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 Post subject: Hording Sub
PostPosted: Sun Sep 12, 2010 11:31 am 
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I hope you don't mind if I get something off my chest here. I've been hording Suboxone.

Last Fall, my doctor lied to me. He informed me that, because he was going away and"legally couldn't prescribe Suboxone with a refill", he had to schedule an appointment for me for ten days after I had an appointment (which resulted in two copays in one month for the visits and for the scripts, one of which was just a 10-day prescription). He told me that he had tried to write for refills before and that the pharmacy wouldn't allow it. I wasn't pleased. So, I checked with the pharmacist (knowing that I go to a pharmacy that most of his patients don't use). Although the pharmacist originally thought that the doctor was correct, she looked it up and told me that the law does allow for refills, only it has to be a 30-day prescription, no more.

Ten days later, I informed my doctor of this fact. My hope was that he would write me a script with a refill. Why? Well two reasons. First, he was traveling to India. What if something happened and he didn't get back in time? Secondly, I felt that I deserved to recoup the additional office co-pay that I had made. First of all, my previous appointment had been made for 25 days, not 30, and that was supposed to be because he was going out of the country. But, at that appointment, he told me that he had to schedule me for 10 days later. WTF????? Why had I come in 5 days early????? I was beginning to feel like his Sub patients were funding his fun money for his trip. I couldn't see any reason why he shouldn't do it. I was an excellent patient. 100% compliant 100% of the time.

I confronted him with the fact that the pharmacist said the script could have a refill. His response? He told me that he always wrote for 30 days only and would NEVER consider writing a refill. That's just the way that he ran his practice. Again, WTF???? If he had told me that originally, I might not have liked it, but I wouldn't argue that he had every right to run his practice as he saw fit. But, hadn't he told me that he knew that refills weren't allowed because he once had tried to write a refill? I felt royally deceived. Still, I was compliant. Until....

He came back and my appointment was for ten minutes and was a joke. I know that he was swamped and was trying to fit in all his junkies into one day (my words, not his). Same thing next month. THEN, he broke his leg and no more appointments for 5 months. All I did was show up at the office every month, pick up my script for 30 days of Suboxone, and (two weeks later) get my EOB that my insurance had been charged $75. Once more WTF?????

During all that time, I relapsed a couple of times, not on oxys (my DOC) but on the Tramadol that I had been prescribed after surgery and alcohol because of some marital issues that I wasn't up to handling. At the beginning of treatment, I signed a contract stating that I would be dropped from the program if I took any mind or mood altering substances not prescribed by him (and he won't prescribe any). A month after I started with him, he told me that he dismissed another patient due to relapse. The guy was given a week's script and told not to come back. Of course, I've never risked telling my doctor about what I've done. But, I've always been afraid of him dropping me and his treatment of me since deceiving me has made that fear stronger than my desire to comply. That's why I've tapered my dose and not told him.

The past several months, I've had a prescription for greater than the amount of Sub that I'm taking. At one time, he was prescribing 16mg and I was on 4mg. Currently, I'm prescribed 8mg and am taking 4mg. I fear that my head is as active as it is because of my deception. I started off so honest. In fact, my previous relapse from another doctor, meant that I had a supply of Sub when I started this round of treatment. I took that supply into my current doctor. I wanted to do everything that I could to make it work. Now, I have a stash of Sub and I know that I won't ever give it up. I don't ever want to feel that vulnerable to someone I can't trust.

Last visit, my doctor called me his star patient and told me to keep making him proud (okay... great... now I've got that age-old adolescent need to keep someone proud of me and the guilt of knowing that I don't deserve it!). I know that there's no way that I'm going to be honest with him. I'm also not able to be honest about this with my sponsor (though I tell her everything else). I don't tell because I can't get rid of the Sub. I often fear that I'll never be able to stay clean. That's probably why I can't come clean about the supply of Sub.

