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PostPosted: Sat Dec 26, 2009 4:25 pm 
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Hi, I am a long time heroin user who has failed to maintain any consistant sobriety though I have been struggling for years to get clean. I have decided to try suboxone treatment and I have many questions. But one of my main concerns is cost b/c I dont have health insurance. I was wondering if some people could tell me how many doctors appointments they had in the first month of their treatment? Also is there a consultation appointment before induction or did anyone do it over the phone? Is anyone in a similar situation and did they find a way to limit visits? Medicaid is not an option so if anyone has any experiences or advise they can share I would be very greatful. Mostly I just want to know how many appointments I should anticipate having to pay for during the first couple weeks or so. Thanks!


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PostPosted: Sat Dec 26, 2009 5:21 pm 
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Welcome.....I am glad you are considering this alternative. Suboxone gave me my life back. This forum is definitely the right place to learn all you can about the pros and cons of Suboxone. First off it doesn't matter that you don't have insurance...I have great insurance but once I started calling around it was cash only(not sure why of this trend...maybe because we are addicts). I found where some Doctors wanted $400 for an induction fee. My personal experience was $100 for 1st visit..had to return in 4 days (another $100)...drug test ($50)...two weeks later another $100 then $100 every month plus $50 for drug test. The biggest obstacle you will probally face is the cost of subs..luckly my insurance pays a big portion but I know others that pay $500 a month. The word is a generic is coming soon and is already out in subtex. Do not let this discourage you...think of all the money we spent on street drugs. I am sure others will post thier experiences here for you. I wish you luck and I hope you make the move......Good Luck


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PostPosted: Sat Dec 26, 2009 6:32 pm 
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Welcome!!!
I have been on suboxone for a little over 2 years now. Most insurance companies wont pay for the doctor visits and it has to do with the diagnosis code which is opiate addiction and they don't consider that a mental health issue, so from my experience my doctor too only excepts cash. Initially my first appointment was $90 and he did not require a drug test and he wanted me back in 3 weeks then after I see him exactly every 4 weeks.
Maybe you should check with your doctor to see if you qualify for the patient assistance program through the company who makes suboxone, its a long shot but I was accepted and This is how it has worked for me. I pay my $90 per month and my 30 day supply is shipped to my doctor each month by the company and I go and pick up the meds for free. So in all I pay the $90 for the Doc and the meds. The only catch to this is your doctor has a limited amount of spots, something like 2 or 3 depending on the number of patients he sees, so if he has a place available maybe you can fill out an application.Oh and by the way the program lasts exactly 12 months. Requirements are the patient has to be without health insurance, and your yearly income has to meet their requirements and then you are on your way. I filled out the application and within 4 days I was approved and my suboxone was sitting at my doctors office!
I too am a recovering heroin addict and I have to say that suboxone and being involved with some kind of therapy group has saved my life. I hope things work out for you and you continue to keep us posted on your transition, God Bless and take care.


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 Post subject: Drs. Apts.
PostPosted: Mon Dec 28, 2009 10:20 am 
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Hello eastchesterny,
Welcome to the site. I think you are in the right place for info on Suboxone. I can only relate my experience with the drug that saved my life! ( SUBOXONE). I do have health ins. and my Drs. apts. are covered. I have an HMO plan in Mass. and I only pat my $20 co-pay each apt. Asw far as apts. go. I started on Subox. Feb. 2009 and have been om 16mgs./day from then till now. I have to go every two weeks for my script (28pills) and my co-pay on the meds. is $50./script so $100. per Month for me. I also go to therapy 1 a week and that is also $20. co-pay! I hope this info helps you. I also so wish you luck in your journey towards sobriety. I have found it to be a whole new way to live and i'm enjoying every minute of it. Check back and let us know how you make out!

God Bless
Tom


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 Post subject: Thanks!
PostPosted: Mon Dec 28, 2009 1:32 pm 
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I just want to thank everyone who has taken the time to answer my question, I really appreciate the information and I will definately let everyone know how things work out.


