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PostPosted: Mon Jan 09, 2017 5:48 pm 
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I was just switched from bupe strips to the generic Suboxone/ naloxone due mostly because I couldn't afford to pay $230/ every 14 days.
I was so nervous to ask him to switch me from strips to pills. It Took me over a year to get the nerve to even ask him. I suffer from severe Rheumatoid arthritis pain (im 35) and I can be prescribed opiates. But i have been clean for 3 years i really dont want to get back on opiates after working my butt off to stay clean. I believe that the subutex would help with the severe pain i go through everyday.
I really want to ask my doctor to switch me from the generic suboxone to subutex. I see him in 2 weeks.
Does anyone have advice on how i should ask him to switch me yet again?? He literally switched.me to generic suboxone 2 weeks ago.Please help me.
I've been going to this treatment clinic since 2012 so the doctor knows everything about my addictions. I just dont know how to ask him. The subutex is only $57.00 at walmart compared to the $95.00 generic Suboxone pills at rite aid.


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PostPosted: Wed Jan 11, 2017 2:37 pm 
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GC81,

The vast majority of doctors won't do it. Why? They think you'll abuse it, possibly try to shoot it up. When they went for their training to get the special DEA number to prescribe Suboxone they were told to only give it to pregnant women. Period, end of discussion.

There are a few doctors out there who will prescribe it but they are hard to find. My brother found one but he was forced off in less than six months. He's okay with that and doing alright so I won't complain.

All you can do is ask and see if he'll agree. Just be prepared to hear NO.

Sorry to be the bearer of bad news. Please let us know if indeed he agrees. Sending powerful positive thoughts your way~~~~~~

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PostPosted: Wed Jan 11, 2017 9:43 pm 
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Gather your information, what you are spending and what you could be saving if getting plain buprenorphine. If you have been stable 3 years, never an IV user (I assume), I would approve it. But we each have our own 'guidelines' or lines we won't cross. I have never had any contact from the DEA except 3 years ago when I asked to increase my cap to 100 patients. Insurers won't cover it but it sounds like you are paying the full amount. In 4 plus years I have had one pharmacy benefit company request plain Buprenorphine. 5 months later the insurance switched to another benefits company and it was no longer on formulary so back to Suboxone at 4000$ a year more.
I think about 10% of my patients are on Buprenorphine, pregnant, severe nausea, peripheral edema, and headaches have all been accepted by the insurance companies upon appeal.
By the way, you must have lousy insurance if it isn't covered. Might even be able to make a case to your state insurance commissioner regarding parity of coverage for addiction and mental health conditions.
I don't get upset when people make specific requests, but then I expect them not to get upset if I say no and explain why. Usually for benzo's, medical marijuana and stimulants.

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I suffer from severe Rheumatoid arthritis pain (im 35) and I can be prescribed opiates

Look for that idea in the future to recede as guidelines come under revision for chronic non cancer pain. Just my view of the medical landscape from 20,000 feet and in the trenches.


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PostPosted: Fri Jan 13, 2017 1:33 am 
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i would just bring up the $ aspect as your reason to switch.

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PostPosted: Fri Jan 13, 2017 1:36 am 
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Doc,
What do you think about pharmacies that refuse to carry suboxone?
I guess they can refuse to do whatever they want, but if the dr. writes the prescription, who are they to refuse to carry it?

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PostPosted: Fri Jan 13, 2017 3:48 pm 
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Just my experience, SisterMorphine, and I really don't mean to downgrade anyone but I just haven't had a whole lot of luck with pharmacist. I've had pharmacist call me a drug seeker when I changed from one Dr (that I had been going to for 14 months) to a new one, to refusing to fill a script even though it was the same day the dr wrote it to be filled and I would b out of meds that day, to calling the dr EVERYTIME enough that even the dr asked what the problem was, and just b plain rude!! I'm sorry, but I hate going to the pharmacy!! I look forward to a dr opinion of why they wouldn't want to carry a certain med.


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PostPosted: Fri Jan 13, 2017 3:59 pm 
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There are certain pharmacists who are idiots and still believe that addiction is a moral failing rather than a brain disorder. They are wrong! Hold your head up high!

I want to give everyone a link to a video on youtube by a doctor who studies addiction medication. She has a good way of explaining opiate addiction and how buprenorphine helps.

She leaves a couple of important things out, like that suboxone binds to opiate receptors so tightly (she does mention that) that the medication prevents opiate addicts from overdosing! She also doesn't realize that buprenorphine takes away the physical cravings and obsession to use your drug of choice. However, the rest of her information is pretty right on. Check it out:

https://www.youtube.com/watch?v=vqY-k7Tm_Ns

Try to avoid the videos of people who are just trying to scare people about suboxone that are on the same page. But definitely follow up with this link to Dr. Junig's videos!

https://www.youtube.com/results?search_query=Dr.+Junig+

Amy

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PostPosted: Sat Jan 14, 2017 9:35 pm 
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Hmmm, my doctor ONLY prescribes generic buprenorphine, b/c it is so much cheaper, unless someone or their insurance wants something else. She says that the naloxone in Suboxone is a scam to jack up prices, that people who'll shoot plain bupe will also shoot Suboxone, so there's no real deterrent.