I recently heard a quote of Oscar Wilde. "Man is least himself when he talks in his own person. Give him a mask and he will tell you the truth." This forum is my mask. Without it, I would have nowhere to divulge such things. Of course, I don't really expect anything to change by posting it. Then again, maybe I am hoping that it will help some to be honest somewhere.


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PostPosted: Sun Sep 12, 2010 2:51 pm 
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I would not be too hard on yourself for hoarding sub. I get it. I used to hate early on in my recovery always coming down to the very last day to fill my script. Anything can happen from getting a flat tire on the way to my appointment to the pharmacy being out of stock and a million other things. It was the one time of month I always still felt like an addict. I've been on sub for almost 7 years and see my doctor every 28 days and get a 30 day supply, as the math proves, I have hoarded a few also. Now what your doing is a different level of hoarding but as long as you are not selling them or planning on selling or trading them, I don't see anything wrong with that. Just my oppinion, some will disagree.

About your relapse and not telling your doctor, this can get a little tricky IMO. Most doctors have some sort of clause where if you relapse you will be cut off or kicked out of his practice. I totally see where doctors are coming from with this but at the same time it doesn't encourage honesty from their patients. Relapses are all different, sometimes the person who slipped up learns more about themself or it just reinforces what they already knew. Some people though are not or have never been that serious about their sobriety and I think that is what the doctors are worried about. If you are one of the first examples and really regret what you did and learned from it, you wouldn't want to lumped in with everyone and be taken off suboxone. Does any of that make sense?

I think you should always be honest with your sponsor, they deserve it and are not getting paid to spend time on our issues, why waste their time. With doctors, especially suboxone doctors, be as honest as you can. I'm sure I am being a hypocrit, as I always preach honesty with doctors, but this is where I think honesty can back fire. If it gets to the point that it
really bothers you and you are loosing sleep, then by all means get it off your chest but if your ok with it I would not beat yourself up too much. I think that fact that it even bothers you is a good thing, I'm sure you never lost any sleep about your honesty when you were abusing, I know I sure didn't. Best of luck and let us know how you handle this.

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PostPosted: Sun Sep 12, 2010 5:40 pm 
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I think I have to agree with Smoothy - don't be so hard on yourself. You aren't diverting it and you aren't abusing it. And you certainly aren't the first person to relapse and not tell the doctor for fear of treatment being terminated. I don't think that's a big deal either. You're seeing things in black and white, and not recognizing the gray areas. Life is not all or nothing, or all right or all wrong. Try to ease up on yourself.

For awhile I was saving up some of my sub, too. I reached a point where I had about a month's worth saved up and decided to tell my doctor I didn't need all that he was prescribing anymore. I don't consider it hoarding, it's just smart. Again, like Smoothy said, you never know when something could happen. Maybe instead of coming fully clean with your doctor, just tell him on your next visit that you are taking a bit less than you used to. Perhaps this will satisfy your urge to confess to him. I don't know...it's just a thought. I just don't see what you've described as terribly dishonest of you. You've lost faith in your doctor and you are protecting yourself and your treatment. Try to look at it that way.

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PostPosted: Sun Sep 12, 2010 11:51 pm 
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Perfectionist that I am, I'm reading your kind replies and am having trouble getting past the fact that I misspelled "hoarding." :roll: I knew that it didn't look right but was too lazy to check the spelling.

Back on topic... black and white... I have such a hard time with that. I have to tell you that it helps to know that, among those serious about their recovery, I'm not the only person that had trouble with being down to my last pill the day before my appointment.

As far as letting my doctor know that I'm cutting down, I did a couple of visits ago. So, I'm down to 4mg and he's prescribing 8. I'm afraid not to keep hoarding because he's made it very clear that I shouldn't be having difficulty coming off now because I'm down so low and that it will continue to get easier as I taper because the physical addiction isn't really there anymore. I worry. What if he cuts me down too much and I go nuts as I have in the past? I know... I need to share some of Dr. Junig's work.

Right now, I need to stop worrying about the future. Believe it or not, I never really worry, unless it involves my addiction.

Thanks guys.