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PostPosted: Mon Dec 28, 2009 8:00 pm 
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Hello!!

I have been clean off of full agonist opiates (last use 6-19-2009), clean date: 6-20-09....but I did not start suboxone treatment untill 6-22-09. Just over 6 months on suboxone and thanking every minute of it, and so are my family and friends!!

My FIRST suboxone doctor was $150 for first visit, 10 mins--piss test some paper work and script---gone. I took first dose as soon as I got to my truck and out from pharmacy. Every visit there after was $100. That included piss test and 2 mins to get script, sometimes 4 or 5 mins. The first month was like, 1 week, then once every 2 weeks for a lil bit, then I think we got to once a month or close to it but we did not see eye to eye at all. That is a VERY long story, but I found another doctor and went 6 days with out in between (because of scheduling difficulties) and switched. I have been with my 2nd doctor, and current, ever since.

My current doctor charged $250 for first visit, and charges $100 for the rest. It is always once a month. He usually gives induction in his office, but I was already on them for a couple months so we just talked a while along with standard paperwork and then he wrote the script...I guess he probably should have just charged me for the regular visit for the first becuase of no actual induction but I did not care. A bit longer than first doctor, but very different. Very understanding. The regular visits are just every month, we talk for a bit, get my script and I leave. He highly suggests 12 step programs, but it is not required as I had found out recently.

I also do not have any insurance because I own my small business, am 'self employed', rates are crazy high for me. I also have pre-existing condition with a really 'effed' up back, so that totaly does not help!! All the doctor visits are paid cash. My first required you pay before you can even give a piss test, let alone see the doctor.... but my current doctor takes care of you first and then you pay the ladies at the front, like most family and other doctors. His ladies even take temp, blood pressure, weight and few other things. First doctor did NOTHING of the sort.

The price per pill at Rite Aide in North East PA a couple-few months ago was just around $6 per pill, actually a few cents more but I forget exactly. The price I pay now in southern NJ at a Rite Aide is ~$6.50 per pill..... ~$292.something for a month script of 45 (12mg per day). I actually have my next appointment in couple days, so if it changes I will let you know. But, all in all, with travel expenses (tolls, bridges, fuel, etc etc), doctor appointment, and script cost I am paying about $500 a month. Well worth it to me. Plus it is over 125 miles each way, and 2.5-sometimes 3+ hours each way depending on mother nature and mainly traffic.

Thanks for listening!! I am not an expert nor doctor.....just an addict....take my advice for what its worth, it is MY experience. Good Luck and Take Care!!

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"The past is finished. There is nothing to be gained by going over it. Whatever it gave us in the experiences it brought us was something we had to know."----Rebecca Beard

"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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 Post subject: Update
PostPosted: Tue Dec 29, 2009 4:36 pm 
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I actually got in contact with a Doctor who had reasonable prices, by no means cheap though, and I set up an appointment for Friday for induction. Mostly what convinced me was that he spent the time to talk with me over the phone for about an hour and seemed to be genuinely passionate about recovery and patient wellbeing. I am supposed to see him twice in the next month and then once a month for the duration of my treatment. Another thing that appealed to me is that he said he's not into pushing people to come off the medication until they are ready. For me this is going to probably be a multi-year commitment and it's good to know that he takes every case individually. Thanks again everyone for all your advise and help, it really helped me make the decision to go through with this.


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PostPosted: Tue Dec 29, 2009 5:10 pm 
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Good for you! I am glad that you hopefully have found what suits you best! Good luck and keep us updated...

