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PostPosted: Wed Dec 07, 2016 5:52 am 
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I am from a small town in upper Michigan. All forms of suboxone treatment have been banned in my town and the entire upper peninsula with the exception of pregnant females. Patients are forced to travel to recieve treatment. I was driving to Chicago every month to recieve treatment. On my last visit, the doc tells me that the cops called him and threatened him about seeing any patients from my town. There reasoning was one person in my town who sees my doctor got caught selling his prescription. This has nothing to do with me. I was doing the right thing and turning my life around. I found a great doctor and everything was going fine until I was told he can't see me no more because of this. Even my doc was frustrated and doesn't know what to do about it. They have banned the sale of suboxone in every pharmacy in the upper peninsula also with the exception of pregnant females. They have called numerous pharmacies in three states bullying them into not filling prescription for anyone in my town/state. Also have done this numerous times with any doc anywhere caught prescribing to anyone in my town. Is this legal for them to do that?


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PostPosted: Wed Dec 07, 2016 8:49 am 
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Legal? I'd say no. But they can still try, if they like. And they can't do anything to a doctor caring for their patients. These "cops" are just asking for ADA lawsuits, the ACLU..etc.. to jump in and have a field day.

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PostPosted: Wed Dec 07, 2016 12:50 pm 
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Wow, that's crazy! I can't believe they're going that far....do they have way to much time on their hands, isn't there a burglary they can go solve? Sounds personal and it pisses me off! Dude I'd wanna move out of that place asap....just saying. I'm in shock lol, geez.

Well the doctor can treat whoever they want to treat I assume. Hopefully Dr Junig or docm2 can read this. I understand that the patient selling their medicine makes it look bad (and really makes everyone look bad who takes buprenorphine) but anyone with a half of brain call should understand that u can't judge everyone because of a bad apple. That's really unfair to u and anyone else who's done very well on this treatment. I mean really, aren't they worried about the pain clinics, there's tons of other drugs they should be focusing on....makes no sense whatsoever to me. If I were u, I'd just find another doctor, one that isn't going to be intimidated by cops that have nothing to do with their time. I'm so sorry this happened to u!

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PostPosted: Wed Dec 07, 2016 1:24 pm 
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Legal? NO, I would listen to there concerns, ask what they were doing with the person caught selling the meds, thank them for the information. If they did what you are describing as far as threatening I would ask that they have their boss call me for a dialogue, if I was in a good mood, if not I would tell them to piss up a rope and hang up.
I don't see how 'cops' can get a legal medication banned in a wide geographical area. Somewhere a provider or pharmacist would push back I hope.
I had not heard this in any provider forums or CME that I have participated in.
Being from Wisconsin perhaps Dr. J has gotten wind of this.


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PostPosted: Wed Dec 07, 2016 1:50 pm 
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I have a few patients in the UP, and at this point they have been able to get Suboxone, but plain buprenorphine is very hard to find. Cash patients pay $150 for 16 mg of buprenorphine per day, and $600 for Suboxone-- so the cost is a barrier to effective treatment.

I was called by the district attorney of a city in the UP a few years ago; he wanted to know why a doc in Wisconsin was seeing patients from Michigan. I explained at the time that there were no doctors in the UP prescribing buprenorphine, so it was only natural that they would travel to Wisconsin. The call was followed by a letter, and then I didn't hear anything again-- but the contact seemed to be a warning shot across the bow that he was 'watching'.

I read in the paper a couple years ago about a doc from Detroit who was driving to the UP to see patients up there. He was arrested and charged with a range of felonies. I don't know anything about his practice-- whether it was unsafe, etc-- but he no longer provides addiction treatment, to anybody anywhere.

I feel bad for the people in that part of the country, where heroin use is epidemic and overdose deaths are common. But I also get nervous about treating people from that area. I am closed to new patients, so it is not an issue any more- but in small towns like Menominee, everybody knows each other, and there are not dozens of city blocks or miles of countryside separating the people who are actively using. That makes it very difficult for patients to escape their past, cut off contacts, and progress to a new life. I don't like the fact that patients in my practice know each other, know the meds each other are taking, etc. A patient will come in and tell me about some other patient who is 'really screwing up', selling his/her meds... and then THAT person will come in and say the same about the first patient.

Adding to those issues is the most frustrating thing-- that politicians from that part of the country complain about their high overdose rates, but then do everything that they can to discourage doctors from trying to help.

Back to the original post...I don't think it is quite as bad as you perceive, because I regularly order Suboxone from a couple pharmacies up there. But yes, the attitude against buprenorphine is not helpful in reducing the death rate. The person to speak with about the issue is your area politicians, providing of course that you have informed and intelligent representatives in your area. Their offices are the people tasked with handling complaints about government agencies-- so consider calling or sending a letter to see where they stand.