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PostPosted: Mon Sep 13, 2010 12:25 am 
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I don't intend to scare you, just inform you, I think your doctor has that backwards. For me and many others on here, it got harder the lower I got. Don't get me wrong, none of the reductions in dosage were that difficult but I did notice it got harder when getting around 5 and 6 mg's. I am currently on 3 and that's been the toughest dose for me to adjust to. You'll do fine, just make sure you and your doctor are on the same page. Try not to let your doctor lower your dose until you feel you are ready.

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PostPosted: Mon Sep 13, 2010 1:31 am 
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I kept up a pretty large reserve stash of Sub the whole time I was on it and I never even thought twice about it. I was on Medicaid, and if you know what that's like, you know that there's always the threat that you won't turn in some form or some other bs will happen and suddenly you're without coverage and you're screwed. I knew I didn't want to get caught in some situation where I'd be thrown into withdrawals, and since I couldn't depend on anyone else to make sure I had that covered, I took care of it myself.

That thing your doctor told you about how it should get easier and easier for you to cut down... :shock: That's exactly the opposite of what my doctor told me and of what my actual experience was. Not to freak you out or anything, but knowledge is power. If I was you I'd hang onto that stash in case you need it to finish your taper properly when the time comes.

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PostPosted: Mon Sep 13, 2010 9:46 am 
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I'm with everyone else.I think you're taking this too seriously.Look,this guy could drop you at a moments notice for any reason and leave you with nothing and not think twice.Doctors do this all the time.What's wrong with having a reserve of the medicine that you so badly need?
Nothing.Go save some more!


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PostPosted: Mon Sep 13, 2010 1:41 pm 
Christin, I've got to wholeheartedly agree with the others. Give yourself a break! While I find your pursuit of rigorous honesty admirable and agree it is an important part of recovery, on this particular issue, I do not find it nearly as important. I 'hoarded' Suboxone the entire time. Because of that, I was able to have plenty left when I got ready to taper. The last time I saw my doctor I told him I was down to 2mg/day and he released me from his care, saying only to call back if I decided I needed to stay on it. That was around 3 months ago. Having all the extra has allowed me to take my time with my taper and not have all this pressure that I was going to run out of pills before I was ready. People do this sort of thing quite often, I believe, even with other types of meds. A lot of times, the doctor even knows it. They know that a lot of us have a hard time paying for our scripts so they'll write the prescription in such a way as to allow one copayment to cover a couple of months instead of just one.
All this may not be the most honest practice, but it is definitely not outright wrong either, in my opinion, anyway. Yeah...let that issue go. You're only trying to be smart and protect yourself.


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PostPosted: Mon Sep 13, 2010 5:46 pm 
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I was worried about this issue as well. I decided to tell my doc today exactly how many I have left and how many I've taken day by day since I started. He responded by prescribing significantly more than I am taking now, even though I already have a couple of weeks worth saved up. I'm not certain where he is coming from other than he seemed to be trying to assure me that I won't have to worry about running out as long as I test clean every time. He prescribed 3 x 24 the first time. I have averaged a bit less than 2 x 24 so far, and the second prescription is for 75. He did say I should have enough extras to get me through vacations and holidays if any issues pop up. The entire process thus far has been amazing! The doc couldn't be more supportive, the sub seems to be working beyond my expectations, and I have so far had no cravings, anxiety, or anything really, other than trouble sleeping at the very beginning. This even though I came to sub from a 5 year methadone addiction, and before that fentanyl. I feel like there must be a dark cloud coming eventually, and yet everything that comes up goes my way. I wish I had heard about suboxone 3 or 4 years ago. I'm not sure that many docs know anything about it.


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PostPosted: Fri Sep 17, 2010 6:31 pm 
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One more thing.I've never had a doctor who was going away who would not give me extra on my prescription if a refill was illegal.Percocets,klonipin or Suboxone.3 different doctors have all helped me out like that.
I would just ask him for double the amount per day for that time he's away.


