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PostPosted: Sun Dec 05, 2010 9:26 am 
Ok, so some of you have probably read about my situation. The fact that i have to take subutex because im allergic to the artificial sweetner in suboxone. And that my doctor has basically been a jerk ever since i switched. Well, actually he was a jerk when i first switched because i was taking the 'generic' subutex which is made by another company and im assuming thats why he was a jerk. Anyways, i ended up having to take the name brand subutex because the generic didnt work well for me. Well, he started treating me fairly well again. However my question is, when i was taking suboxone and before he became a jerk, he would put on the bottle, take 1 tablet twice a day. Thats all his instructions would say. Well, now that i've switched to subutex his instructions are, take 1 tablet twice a day "for opiod dependence." Freakin jerk!! How imbarrassing. I already get enough problems at my pharmacy. Stares, always complications etc. Well, i dont understand why he puts on the bottle, for opiod dependence. Other than i think hes just being a freakin jerk. Here is my real question, since its subutex, is he required to put, "for opiod dependence" in the instructions that are then put on the bottle by the pharmacist? My problem is, the opiod dependence is my business and my doctors. Not everybody at the pharmacy. I truly think he is just being a freakin jerk!! I am so aggravated with this doctor but im limited to him because he is the only option i have at this time and i've been with him for 19 months. I have a perfect record. I've passed every drug test. Im the perfect patient. Therfor i have built up trust yet he is still a freakin jerk. He didnt ever put, for opiod dependence when i took suboxone. Is he just being a jerk or is he required to do this because its subutex? Does anyone else take subutex and does their instructions say, "for opiod dependence?" Thanks everyone for any help or advice you all can give me!!


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PostPosted: Sun Dec 05, 2010 9:36 am 
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I think when it comes to writing the diagnosis on the script, it varies from doctor to doctor. My sub (I also take it for pain) says "take 2 to 3 tablets a day for chronic pain". I have other scripts that say, "take one per day for high cholesterol". That said, I don't believe it's NECESSARY to put the diagnosis on the script, I think it's just personal preference on the part of the doctor. I would think you could come right out and ask him to take the diagnosis off the script label, due to privacy concerns related to the pharmacy. Of course you're saying he's a real jerk, so who knows if he will do as you request or not. Good luck and let us know how it turns out.

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PostPosted: Sun Dec 05, 2010 9:47 am 
Thanks hat!!

See the thing is, i took suboxone for about 12 to 13 months and not once did he put, for opiod dependence on the prescription. So, with what you said an what i believe, i think hes just being a freakin jerk!!


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PostPosted: Sun Dec 05, 2010 12:38 pm 
I guess my goal here is just to find out if anyone else's doctor does this. And, before i ask my doctor at my next appointment i would like to know a little bit more about it. So, if anyone has any answers just throw them my way. Thanks!!


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PostPosted: Sun Dec 05, 2010 3:57 pm 
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lifesaver wrote:
Thanks hat!!

See the thing is, i took suboxone for about 12 to 13 months and not once did he put, for opiod dependence on the prescription. So, with what you said an what i believe, i think hes just being a freakin jerk!!


Just a lil confused how did you take suboxone for 13 months if you are allergic to the artificial sweetner in suboxone?

But as of what drs put on script lables my suboxone just says take 4 half tabs 4 times a day! But my oxyscript use to say take 200 mgs for chronic pain management. so i really dont know but it does seem like your dr is being a jerk.


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PostPosted: Sun Dec 05, 2010 4:38 pm 
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Mine has always said "take one tablet under the tongue everyday" and that is all, besides the date filled, discard after date, pharmacy info and warnings about breastfeeding and also about drowsiness. the thing is though, my doctor doesnt' want me to take a full 8 mg tablet every day, she wants me to take 4 mgs max--I guess we finally agreed that that is the dose I am supposed to be on. But anyway, NEVER has it said anything about opioid dependence. I'm in California, btw, I think laws can vary in different states. Sorry your doctor does that, I would find that unnecessary and embarrassing too, but then...sometimes they do put the condition on script labels, i.e, "for pain" or whatever but...my antidepressant meds don't say "for depression" --and never have regardless of the various doctors who've prescribed them to me over the years. Also I've been lucky that at my pharmacy I've never faced any hint of a stigma or attitude regarding my sub. I'm sorry you feel like your doctor is a jerk--I hope things get better somehow.