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"The past is finished. There is nothing to be gained by going over it. Whatever it gave us in the experiences it brought us was something we had to know."----Rebecca Beard

"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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PostPosted: Tue Dec 29, 2009 7:00 pm 
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Eastchesterny,
I'm so glad that you are on your way!!!! I chose the doctor that I see for that same reason, passionate, and would allow long term use of suboxone. He said that when I felt ready to come off then we would do it but for me to realize that this is a disease and this disease requires medication and some people need this medication for life. It gives me hope and I plan on staying on this medication for as long as I am able. I have been in active addiction for over 10 years and have never been able to accumulate any amount of clean time until now and its been over 2 years and Im actually clean!!! And I don't fell guilty for using suboxone, its just another part of my life that I have come to terms with. The best part about this med is I don't have those awful cravings anymore, I don't obsess over how and when Im going to get my next fix, it truly has saved my life! Please feel free to get in touch anytime, and if you see my in the chat rooms please say hi!


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 Post subject: Another Update
PostPosted: Mon Feb 08, 2010 2:09 pm 
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Well, just to update everyone. I did not get on suboxone for reasons outside of my control. My family was going to help me pay for it because I am out of work and had no means on my own (In case anyone wonders how I paid for my drugs on the street, I did so by dealing, something I couldn't keep doing if I was planning on staying clean with suboxone). Anyway my family only agreed to help because they didn't know that the drug was for people currently using opiates, I had sworn to them over the past month that I was clean, and when they found out they told me they weren't willing to help. I don't blame them at all, they have done alot for me in the past and they probably just saw this as another way to throw away their money. I tried being honest but it was too late. However, I found another option; one that I have concerns about but one that I can afford: methadone maintenence. This isnt a methadone forum so I wont post my experience (suffice it to say that its working, im doing well, and i can afford it since it's free with medicaid; something suboxone is not since no doctor would take any kind of insurance). But anyway thanks everyone


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PostPosted: Mon Feb 08, 2010 10:33 pm 
Thanks for coming back and letting us know how you're doing!
While this forum is mostly about our experiences with buprenorphine, I think the main focus is recovery in general. So please feel free to visit and post. I personally won't be able to help you much when it comes to Methadone maintenance in particular because I don't know that much about it. But I'd love to hear about how you are doing in recovery.
Congratulations for finding a way to get into recovery! I'm sure it took a lot, since you aren't getting any support from your family. In my opinion, anyone who is that ready to fight this disease is to be commended, so good for you. I hope everything continues to go well for you. Who knows, maybe someday, if you desire, you'll be able to make the transition to bupe.
Whatever happens.....stay focused on recovery and 'keep doing the next right thing', as they say. Take care of yourself!


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PostPosted: Mon Feb 08, 2010 11:46 pm 
I hate hearing about these docs that require multiple unneccesary repeat appointments and only take cash. Doctors that do that are IMMORAL. It's not that the insurance companies won't pay for Suboxone related visits, because the visit is billed as a regular office visit just like any other. The reason the doctors want cash is because they are predatory and know they can take advantage of the less fortunate in society who must pay them high cash prices to find relief for their burdens. My doc takes insurance, requires only one intake appointment, and requires only one check-in visit every three months. There is no reason to even require a compliant patient to come in once a month. I pay no co-pay for my visits, insurance covers all of my pills, and he gives me a 30-day prescription with 2 refills every time I see him. He told me to never go to a doctor that only takes cash for prescribing Suboxone or any other drug, as this is a dead giveaway that the doctor doesn't give a damn about the good of the patients, but only cares about lining their pockets. And a good doc will be able to titrate you up to the correct dose in one day or two at the most. You don't need to come back every week for the first month and every two weeks after that and all that crap. What a bunch of bullsh*t. It's so sad.
JD

ps....Suboxone is NOT only for people who are currently taking opioids. It is also for those who chronically relapse and are at a high risk of relapse. I had just gotten released from my 6th stay in jail, a 13 month sentence for prescription fraud (trying to get painkillers illegally) and I hadn't used opioids for over a year when I went to my Suboxone doctor for the induction visit. However, It was a matter of days before I would have used illegal means to get prescription painkillers. My doctor said it was absolutely appropriate to prescribe Suboxone to someone who wasn't currently "using" because I still had the disease of opioid addiction with the intense and uncomfortable cravings, which for me inevitably resulted in substantial life consequences such as jail time, overdose, and further alienation of my family. So for me it was either legal Suboxone or illegal oxycodone. And 5 months later, my life has totally turned around, and my future looks wonderful. Also, I have Medicaid/Medicare and that's what pays for my doctor visits and 100% of my Suboxone. I'm in Virginia, so before you give up on Medicaid paying for Suboxone make sure you verify that that's really the case!