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PostPosted: Fri Sep 17, 2010 11:11 pm 
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OMG! :shock: I swear that my doctor must be from Mars! He's so tight with his Suboxone scripts that he doesn't allow for one, single extra tablet each script. He prescribes on a multiple times per day dosing schedule. When I was taking 16mg (8mg in the am and 8mg in the pm), I would need to fill my script the day of my appointment because I didn't have my afternoon dose unless I did. Believe me! That was nerve-wracking. Of course, I know that the half life of Sub would mean that I wouldn't go into withdrawal if I didn't get my script until the next day. But, that didn't matter. I still felt pressured to fill the script. I hated that, absolutely hated that feeling. Thanks for all the understanding replies.

As far as it getting harder the lower the taper, I know. Twice, I've tried to cut from 4mg to 3mg and have failed. Fortunately, I haven't relapsed, though that's where the tapers have led my head. There's something about knowing that I'm a breath away from being able to use and find the relief that my head begins demanding. I start waking up in the middle of the night, craving, sometimes having dreamed about copping, sometimes not. The physical symptoms are annoying, but it's what they, and everything else, does to my head that makes the taper so, so hard.

My doctor doesn't understand. Fortunately, he hasn't pushed me to taper further these past few visits.

Thanks again, all!


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PostPosted: Sat Sep 18, 2010 2:07 pm 
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I feel for you so much.I would look for another doctor.Who knows a new doctor might make you feel better and give you a little more slack?

Hang in there,
Tony


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PostPosted: Sat Sep 18, 2010 4:48 pm 
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If you still had other opiates available to you would you be more inclined to relapse. I still have quite a bit left and though I haven't been tempted yet, I can foresee that I could get to a bad place. I'm thinking I should probably flush everything but sub, but I haven't been able to make myself do it, just knowing a time could come someday when I get cut off or run out or circumstances......


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PostPosted: Sat Sep 18, 2010 7:34 pm 
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new_sub wrote:
If you still had other opiates available to you would you be more inclined to relapse. I still have quite a bit left and though I haven't been tempted yet, I can foresee that I could get to a bad place. I'm thinking I should probably flush everything but sub, but I haven't been able to make myself do it, just knowing a time could come someday when I get cut off or run out or circumstances......

This post took me back to February of 2009 because, at that time, I could have written this post.

To answer your question, I most definitely would be more inclined to relapse if I still had other opiates available to me. Ummm... let me correct that... I mean, I did relapse when I had other opiates still available to me.

It was my first round of Sub (that lasted such a short period of time, it hardly deserves to be called a "round.") I kept my oxys because I was afraid that Suboxone might not work for me. Actually, I've never been able to flush pills.

The thirty or so oxys seemed harmless enough. After all, weeks had gone by and I wasn't taking them. But, having them and not taking them, only gave me a false sense of security. (I had pills and wasn't taking them. Wow, was I doing well!)

Another week or two passed and things in my life started getting really stressful. I discovered that I could relieve some of the anxiety and the stress just by acquiring pills. I'd go to the doctor and get a Vicodin script. Whew! I felt better even though all I did was store the pills with my oxys. Another load of crap hit the fan... I snatched a couple of dozen oxys from my dad's underused bottle. This went on for a couple of months, until something happened that I (conveniently) stopped taking my Suboxone for a few days and then (equally conveniently) convinced myself that I had to use. There was no way around it. If I didn't, the obsession would never go away and the stress and insanity would just keep getting worse. Of course, using doesn't make the obsession to use go away and within two weeks, I ended up ingesting or snorting every pill that I had "innocently" stockpiled, and now I was using more than before I went on Suboxone.

The only way that I could remain on Suboxone and not relapse on opiates this time around was to inform my doctors, my father, and my father's doctor not to allow me access to opioids. Just knowing that I was only a doctor's visit away from a fix was too much for me to handle. As long as my head could go there, I was in danger of an easy relapse. Even now, I'm jealous over what you have.

