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PostPosted: Thu Jun 09, 2011 6:54 pm 
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hello. i have been going to an actual reputable suboxone doctor for about a year. i started at three a day, and am now down to 2. last visit, she said she is going to cut dose again next month. i replased last time dosage was cut. is there law about how long someone can stay seeing a sub doc or is it just how every doctor does it? is there anything to say if i want to stay at my dosage? i know i will use oxy again if i do not stay taking sub. it actually works for me.


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PostPosted: Thu Jun 09, 2011 10:57 pm 
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Hi script,

There's no law with regard to how long a person can be on suboxone or how long they can see a suboxone doctor. Some people may need it for life, others not so long. If I were you, I'd tell the doctor exactly what you told us - that you fear a relapse and why. You might want to ask her what her goal is for you and discuss long term vs short term sub treatment. Some doctors don't subscribe to the idea of long-term maintenance. This would be your chance to make sure you're on the same page with your doctor. If you're not, then it might be time to consider looking into other nearby doctors in case there's one in your area that's better suited to you. But I would definitely talk to her and just be honest about your fears. She's there to help you, after all. Let us know how it goes.

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PostPosted: Fri Jun 10, 2011 10:30 am 
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Hi, and sorry you're being pushed so hard by your doc. I'm not sure what you mean by your dose being 2 instead of 3. Do you mean milligrams or tablets or films? The only reason that makes a difference is that if you are only taking 2 mg instead of 3, you are beneath the ceiling effect. If your doc cut you from 3 to 2 8-mg tabs, well, I think that should still cover you.

Anyway, I seriously get nervous whenever someone's doctor is making them feel forced to decrease their dose or stop altogether. It's a scary feeling and it makes the doctor the bad guy. I went through that myself with my last doc and it was frightening and really annoying to have someone making these decisions for me, regardless of how they affected me. It completely defeats the purpose if you are not on board with this, because, like you kinda of said, you will feel like you are going to go use automatically. If I were you, I'd call ahead of my next visit and have the receptionist tell the doctor you are having some serious concerns regarding this plan to cut you back and you want to make sure you will have sufficient time with her to discuss all your concerns. That way, you don't end up running into her lunch hour and trying to talk to her as she is trying to get to the door.

I don't understand where your doc is coming from. There is not a limit on how long someone can stay on Sub. You've been on it a year, so you are past the time frame where some doctors get people off to avoid becoming dependent on it. So, why now? She needs to explain why she believes it is best for you to go down, because any decision that she makes has to feel to you like it is your decision as well. If she starts making decisions for you and not respecting that this is your body and your life and your recovery, then you need to find another doctor (if you can). This is especially true if she plans to continue cutting your dose, no matter how you feel about that.

If you read about people stopping Sub successfully, the majority of them are doing it because they want to, even if it started out as something their doctor was pushing. Being forced puts you back in that mentality of being at the mercy of something (your doctor, cravings, etc.) and that is so reminiscent of being at the mercy of your old drug habit(s). I think it gets an addict's brain running in the addict mode and not in the recovery mode. It leads a person to feel that relapse is practically justified. Try to explain all this to your doctor. Tell her, "Doctor, I am not ready and if you cut my dose, I know I am going to relapse." I cannot imagine any doctor hearing that and wanting to go ahead with it. One more thing: you may be an addict, but your opinion matters. This doctor is supposed to be caring for you; that's what she is paid to do. I think sometimes people on opiate replacement don't get the respect they deserve when it comes to making decision about their treatment or addressing their concerns. This is opiate replacement, but it is a medical treatment, and you deserve the same respect as any other patient with any other medical condition.

laddertipper

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PostPosted: Fri Jun 10, 2011 3:27 pm 
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GREAT RESPONSE LADDER!!!

That's EXACTLY how I feel about it.....only you stated it better than I ever could've! Im going through the same thing with my Sub doctor. Actually, I've had this issue with him for awhile but got kinda sidetracked in finding a new Sub Doc once I became pregnant. A few months ago, my doc was pushing pretty hard for me to swith to Butrans. I see my doctor every three months now, so for three freakin months I was filled with anxiety and fear not knowing what would happen at my next appt( if I didn't agree to switch.)

It actually turned out OK. My appt was this past Tuesday. I didn't even bring up the patches.....I let him speak first......my doctor must not even read my chart because at THIS appt, he said "Ok, you were taking 60tablets/month and Im gonna reduce you to 55 tablets this time.".....................I WAS ALREADY DOWN TO 55!!!
So, I ended up remaining on the tablets AND I didn't even get a decrease this time. But, my point is, I feel these Sub doctors should listen to their pts more than some of them do.

I started off on a high dose, now (almost two yrs later), my dose is less than half of what it was whenever I was induced. And, I don't have a problem with SLOWLY tapering to get to a maintainance dose......BUT, I AGREE, THE PT HAS TO BE ON THE SAME PAGE AS THE DOCTOR, OR ELSE THE FEELING OF BEING FORCED CAN BE A TRIGGER.
And if a patient is on the Sub for maintainance and is stable at a particular dose.......what's the big deal about continually trying to FORCE them down?.........Dosen't make sense to me.

To the OP......You should talk to your doctor about your dosage and anything else that you're concerned about. If you find that your doctor just keeps blowing you off whenever you try to talk to him/her, I'd highly suggest finding a different doctor. These are "OUR" bodies, and we have a say as to how they're being treated. DON'T be like me, and wait around for almost two yrs to find a better suited doctor..........suffering from anxiety after every visit!


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Dr. Jeffrey Junig, M.D., Ph.D.

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