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PostPosted: Sun Dec 05, 2010 5:31 pm 
Bboy42287:

It all started because i begin getting horrible ulcers in my mouth and i couldnt ever figure out why i kept getting them. I was getting them like twice a month every month. So, i changed a lot of stuff around in my diet etc. and ruled all that type stuff out. Well, i ended up finding out that suboxone has an artificial sweetner in it(Acesulfame k Sweetner). Im allergic to artificial sweetners and even told my doctor all the things im allergic too on my very first appointment. He even had it in his chart when i brought it to his attention. Hes an idiot or at least, hes very under educated about suboxone/bupe. Anyways, it took me 12 or 13 months before i realized their was an artificial sweetner in suboxone. My fault for not doing enough research however, a doctor should know this stuff especially when i tell him im allergic to this or that etc. So i was then switch to subutex after taking something im freakin allergic to for 12 or 13 months. I cant really remember how long i took it. I was mad as hell because those ulcers were like going through pure hell. If you've ever had them, imagine them 2 at a time. Omg they hurt so bad and when i would get them, they would last for like 2, sometimes 3 weeks. May sound hard to believe but its true. I was ready to snap on this doctor but i didnt. I was/am a different person now and i wanted to do things different for a change. Anyways, ever since hes not quite treated me the same. Anymore confusion just let me know. I forget to put enough details sometimes. Sorry.


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PostPosted: Sun Dec 05, 2010 5:36 pm 
Thanks everyone for your replies!!

I kinda figured hes just being a jerk. Like i said, he never put, "for opiod dependence" on the bottle when i took suboxone. So, im gonna have a few nice, calm words with him next appointment an see if i cant "straighten" him out. lol


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PostPosted: Mon Dec 06, 2010 4:55 pm 
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Are you sure that he is putting this on your prescription? There is certainly nothing that would require him to do this. That said, I really have to wonder if this is happening by your doc or by your pharmacy - or their computer. The way to find out is to look at the scrip the next time you get it. See what it says on there. If it does not say what you are seeing on the bottle, it is not your doc's fault. It's just a thought. It would not at all surprise me if this is not computer automation creeping in.


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PostPosted: Mon Dec 06, 2010 6:10 pm 
donh:

Yep i thought of that and checked. He puts, "for opiod dependence" on my actual prescription. Aint that some bullsnit!! I knew he was being a jerk but at the same time i had the thought that maybe he had to do this because it was subutex instead of suboxone. Now that i think about it, hes gotta just be being a jerk. I appreciate everyones help with this and im gonna do my best to straighten this out at my next appointment because my condition is nobodys business but mine, my doctors and whoever else "I" choose. Again thanks everyone!!


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 Post subject: Hey lifesaver........
PostPosted: Mon Dec 06, 2010 6:45 pm 
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You know your Dr. we don't... If my Dr was putting that my script he would not change.... He's kind of a arrogant ass, alot of Dr,s are ( not the one that runs this forum though ) .. You might joke about it and see if he's receptive, Please don't piss off your Suboxone Dr. over this, No telling how many people at your pharmacy gets Suboxone, Maybe your being a little to sensitive about this ,I understand your point though, Just remember 1 thing " it is not a crime in America to be an asshole " ........... Mike


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PostPosted: Mon Dec 06, 2010 10:21 pm 
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The fact that he now puts 'for opioid dependence' on the script is not as big a deal as it seems-- here is why...

Docs need a waiver from the DEA to prescribe buprenorphine for opioid dependence. They do NOT need a waiver to prescribe buprenorphine for anything else; all they need to prescribe it for chronic pain, for example, is a DEA license.

In order to have the waiver to treat addiction, doctors must agree to use it for only 30 patients at a time-- it can be increased to 100 patients after the first year if approved by the DEA. The DEA keeps track of patients who are treated for addiction vs those who are treated for pain or other conditions by requiring docs to use something called an 'x-number'-- a number that comes with the buprenorphine waiver certificate.

When a doc writes for buprenorphine for opioid dependence, the prescription must have the 'dea x-number' on it, to identify that use of the medication. That number tells the pharmacist that it is being used to treat addiction; it allows pharmacists to help keep track of the number of patients (roughly) that doctors are treating for addiction, to reduce the chance that a doc is setting up a 'pill mill'.

If a doc writes for bupe for chronic pain, no special waiver is required. Some pharmacists call doctors to ask for the x number, so some docs will specify on the scripts that the script is NOT for addiction. That is why scripts will often say 'for chronic pain', if that is what the bupe is being prescribed for.

But chances are that the script in this case has an x-number that identifies the patient as being treated for opioid dependence, well before the other words were added. There may be other rules in your state that govern what scripts say; believe me, there are SO many rules for docs to follow these days that it is hard to keep track of them!