I'd print out goodrx coupons for each drug formulation - show them to the doc and explain how much money you could save. Be straight about your injection history, if you've ever injected


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PostPosted: Sun Jan 15, 2017 9:23 am 
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Quote:
I have never had any contact from the DEA except 3 years ago when I asked to increase my cap to 100 patients.


That patient cap thing seems like pure idiocy.

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Generic Suboxone


I didn't know there was such a thing. If so, I want it! We're talking about the 8 mg bupe/2 mg naloxone?


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PostPosted: Sun Jan 15, 2017 9:59 am 
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Morning ,
A few thoughts and facts.
First off, Amy has give a great learning tool, UTube video s. There you will also find Dr Junigs Addiction Remission channel. Watch them ALL folks. Great place to learn! !

There are Two types of bupe. Plain Buprenorphine. And Buprenorphine /Naloxone combos.
Subutex /Generic Buprenorphine, has no naloxone. This product is almost impossible to get from most drs in the U.S.
Why?, fear of diversion fed to them from bad media and DEA frowns on it in most states. That is the short answer.
So, now we have several other products. All are bupe/nal combos: 2 generic tablet s made by two pharmaceutical company s .Activus an Anmel.... (sp)..
A newer fast desolving tab called Zubslov. . .
And newer film/patch for the cheek called Bunaval. These two products have a faster and quicker uptake/bioability. Both come with company discount cards
And of course Suboxone Film. Discount card also..
So this gives us at least 6 different products of the same active ingredient, Buprenorphine. Bupe is bupe folks. How you take it, how much you pay for it is up to you and your Dr.

Hope this helps alittle.....

Razor r...


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PostPosted: Sun Jan 15, 2017 12:30 pm 
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KnockedOut I can assure u that ur doctor is unique to the fact of only prescribing plain buprenorphine. That's not usually the case. Now I definitely do not think there's some kind of conspiracy with naloxone going on, that sounds kinda crazy. Regardless though, most doctors don't favor plain buprenorphine over buprenorphine with naloxone for all the reasons Razor said :)

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PostPosted: Mon Jan 16, 2017 7:13 am 
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I didn't mean to imply that there's a conspiracy of any kind - just the fact that adding naloxone to the bupe makes it cost at least twice as much (and in the case of the name-brand products, 3-5x as much). My doc said that she is pretty certain that the naloxone doesn't benefit the patient in any way. I asked, 'but what about the injectors who would inject bupe but not bupe/naloxone?' and she said that she'd never encountered such a person. She said she's had many heroin-injecting patients inject their meds, at least initially, and the naloxone in the original Suboxone was not a deterrent to any of them.

I think it's possible that there are regional differences in what doctors prescribe. From the research I've done, it seems like in San Francisco (where I live and where my doc practices), doctors are fine prescribing bupe without naloxone, and plain bupe appears to be the preferred formulation (in that pharmacies carry it, but have to order the other naloxone-containing products). That may have something to do with the liberal politics here and the general distaste for both pharmaceutical companies' high drug prices (can't even tell you how many protests I've seen against Gilead's prices on Hep C meds) and a hatred for the War on Drugs/the DEA telling doctors what to do.
But those are suppositions on my part. No idea why it would be so different here. Perhaps b/c there are so many docs with the DATA-waiver that patients have more choices. It's not like in some other areas where only one or two doctors prescribe buprenorphine and those docs have their patients by the you-know-whats.


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PostPosted: Mon Jan 16, 2017 3:05 pm 
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I misused the word conspiracy I think. I was actually just referring to ur earlier comment that ur doctor thought naloxone was a scam.... I think that's the words u used. So no worries, I used the wrong word when I said conspiracy :)

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PostPosted: Mon Jan 16, 2017 3:28 pm 
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jennjenn wrote:
I misused the word conspiracy I think. I was actually just referring to ur earlier comment that ur doctor thought naloxone was a scam.... I think that's the words u used. So no worries, I used the wrong word when I said conspiracy :)


I bet a bunch of high paid suits got together looking for a way to charge more money and one of them eventually said "I know...lets....."

And the other suits pounded him on the back and congratulated him because they were all going to get even richer. Then before they shut the lights out to go home one of them said. "Well you know, it won't really work. These kids are going to shoot the stuff up anyway and there's not enough naloxone (or whatever the reason is it doesn't work) to stop them."

And the first guy replied, "I know. But let's do it anyway. And of course we'll keep this among ourselves."

I'd say that qualifies as a conspiracy. :D

Or perhaps they had good intentions but then found out it wasn't working. They have to know by now. And they're continuing to market it under false pretenses anyway. That qualifies as a conspiracy too.

con·spir·a·cy
kənˈspirəsē/Submit
noun
"a secret plan by a group to do something unlawful or harmful."


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PostPosted: Mon Jan 16, 2017 3:50 pm 
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Very true Godfrey!!! Lol :)

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