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PostPosted: Fri Feb 14, 2014 2:50 pm 
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Hey guys. I posted a couple of weeks ago that I was having trouble with obamacare and that they keep saying i'm not effective yet when I should be so I've been having to pay out of pocket for suboxone. For those of you without insurance know how expensive this can be! Anyhow, I told my doctor about this and he gave me a prescription for subutex until I can get this insurance shit taken care of. So my question is, how different is subutex from suboxone? And if I tolerate suboxone well, will I tolerate subutex well? Any help would be appreciated, thanks!


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PostPosted: Fri Feb 14, 2014 10:48 pm 
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'Subutex' doesn't really exist anymore; the drug was a brand form of plain buprenorphine, and now the brand is no longer made, so you will get 'generic buprenorphine'. It is identical to Suboxone: http://www.suboxonetalkzone.com/is-suboxone-clinically-identical-to-buprenorphine/

Call around; in WI, Walgreens sells buprenorphine for $4, but small mom/pop pharmacies sell it for $2.25 per dose. The only difference with buprenorphine, compared to film, is that it is a firmer tablet. Take it the way I describe here: http://www.suboxonetalkzone.com/is-suboxone-clinically-identical-to-buprenorphine/ -- just crush it in your teeth and use all the surface area, as I describe. About 25-30% of the buprenorphine in film or tabs is absorbed; you can increase that number pretty easily.

BTW... I have 2 patients on the 'ACA' or Obamacare... yes, it is a nightmare. They have needed PA's for ALL meds, but when you call the insurers, they have no way to access the accounts, to process the PAs. The insurers call it a 'linking problem'; news reports call it problems with the 'front end' (the sign-up web site) communicating with the 'back end' (the insurer's part). From my experience, after waiting on hold for hours, literally, the insurance people still have no way to access the accounts of the people they are supposedly 'covering.' The people who signed up for the ACA were 'true believers' a couple months ago; now they are 'truly disgusted', after being off meds for two months (Abilify plus Cymbalta totals about $1000 per month-- so it isn't like they can just pay out of pocket for a few months!). Truly a 'fail'. I can't believe there has been nothing but political cover, and blaming of the people who were locked out of the process of creating the law. There should be a parade of people fired for this mess.... any major company, once such problems were identified, would get their act together within a week. It's a friggin' WEB SITE!


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PostPosted: Sat Feb 15, 2014 2:52 pm 
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Not to be disagreeable, just to clarify the answer you received on the earlier post, Suboxone DOES NOT EQUAL Buprenorphine, though it does contain that drug. Suboxone's other main ingredient is NALOXONE. With that said, the generic name of Suboxone is Buprenorphine/Naloxone, while the brand name Subutex only contains Buprenorphine. The Naloxone ingredient is an opioid antagonist which is given to those who have overdosed on hereon or other forms of opioids.

Here's some further information on Naloxone


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PostPosted: Sat Feb 15, 2014 3:58 pm 
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yes, naloxone is added to Suboxone, supposedly to deter iv use of the drug, however the functions of Suboxone and the mono product buprenorphine are clinically identical, because when taken orally or trans mucosally/sublingual, the naloxone serves no purpose, is poorly absorbed, and is destroyed by first pass metabolism at the liver. so for a person who doesn't have an IV usage problem, the naloxone is unnecessary! in fact, some people who have used both Suboxone and the mono product intravenously say there's no difference in their experience at all making the addition of naloxone purely for the financial gain of the manufacturer, imo.

that's why Dr. junig advocates for people who dont have insurance and can't afford brand name Suboxone which can cost upwards of a thousand bucks a month, to ask to be prescribed buprenorphine tablets, which can mean significant savings. for a ninety tablet rx it costs around 240.00, compared to 1000.00, that's a big difference ! it can mean the difference in receiving treatment or not for some people.

naloxone is given intravenously to people who've overdosed on opioids in far larger amounts than what are included in Suboxone and it's generics to reverse the effects of the opioids taken, which imo, further prloves that's it's addition is merely for financial gain.