I still have the temptation of buying off the street or shopping around for a doctor who doesn't know me. But, those avenues take more effort and involve too much of a risk than I'm willing to put into a relapse. Burning bridges (and getting rid of supplies) has been frustrating and, therefore, has been good for my recovery.

Is there someone who will help you to flush what you have? Last August, I found an oxy a week after re-starting Suboxone. Even though there was no way that it would get me high, I still needed to ask my husband to get rid of it. Anytime that I've quit, I've had to finish my supply. I could never flush it. :roll: I hate the pull that the pills have on me.

new-sub, if you're anything like me, you're playing with fire having other opiates around and, eventually, you're going to get burned because your head is very cunning and it will be able to convince you that the drug won't burn you, it'll only make you feel comfortably warm. That's what my head always tells me and in the past, I always believed it. Why wouldn't I? After all, the first time, that's exactly how it feels. It's the every other time afterward, the times that I can't prevent from following the first time, that remind me how terribly, horribly it burns.

I wish you all the best in getting rid of the other opiates.


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PostPosted: Sat Sep 18, 2010 8:07 pm 
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Thanks for that. I needed it. I will get rid of them or get my wife to do it. IT will be hard because I rat holed months worth of everything as I was tapering down this summer. I'm not sure they have as much pull on me as you've described, but a major stressor in my life could very well make me choose to use. It's more likely that I would go back to them if I lost the subox, and that's where my fear comes in, but I can envision something happening that would drive me to them, such as hurting my neck which is how this all started to begin with. I think I've been in that place where having them around makes me feel secure. I've already managed to get plenty of extra subox too, so I should be able to live with that.


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PostPosted: Sat Sep 18, 2010 11:10 pm 
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I have to agree. I think you'll benefit from getting rid of your stockpile of pills. Why have easy access to something you're trying to rid yourself of? I'm glad that your wife can help/do it for you. I predict you'll be glad that you did.

Just my two cents.

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PostPosted: Tue Sep 21, 2010 7:36 pm 
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new_sub wrote:
Thanks for that. I needed it. I think I've been in that place where having them around makes me feel secure.

I'm glad to hear that you're getting rid of the extra pills. (It's Sept 21st. I'm curious. Are they gone?)

I totally understand the sense of security that you feel in having them around. Isn't it strange that we feel secure about something that's really the equivalent of a train wreck waiting to happen in our lives?

I also totally get the neck pain issues. With three herniated dics, I keep thinking that someday I'm going to need opiates. Of course that's my addiction talking.


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 Post subject: Hoarding
PostPosted: Fri Sep 24, 2010 9:03 am 
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I may be about to switch sub docs because I don't have complete faith in my current one. I had a fairly negative recent psychological evaluation & am expecting I might be booted next visit. So yea, you'd better believe I've been hoarding sub.

I count my sub-pills daily just like I did my oxy. And I've been through sub w/d. I know one guy whose doctor up and died. It's
pretty scary to think about a forced jump from 8,12,16mg or whatever.....I don't know anyone who doesn't have some pre-occupation with this, and I think it hinders recovery. What are you supposed to do if your boss tells you that you have to fly out of town for a week the day before your sub appt and you have one pill?

That's one things that's rough about sub- we are tied to it like a heart-lung machine. I could do much better things with the time I spend worrying about my next sub appt. Really I think the docs should allow us to have several extra tablets in case of that flat tire or other emergency that prevents getting the refill.

Personally, I can stretch one 8-2 for about 8 days to keep from getting sick. And yes, since things are "up in the air" I'm hoarding like crazy. I think it could easily take 4-6 weeks to get with a new doc, and I'm sure a lot of people have been dropped on their heads. I mentioned this to my psych, and he said he'd RX Ultram to me if I something happened, which I hope would help.

At one point, my psych carried me over a missed sub appt with 3x Norco 10/325 and I didn't get sick. I wonder if anyone can speak about whether Ultram is effective (potent) enough to stave-off opiate w/d temporarily- this is an important question for me.

