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PostPosted: Wed Feb 25, 2015 11:31 am 
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Mods: fell free to move this to a different section if desired.
I have a question I hope the community can help me with. The program I am associated with is up against the cap. We are saving a few spots for women that are pregnant and entering treatment and then our long-term halfway house. A few months after delivery they will taper to make room for the next mom.
My question then. Knowing that you are coming in to residential treatment and will not be placed on maintenance therapy: would you want to do a 2-3 week Suboxone taper starting at 8-12 mg, or do a medical detox with the usual meds; Catapres, Imodium, Zofran, Vistaril, ect.? How likely would you be to not even come, seeking care elsewhere or continuing DOC?
I know it is a crappy situation, I have wondered if we should stop taking people with primary opioid addiction knowing the dismal long term outcomes. For months we knew this day was coming. Both the director and I have met with community doctors (our referral source and in many cases, the source of their drugs in the first place), and cannot get anyone interested to get their waiver.
Your thoughts and insights will be appreciated.
PAX


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PostPosted: Wed Feb 25, 2015 6:02 pm 
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I hate the choices! Why can't these women just have their babies and then continue on with their regular sub regimen? This system seems broken.

Amy

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PostPosted: Wed Feb 25, 2015 6:22 pm 
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Amy, I don't disagree.
Our regular practices are almost full. We are keeping a few slots open for detox and pregnant women. If we keep the people we detox on maintenance long term then we won't be able to continue with detox or manage women through their pregnancy. My hope, is that after delivery they will have had several months to find their own sub doctor and will be able to continue. Nobody within 100 miles is treating pregnant women except for us. Even the methadone clinic started turning them away about 4 months ago.
It sucks, trying to decide which options suck less.


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PostPosted: Wed Feb 25, 2015 8:25 pm 
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I've been thinking and wondering more and more if rather than lobby the legislature we should not lobby the local medical community - or at least do both.

What about along with you meeting with these local docs you enlist the help of their patients? They may be more receptive that way. If you guys agree to do the "Hard work" and then retun the patient to them for maintainence would they agree to that? They may say no to you but would they to their current patients? If enough call and petition that may help. Just a thought.

This God awefull cap us killing people!


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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