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PostPosted: Sat Feb 15, 2014 8:03 pm 
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Not to be critical of the reply answering the guy who didn't want to be seen as critical in his comment... But in the interest of accuracy and not spreading misinformation, the statement that "naloxone is given interveiniously to people who have overdosed and in far higher doses" (paraphrased) - that really is not true on both accounts. First the standard dose exactly is the same as in 8 mg of suboxone - 2 mg. so it's actually not far higher it's exactly the same - a 2mg dose. Also Narcan most certainly can be given IV, it works very well IM (a shot in the muscle) as a nasal mist or even rectally. This is very important as it's often hard to start an an IV on a drug user. There are more and more programs that now provide Narcan to the public (most not trained to start an IV) to be given as a shot or nose spray.so IV is only one of many routes of administration.

Again, just wanting to help educate - not be critical. Just thought this one was pretty important.


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PostPosted: Sat Feb 15, 2014 10:25 pm 
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oh yea donh, the project Lazarus program, that's what your talking about right?

donh, please refer to http://www.globalrph.com/naloxone_dilution.htm
the information I attained pertaining to the subject there started that the drug can and is given iv ,and I'M. Yes the 2mg is correct, however the dosage is often repeated depending on the response of the patient who has overdosed.

read all the info there, it's really interesting, bit the info I'm referring ti is about halfway our so down the page, maybe a bit less than half


Last edited by lizzieshug2013 on Sun Feb 16, 2014 12:33 pm, edited 1 time in total.

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PostPosted: Sat Feb 15, 2014 11:16 pm 
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at the previous website I referenced I read;

"A continuous naloxone infusion should be considered in patients who have a positive response but require repeated bolus doses up to 10 to 20 mg in some cases because of recurrent respiratory depression"

the short half life of naloxone or narcan often 45 mins or less, often does not outlast the respiratory effects of the drug which was used to overdose and therefore must be repeated more than once.

you could also visit Narcan official FDA information, side effects and uses at www.drugs.com/pro/narcan.html. I found out to be full of information about narcan and its uses, both intramuscularly, and IV, and intranasally as suggested and evidenced by project Lazarus. but it is commonly used IVZ FOR overdose cases according to all information I've read donh.


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PostPosted: Sat Feb 15, 2014 11:34 pm 
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Naloxone is given iv. I never said it wasn't given IM or rectally, or via intra nasal mist. I simply said, naloxone is given IV.

while the initial dose may be 2mg, the total dose an addict in an overdose situation receives can be quite a bit higher, that's what I was referring to by saying, "dose".

I appreciate your concern for accuracy, but think you went overboard in over analyzing my previous post. I could see the need, had I posted grossly inaccurate information, but as you see, I didn't. thanks donh for always looking out for us all.


Last edited by lizzieshug2013 on Sun Feb 16, 2014 1:19 pm, edited 1 time in total.

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PostPosted: Sun Feb 16, 2014 9:11 am 
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Is anybody really able to help me? I have never spoken to anybody about the hell I have got myself into. I am past the end of my rope I'm making my last attempt of trying to get some help to get off my addiction to heroin.. going on 2 years which after being up all night searching for information sounds very short to most but I started with a script for hydrocodones I got female my doctor after a horrible car wreck which left me with blinding migraines that never stop when my forehead sliced frm side to side doctors said they saw my brain. I was prescribed. 36 yellow ten's twice a month for 7 months during my rehabilitation, along with depression, anxiety, and sleeping pills. But once my


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PostPosted: Sun Feb 16, 2014 9:59 am 
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Sorry something came up but but once I won my settlement which only paid for my medical bills I was introduced to heroin so I tried it because the pain was too much I question is I went from half a pill twice a day to a gram or more the worst way possible which we all know what that is every 4 hours I have to do another one I would like to try suboxone but don't have insurance I'm willing to pay but I don't know how to find it and every doctor I've spoken with either tells me they're not taking new patients or no how can i get some please if anybody can hear me I'm so tired of the runaround and I'm about to lose it please I'm so depressed