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PostPosted: Wed Dec 07, 2016 2:35 pm 
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Back to the original post...I don't think it is quite as bad as you perceive, because I regularly order Suboxone from a couple pharmacies up there. But yes, the attitude against buprenorphine is not helpful in reducing the death rate.


Dr. J

Have you ever had occasion to testify before congress? Maybe a long shot, but if you were to contact a sympathetic congressman and offer your services in that regard. I think they conduct occasional hearings on the current opiate epidemic. I also think there's some legislation pending...perhaps sponsored by Senator McCain,,,,but I don't know it it's any good or not.


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PostPosted: Wed Dec 07, 2016 3:38 pm 
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I have a feeling that your best bet will be to contact the ACLU in your area. Overdose death is a high profile problem everywhere, so they might consider the issue a priority. Here's the website:

http://www.aclumich.org/

The current HHS department in Washington DC has made statements in favor of increasing Medication Assisted Treatment for opiate addiction. It's something of a question mark what will happen when Trump takes office. His pick for HHS Secretary is Tom Price. For now, though, this is the current policy:

https://www.whitehouse.gov/the-press-of ... ns-address

We will have to see how Tom Price deals with the epidemic. His wife, an anesthesiologist, tried to get some legislation passed that would provide clean needles to addicts, but it failed in the Georgia senate.

Amy

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PostPosted: Thu Dec 08, 2016 12:21 am 
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Finding another doctor is going to be very hard. I need to find a doc that will prescribe buprenorphine instead of suboxone. The price of driving every month is enough. Then there's doctor fees and finally the price range. The price of Subutex is 16 mg. A day is $156 compared to over $500 on the other. They really make it impossible to receive treatment in this town. It's like they've failed to educate themselves on what this medication really is about. I'm at a loss and don't know what I'm gonna do. I've done everything right. My doc said I was an ideal patient. My urine screens always came up good. I never called and complained about stuff. I wish he'd of fought the cops on this but he said he didn't want to get into a legal battle for financial reasons. I got one last script and then I'm at a loss of what to do now. Most doctors refuse to prescribe subutex. I can't afford the other.


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PostPosted: Thu Dec 08, 2016 12:42 am 
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My goodness Big Rudy, that's a tough break. I sure hope you can find a resolution to this nonsense. What the heck is going on in that part of the country? I feel sorry for the ones living there. I think I'd be looking for some relative who lived out of state some where. Do you have any friends you might could visit for a little while? Idk, this whole thing just angers me the longer I think about it though. Wish I could be more help. Good luck Rudy-----Bamagirl


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PostPosted: Thu Dec 08, 2016 8:26 pm 
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U can't give up though, no matter how hard it's gonna be to find another doctor, just keep trying and fighting tooth and nail! U deserve treatment, don't give up. Obviously the area is fighting against u, but there's gotta be a doctor out there....and a lot more doctors prescribe plain buprenorphine, u could very likely find one. Just don't give up, call every single person u can find.

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PostPosted: Fri Jan 06, 2017 8:04 am 
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If you're looking for legal remedies, the Drug Policy Alliance legal branch (in Berkeley CA) is more likely to be of assistance than the ACLU. They've sometimes worked together on cases (like the 'Bong Hits for Jesus' free speech case) and the ACLU relies on the DPA for expertise on the drug angles.


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PostPosted: Fri Jan 06, 2017 10:12 pm 
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Ummm,ya, I'm from the upper peninsula and have had no problems filling suboxone. There are a lot of suboxone doctors, mainly marquette.

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PostPosted: Fri Jan 06, 2017 10:42 pm 
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I think he was having a hard time finding a doctor to prescribe generic buprenorphine in the area.


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PostPosted: Fri Jan 06, 2017 11:15 pm 
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That's what I doubled checked, he said all forms of suboxone treatment have been banned

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PostPosted: Sat Jan 07, 2017 12:10 am 
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Yes, I believe he misspoke-the second part of that sentence is "with the exception of pregnant females" . Then Dr.J says Suboxone is available but not a lot of plain bupe. Then in the rest of the OPs posts he is talking about generic bupe. so that lead me to believe that is what he was talking about


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PostPosted: Sat Jan 07, 2017 9:01 pm 
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Oh, I got ya. Thanks for clearing that up, didn't make any sense to me.

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PostPosted: Sun Jan 08, 2017 12:11 am 
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No problem. I read it a few times because it didn't make sense to me either. But when I substituted Suboxone with generic bupe. it made more sense so I think that's what happened


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