. You want to get as much medicine into your system through the lining of your mouth as possible. About 20 minutes after you swallow you should start to feel a lot better as your WD symptoms will begin to melt away.

Prepare yourself for some dosage adjustments. It took me a few weeks to get on the right dose as each person is different. I don't know how much of a habit you had but you may be given up to 16mg's a day within the first few days. Even if you took quite a bit of H buprenorphine is strong and might make you feel a little sick to your stomach. Just be honest with your doctors about how much cravings you're having so they can adjust your dosage. Let us know how it goes.

- OpenMind

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