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PostPosted: Sun Feb 16, 2014 1:17 pm 
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I am so sorry to hear your in such a terrible way with heroin. addiction is a miserable and crippling disorder and I truly feel your pain.
you can start looking for a doctor to rx Suboxone, by visiting the website http://www.Suboxone.com. there you can type in your zipcode and how far you can travel to see a Dr. and get a list of doctors in your area that may be able to take you. then start calling every one of them. there's another website http://www.naabt.org, that has a treatment locator service as well where you type in your info, which is kept confidential,btw.. and type in what you are looking for in a doctor/ provider, and a doctor with an opening will contact you via e-mail to let you know and give you his/ her contact info. this is actually how I found my current doctor. hope this also works for you. you sound like you are very much ready for a change.

As far as cost goes, Suboxone can unfortunately be very costly, however, there are now generics available, and coupons from the manufacturers are also available to help defray costs. Suboxone providers are allowed to have up to three patients at a time on the here to help program from the manufacturer of Suboxone, Reckitt Benckiser, in which your Suboxone is free for your first year of treatment. to do this,I think there is some paperworkto be filled out by you and your doctor, provided he's not already got his three patients using the program. also,there's a drug called buprenorphine that your Dr could rx that is a fraction of the cost of Suboxone. it used to be called subutex.you may have heard of it. some doctors aren't willing to prescribe it though because it's said that it can be more easily abused intravenously because it does not contain naloxone, the other ingredient in brand name and generics of Suboxone, but it is worth a try. the only other way I can think of to save money on your sub treatment would be to stick to as low of a dose as possible to keep away withdrawal and control your cravings for heroin and other opioids. this is a good rule of thumb anyway.
that's all I've got for you, wish it could be more, but I'm sure some other members who have more experience will chime in soon with more help and advice for you. good luck, and please let us know how it all goes. my heart goes out to you.


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PostPosted: Sun Feb 16, 2014 4:37 pm 
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Hi Iwnt2liv,

You got a great response from Lizzie above. You should definitely register at the website she gave you to find a doctor that has an opening for treating you. If you can't find one, then you need to get on the waiting lists of every doctor that is anywhere near you.

Unfortunately, the process of finding a doctor isn't always easy. But, you need to keep in mind how important it is to make this first step. If you really want to live, then you have to be willing to work as hard at finding a doctor and doing whatever it takes to be able to afford it as you have at finding and buying your drugs in the past. That's just the hard truth.

I wish you the best of luck. As Lizzie said, please let us know how it goes.

Qhorsegal2

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PostPosted: Mon Feb 17, 2014 4:34 am 
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I will!! I am so rdy to and determined! I know that it won't be easy but I am going to look till someone excepts me... eventually I mean its truly unbelievable the way they speak and act tward's u the moment the h word leaves my lips.. people don't even try to hide the utter disgust and judgemental tones! Why r they answering the phones at a rehabilitation clinic.. if they get sick frm talking to the boyhead but no more excuses it's do or die time!


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PostPosted: Mon Feb 17, 2014 10:11 am 
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You are absolutely right...they should be more professional and caring. It is a shame that people look at our disease differently than others, I know it is difficult for others to understand, but there should at least be some compassion. I hope you find someone who is willing to help you and who is kind. Don't be afraid to stand up for yourself! Just tell them, look, this is not easy for me to do, I made this call knowing that I would be judged...but I did it anyway because I need help. I am being strong by making this decision, so please give me the respect I deserve. :D

You are going to do just fine. And once you get into treatment, you will start to feel proud of yourself and it will come more easily when you have to face these circumstances. You just keep your head up, and do whatever you have to do to get yourself well, and save your life.

Good luck!