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PostPosted: Fri Feb 19, 2010 11:31 pm 
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east chester:
Thanks for the update! I am glad that you have found help at least with your recovery. There is NOTHING wrong with methadone if used properly to stay out of active addiction (or for pain for that matter). ME personally, I choose suboxone. That means nothing though, because it matters what works for YOU. If you cannot afford suboxone, things aren't working out with it, then do not feel as if you failed or took a step back in recovery just because you are on methadone. I am very happy that things are going 'well' at the moment. I have limited experience with methadone, but if you need any help or any questions answered, please just ask and I will do my best to assist you or lead you in the right direction. Good luck and take care!!!

_________________
"The past is finished. There is nothing to be gained by going over it. Whatever it gave us in the experiences it brought us was something we had to know."----Rebecca Beard

"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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 Post subject: Your choice is fine!
PostPosted: Sat Feb 27, 2010 1:49 am 
Yes, I wanted to say that Methadone is also a perfectly fine choice. It has helped many people and, if you are truly motivated and have the correct intentions, it can help you as well. One thing: make sure you are receiving a dose that is truly keeping your cravings at bay. Sometimes the clinics undermedicate. If they won't give you enough, move to another clinic. That's actually a common problem, so don't blame yourself if it happens to you. If you do some research on the history and present condition of the Methadone maintenance clinic system in the United States, you will learn this and a lot of other interesting things. Many people will tell you how "evil" Methadone is, how it "gets in your bones", but this and most of what you will hear is just myth. With the right dose and intention, it can work. However, it will be worth your while to research carefully to find a reputable Methadone clinic that will meet all of your needs. Like I said, some clinics like to undermedicate, and some clinics withhold the Methadone dose if you miss a payment. That is ILLEGAL. Legally, the clinics must works with you to make payment arrangements, and they cannot withhold the medication once you are on it. Beware of any clinic where the staff is actually taking Methadone themselves, and/or they are selling it on the black market. And remember, your circumstances may change in the future, allowing you to switch to Suboxone.

Also, if you have financial issues, you need to go to your city's Social Services office (or equivalent) to apply for Medicaid and/or other prescription and medical assistance. Also go to your city's Substance Abuse Services Board or Mental Health Center or whatever deals with these kind of issues. Some cities have grants available for low-income substance abusers to pay for Methadone and other treatment protocols. They can also give you info about possible alternative housing, because it sounds like your staying with your family is probably not very good for you or your recovery. For instance, there may be housing available for addicts that take opioid maintenance such as Methadone. Then you would have support for your recovery 24/7. The mental health/substance abuse department people can also hook you up with mental health treatment if you need it. This would include personal counseling/therapy and possibly psychiatrisy visits with medication managelment. Also, they could help you apply for Social Security Disability benefits if you are eligible. Unfortunately, even though drug addiction/dependence is a mental disease, it is NOT considered a reason for a disability determination by itself. They would have to determine if you are eligible.

Basically I'm just hoping you realize that you have a lot of options. You don't have to depend totally on your family. If you're in a small town, get online or get a family member to get online and research options in the nearest semi-large city for drug-dependent individuals seeking recovery. Bigger cities have more resources, usually (but that's not always the case at all). The bottom line is that YOU have to take control of YOUR life and YOUR recovery. I know it's hard, it's hard as a BITCH, but you can do it. We all eventually have to change. It's just a matter of when. Good luck!

james


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