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PostPosted: Mon Dec 06, 2010 10:41 pm 
Thanks everyone!! See, its not really a huge deal but its the fact that while he was prescribing me suboxone, never once did he put that on the prescription. I have seen the x number at the bottom though. I've excepted who i am and what i am but my town is very small. Everybody in my town knows about my drugs history. My drug history has had enough publicity. I just cant understand the need for him to do that and like i said, the one and only reason i dont understand it is because i took suboxone in the beginning for 12 or so months and he never once put, "for opiod dependence". Also, if you've read any of my other post about what happened when i switch to subutex and started off with generic, you could also see why i believe hes just being a jerk. Thats when everything started. He had such a big problem with me taking the generic subutex and he flat out told me he didnt want me taking generic. He insisted i take name brand but at the time i didnt have insurance so i couldnt. He went from treating me like royalty, to now telling me i was just a drug addict an addicts cant be trusted. Well, i finally got my insurance and the generic just wasnt working well for me at all so i switched to namebrand subutex. Now im royalty again. Yet the only thing is, hes still putting that crap on the prescription. I dont know what to believe with him anymore but i do know that its my best option at the moment because i've built up a perfect trusting relationship with him and might i say 19 months worth at that. Im just not in the position to change doctors right now. Anyways, again thanks dr J and everyone else for responding!! Hope everyone has a great night!!


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PostPosted: Wed Dec 08, 2010 3:32 pm 
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Only you can really tell us how much of a "jerk" your doctor really is, but I'm going to take the devil's advocate position here for just a second with a little bit of a reality check.

You have told us you were on brand name Suboxone for 13 months and then switched to generic Subutex and now brand name Subutex.

Now, what you should consider is this: Suboxone has one purpose: Treating Opioid Addiction" That's it. Yes, it is sometimes prescribed "off label" for other things, or to get around the waivers that Dr. Junig has described here, but the fact is, the drug exists for the sole, primary purpose of treating opioid dependence. Subutex is the same thing. It's primary use is the treatment of opioid dependence.

So, you're telling us that you are concerned about privacy, and I DO very much understand and relate to those concerns. We're all concerned about privacy.

But do you REALLY think that the people in the pharmacy DON'T know what Suboxone and Subutex are prescribed for?

What I'm saying is, you're getting yourself upset over something that is kind of irrelevant. The people in the pharmacy know what these drugs are for and they know why people are taking them, and I'm SURE they know that your doctor is treating addicts.

Please understand that my intent here is not to disparage you in any way, I am only trying to help you realize that while your doctor may be a jerk, what he writes on your prescription and what is printed on your prescription bottle is not telling the folks in the pharmacy anything they didn't already know about you after you filled your first prescription there.


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PostPosted: Wed Dec 08, 2010 5:06 pm 
junkie781:

I most definitely understand what you mean and i didnt take it any way other than how it was meant. And i appreciate you taking the time to comment. If i were to be honest, i would probably say that i have had a grudge against this doctor ever since he started treating me like crap and it just seems like by him writing what he does in the instructions, that its just a bit much. Your right about the pharmacy, and i dont have a problem with the "pharmacists'" knowing, but the cashiers, who look into the computer everytime i drop the prescription off, are able to see everything including the instructions on my prescription and theirs a few of them that i went to school with. Its just a bit embarrassing. I guess theirs just a lot in my history that hasnt been included on this site about things i've been through like abuse from my moms ex-husband, all the way to my reputation. I've been through a lot which kinda makes me hypersensitive to certain things. Im the guy nobody wants their kids around because of my reputation with drugs. Im just tired of everything being so public and im very much working on moving away from this town. Anyways, i appreciate everyones advice and help with this!! Im just gonna ask the doctor if its that necessary to write that on their and if he says yes, then i'll just except it and move on. Again thanks everyone!!


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PostPosted: Thu Dec 09, 2010 12:51 am 
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I agree with you that I wouldn't want that on there. When it isn't on there, you still have the illusion of privacy. Addiction already has made us all feel so out of control that it is nice to have some sense of control when it comes to this area of our lives.

Your doctor may very well be a jerk. I kind of thought that since he is rather ignorant about suboxone/subutex, that HE may be concerned about what other people will think of him such as the pharmacists. I wonder if he thinks they will judge him as a "pill mill" or that he is just helping addicts get high. So maybe he is putting it on there because if he was so ignorant to think that taking subutex was a "bad" thing, he may very well assume the pharmacists will incorrectly think that way as well so he is just trying to be sure they know he is still properly treating the addict and not doing something irresponsible. He may be fearful for his license.