Q

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PostPosted: Mon Feb 17, 2014 1:31 pm 
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Iwant2live,
I hope you get the treatment you so want and deserve! We all deserve it! It's a shame that doctors can only have up to 100 patients at a time. It's like, hello! There are way toooo many addicts out there and that is such a LOW number! A lot of doctors are just scared to do it, so i've heard. Don't quote me on that! I know everyone else has already told you to sign up with a doctor or get on a waiting list but is there a detox program you can get into that will prescribe suboxone for a short period so that you can atleast avoid withdrawal? Maybe that's an option? Idk check around. Wish you the best of luck! Hang in there!
Thank you doc and everyone else for your replies to my original post! Pray for me that all this obamacare crap gets straightened out for me! LOL


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PostPosted: Mon Feb 17, 2014 3:01 pm 
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I wish I could go to a detox center. I have looked into it and it to me sounds like the easiest way to end my hell. A week or two of help is really all I want to get me thru the worst. I would go in a heart beat.. but the truth is no one in my life knows anything about the struggle that I am dealing with I've managed to be a functioning closest case so I can't leave for a week out the blue for no apparent reason. But I'm feeling a bit more opptimistic been on the phone calling doctors no luck yet. Not giving up yet tho. Finding this site and just being able to talk to people who truely understand out I am going Thu completely alone has greatly helped rest my demons


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PostPosted: Mon Feb 17, 2014 3:16 pm 
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Iwnt2liv wrote:
But I'm feeling a bit more opptimistic been on the phone calling doctors no luck yet. Not giving up yet tho.
That really stinks that you want to get into treatment so bad and no doctors willing/able to take you in right now. I hope you do continue calling and asking each place you speak to if they happen to know any other doctor taking new patients.

Your getting lots of advice, suggestions, and support. I would just like to suggest going to an NA or AA meeting to get additional face-to-face support. I was scared out of my mind walking through the door that first time, but now I actually look forward to attending as many meetings as I possibly can each week.

You don't have to say a word, just sit back and listen to what is being said. Talk only when you feel comfortable and ready to do so. You will meet many real good people that really understands what your going through. They will offer to help, and the support they provide is nothing short of amazing! I hope you give it a try, you might find it's exactly what you need right now as you wait to get into a doctor.

Good luck and hope it happens sooner than later.

Karen


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PostPosted: Mon Feb 17, 2014 3:19 pm 
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Yeah NA may help a lot. Right now I'm thinking about your withdrawal symptoms as I know those are uncomfortable as hell and can be very discouraging when you are trying to stay clean. So is it that you are feeling uncomfortable telling some people in your life about your addiction? Would they not be supportive?


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PostPosted: Tue Feb 18, 2014 10:54 am 
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I've thought about telling my friends or family a few times but no they would freak out on me and most likely put me out and make things harder for me so I am doing it on the down low.. LOL but the good news is I've got an appointment tomorrow to see a doctor. She was real nice on the phone. My only concern is she said I have to be in moderate to servers withdrawal b4 they give it to me. I won't be able to do anything for the rest of the day and that is making me freak out.. I have to do it like every 4 hours or I start getting sick.. what should I do? Could I stop at like 6 or 7 tonight and be OK? That would be 12 hours off cuz my appointment is at 6 am?


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PostPosted: Tue Feb 18, 2014 11:26 am 
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I would do EXACTLY as the doctor advised! That is the very best way to do it. I promise you want no part of precipitated withdrawals. Yeah it's possible you would be ok if you did it your way, but there is no way I would take the chance myself, having gone through those PW's.

You only have to do this ONE TIME so why not do it right? It's to your benefit to wait as long as possible before induction. Yes it surely sucks to be in withdrawals, we've all been there. But once you get that first or second dose of sub in you things brighten up immensely!

Hang in there and try to take nothing ok. You can do it. It's so worth it in the long run I promise!

Congrats on finding a doctor!

Karen


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