Thx


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PostPosted: Fri Sep 24, 2010 5:16 pm 
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First I have to say how infuriating it is to hear about a Sub doctor kicking someone out of treatment for relapsing. I don't know how a doctor could do that and then when the patient ends up dead convince themselves that it wasn't at least partially their fault. If a sub patient relapses they should be able to tell their doctor what happened without fear of being kicked to the side of the curb as long as they are willing to do what it takes to get back on the Suboxone and make another attempt at staying clean. It also just cracks me up how so many doctors are soooo afraid of Suboxone being diverted and having all kinds of special rules about not wanting to allow refills, extra in case something happens, having appointments on the exact day the medication is out etc. I just want to shake those people......don't they realize how much easier it is to get ahold of pure agonists like Oxy?? I realize I'm not a doctor but if I were I would feel alot safer with extra Suboxone being diverted instead of oxy or other agonists that can easily kill individuals with low/no opiate tolerance and addicts alike. If an opiate naive person took Suboxone by itself without any other central nervous system depressants the only way they could die is if they were dumb enough to drive a car and nodded off. If the Suboxone is diverted to another opiate addict it basically guarantees they won't kill themselves for at least a couple of days or more depending on how much they take. Literally every single case of diversion of Suboxone I've heard of involved the medication being given or sold to other addicts who were still using and just wanted a day or two that they didn't have to worry about getting dopesick. There are certain pharmacies around where I live now that won't allow a suboxone refill to be picked up a single day early. They have literally made me wait until the day I would run out before they will refill the prescription and yet those same places didn't think twice about refilling oxy scripts a day or two ahead of when if I were taking the medication correctly I would have been out by.... I just don't understand

I'm just so tired of opiod addicts especially those in recovery being treated like second class citizens. If someone with any other kind of psychological disorder/disease had a relapse of symptoms or intentionally stopped taking their meds do you really think doctors would kick them out of their practice? My dad's a type II diabetic and I've seen him on numerous occassions willingly and intentionally eat foods he has doctor has told him not to eat and even if the doctor witnessed this first hand does anyone really believe the doctor would cut off his medication? Or just up and tell him he's no longer going to get medical treatment? Maybe I'm just naive to think we could ever be treated like anyone else with a medical condition but I guess I just can't give up hope that maybe someday all doctors will treat us with the compassion and respect we deserve as fellow human beings with a disease that we didn't ask for. Until or if that ever happens though I just wish there were more Sub doctors that are recovering opiate addicts themselves. I'm just tired of feeling like everyone else just views us as being careless and stupid and acting like we could get better if we would just choose to stop using...... or making us feel lilke there is something morally wrong about us and if we went to counseling enough and talked about bad things that have happened to us enough we'd suddenly have some breakthrough moment like happens on t.v. and we'd be all better and never ever use again!

Anywho I'll end the ranting it's been a long week but thank goodness it's Friday! I hope you guys all take care and have a great weekend :)

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PostPosted: Fri Sep 24, 2010 5:42 pm 
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Matt, I can't tell you how many times I've thought or said every word that you just posted. The only thing that I might question is the assumption that a recovering opiate addict turned suboxone doctor would treat the still-suffering addict with compassion and as a human being suffering with an illness.

My first Suboxone doctor was a recovering addict. He bragged about how he sold "recovery" and not just Suboxone. Yet, he ran a "cash only" business. The first month's fee (with all the benefits of an in-your-car or wherever you hung out induction) was almost $400.00. Every subsequent month was $150 (just for the script). His justification for requiring cash was that "it costs a lot more than $400 to have a habit and if they can come up with the money for dope, they can come up with $400 to get on Suboxone."

On the surface, to a non-addict, this might sound reasonable. But, what do addicts do to get their fix? Steal, sell themselves, deal dope, lie to doctors. Is this really the kind of behavior that a doctor would want to encourage in his patients? I had good insurance when I went to him. STILL... he wouldn't deal with my insurance carrier.He just couldn't be bothered.

I'm sure that he's not the norm. I just had to rant. We are just really hard-pressed for decent Sub docs in my area.


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

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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