When you bring it up to him, just be careful (which I think you already will be based on what you have said) and try not to assume that he is just being a jerk and try to think of this from his perspective the best you can. Tell him how it makes you feel to have it on there and just ask if there is any way it could be removed.

Good luck!
Cherie

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PostPosted: Thu Dec 09, 2010 9:04 am 
Jackcrack:

Thanks for everything you've said!! I definitely understand where your coming from but i pretty much figured last night after talking to a friend of mine that i talked into going and getting this treatment. Well, my friend actually started out with another doctor who mostly used subutex. Well, this doctor my friend was going to ended up not being a maintenence doctor and was only gonna allow my friend a short term taper. My friend was in deep and he was needing a long term treatment. Well, i convinced him into going to the doctor i use. This is before all this mess happened with me and my doctor. So, my doctor just continued him on subutex since thats what his previous doctor had him taking. It had been awhile since i had talked to my friend and i remembered that he is prescribed subutex by my doctor also. So, i called him and told him what the doctor was putting in the instuctions, and he says that his prescriptions dont say anything about, "for opiod dependence". I bout lost my kool but i didnt. He said all his said was, take x number of tablets x number times a day, and thats all. So, i've now come to the conclusion that he is without a doubt being a freakin jerk. I know that when i speak with the doctor im not gonna say anything about talking to my friend because i dont want him to have to go through any problems like i am. Its a crock of bull!! Anyways, i appreciate everyones help with this!! I dont know how to handle this problem seeing how i have basically proven him to be a jerk. Whats hes doing has to be wrong on some level. I do know without a doubt my friend is in fact getting subutex, and not suboxone from my doctor. So, any ideas on what any of you would do if you were in my shoes? Again thanks for all of your help!!


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 Post subject: Just Me
PostPosted: Thu Dec 09, 2010 9:52 pm 
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I would mail him a prescription bottle with tic tacs in them and type up a label with his name on it that says Take one twice daily to keep from being a DICKHEAD.......prescribed by your alter ego Dr. Jack Ass. Of course that's just me........

Ok....seriously this is a tough one because you know you have had issues with him and your probably not sure how he is going to react. If it were me I would bring my bottle in and say to my Dr.....you know my recovery is very serious to me and you have helped me greatly and I am glad we figured out about my allergic reaction before it became worse than it already was(oops should I consult an attorney). I am confused about somthing though... after 19 months of being your patient I noticed that you are putting on my prescription "for Opoid Dependence.".....Why is that?... because my PCP doesn't put Take 1 5mg Cialis daily for erectile dysfunction......I would just say I am worried that family, friends or co-workers might see my prescription bottle and figure out Subutex is for Opiate Dependence. Is there anyway you could help me so it doesn't say that and I put my job or my recovery in jeopardy because people do not know why I take it and I don't tell them I take it.

He may say no that's how I write it and I would respond kindly.........do you prescribe it that way to everyone or just me? I think if you are kind...non confrontational and just ask him ...hopefully he will figure out on his own that he is being a jerk and fix it or you will know your Dr. is a jerk and now you have to make a decision........do I stay with this jerk or get a new Dr? I hope this helps...just remember to be calm but concerned about your recovery......make it about that and not him....Good Luck.

Jim


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PostPosted: Thu Dec 09, 2010 10:58 pm 
ReRaise:

What can i say, that was awesome!! lol. I will definitely take that advice and run with it. You think similar to me in terms of what you said in the beginning. I've actually had to learn to refrain myself from acting like that though cuz its gotten me into trouble in the past lol. Im for sure gonna make it strictly about the importance of my recovery. Also, the importance of my personal life as well. People talk in small towns and everybody knows everybody's business. Anyways, i thank you for your input!! It has definitely strengthen my confidence in saying what i need to say to my doctor. Although its the end of the month before my next appointment, i will for sure return to this thread to give an update. Again thanks everybody for your help with this!!


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PostPosted: Fri Dec 10, 2010 8:26 am 
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Well you are right. I can't think of any other reason besides the fact he is a dickhead either. At least you made the effort to explore other alternatives before making the accusation.....much more than we can say for him. So you are still the better person. Also, this way, when you do try to resolve the issue, any excuse he gives you will at least know in your mind whether or not it could be true or is just bullshit. You know, if you say something to him and he tries to say he puts that on all prescriptions for subutex, tell him you asked the pharmacy and they said "no". That way your friend doesn't get called out but HE does. I like Jim's ideas and won't add anything more. As always, Jim also made me laugh.

Cherie

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