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PostPosted: Thu Feb 16, 2017 5:12 pm 
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Hi everyone-

I have been reading for a long time now, not really posting. I started buprenorphine treatment in early Nov '15... (my story is too long for here but regardless, not the point) - I don't have insurance so I have been paying cash since I started. The Doctor's visit is $140/mo (I was led to believe it's actually $100, plus $40 for the urine test, which is of course mandatory) ... When I first started, the doctor prescribed me Zubsolv because it had a discount card program (Similar, I guess, to Suboxone) but was less than half the price. I asked a few times about generic versions, and he admitted there was a cheaper product called Subutex (buprenorphine only, rather than bupe/nalaxone) but in his views that was not for Opioid Replacement Therapy since "it doesn't have the blocker" ..... I well know that the buprenorphine itself, not the nalaxone, is responsible for the 'blocking' but I am not going to argue with the doctor, who all in all is a pretty good guy. ANYWAY. Initially, for 60 Zubsolv 5.7/1.4's was like $350... then after a month or two it went up to $370... then $385... then almost $400. (The mfgr of Zubsolv has raised their prices almost every 3-4 months it seems.) I again asked about the generic Subutex, based solely on the financial aspects ( I really have no problem with Zubsolv, nor nalaxone, no problems here.) -- Again I was told, .... no.... maybe after a year or so of perfect record etc. I wound up having to cut my dose to 1 1/2 from 2 tablets a day, so I'd only be buying 45. They raised their price again, I went down to 30 tablets (1 a day) a few months back. But I am not feeling the same, gaining weight, less active, etc. Plus financially it's a big, big expense.

This month I approached my doctor and explained, "I felt much much better with 2 tablets, but I'm really thinking I'd be fine with 1 1/2... but I simply can't keep spending $215? for 30 tablets a month, $325? for 45.... plus $140 a visit a month... please, considering the fact I have had an absolutely perfect record since day 1, reconsider the generic buprenorphine for the financial aspects." -- He actually agreed this time, said he would rather me be healthy and happy and not worry so much about the money issue. So I will be switching to 8-12mg buprenorphine a day from 5.7mg Zubsolv (bupe/nalaxone that supposedly has the same bioavailability as 8mg Suboxone/subutex)





SO after all that, in a few days I will fill my first Subutex/buprenorphine script. I was wondering what I am looking at as far as costs? I could not care less the 'brand' of the generic, frankly I don't believe there's much difference but am not looking to start that argument. I am just wondering what I am looking at bill-wise. The internet seems to have every price under the sun, from $1/pill to somewhere between $1-2 a pill to $4.40/pill to even higher. I am just wondering if anyone can provide actual (and fairly recent) prices? Thank you very much!


Last edited by SerBarristanSelmy on Tue Feb 21, 2017 11:07 pm, edited 1 time in total.

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PostPosted: Thu Feb 16, 2017 5:46 pm 
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Call the pharmacy you plan to use. Locally price can vary by quite a bit, just like you have found.
Congrats on breaking ground with your doctor. Expect that perhaps they will be watching very closely and you would be setting a precedent for anybody else in your circumstance.
For me, I haven't seen any problems with my buprenorphine patients vs. the buprenorphine/naloxone patients.
Welcome to the forum :roll:


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PostPosted: Thu Feb 16, 2017 6:18 pm 
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docm2 wrote:
Call the pharmacy you plan to use. Locally price can vary by quite a bit, just like you have found.
Congrats on breaking ground with your doctor. Expect that perhaps they will be watching very closely and you would be setting a precedent for anybody else in your circumstance.
For me, I haven't seen any problems with my buprenorphine patients vs. the buprenorphine/naloxone patients.
Welcome to the forum :roll:



Thanks very much Doc. for your time and help. I will probably do that.

the problem I have with calling the pharmacies is that the second you mention an opioid medication, a pharmacy thinks you're bamboozling them because you're a hardcore dope-dealing street despot looking to bamboozle them and commit felonious assaults on society.

I was just hoping someone had the ability to say, "Yeah I'm paying $x/pill these days" but I guess I will know soon enough,


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PostPosted: Thu Feb 16, 2017 6:22 pm 
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Hey Selmy.

Like docm2 (he's a doctor btw) I'd call the pharmacy too. That's exactly what I did bk before I started suboxone. I ended up using the pharmacy my doctor told me to go to for my induction. In my area, just like most I assume, prices vary. So what costs here will be different there.

After I started my treatment, my medicine went up 50 cents every month 3 times. It's stayed the same since then though thankfully. I pay cash also. Cash for my doctor each month plus medicine, and here, I pay $9 a strip! So I understand fully about the financial part. But as long as I'm out of active addiction I'm happy :)

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PostPosted: Thu Feb 16, 2017 9:32 pm 
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I am EXCITED to answer this one!! And I get no commission-- but the 'goodRX' app for phones is simply incredible. They also have a web site-- I think it is goodrx.com...

Gosh, I sound like one of the emails I get in my spam folder.... but I have a high deductible, so I use it all the time. It tells the prices for meds in your area; it does not usually include the small, independent stores, but all of the chain store prices are there-- and the coupons are incredible. I often have patients use it for Abilify, which costs over $900 for cash, but costs about $120 with the goodrx coupon.

I don't know if the coupons will save you money with buprenorphine, but the app or web site will at least tell you the prices at each store. I don't know the mechanics of it-- how they make a $300 script for Lunesta go for $34... but it works. Every now and then I've had a pharmacist say 'those cards don't do anything'. I'll say 'I know-- but could you please try it?' The pharmacist punches in the numbers from my phone, and then starts asking me where I found the app.

BTW-- in my area, plain buprenorphine, 30 tabs, costs about $70. I'm glad your doc finally saw the light-- because in the absence of injecting, they are the exact same medications. And frankly, even people who inject bupe vs the combination product say that they feel about the same.. but I'll save that for another post!


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PostPosted: Sat Feb 18, 2017 3:45 pm 
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suboxdoc wrote:
I am EXCITED to answer this one!! And I get no commission-- but the 'goodRX' app for phones is simply incredible. They also have a web site-- I think it is goodrx.com...

Gosh, I sound like one of the emails I get in my spam folder.... but I have a high deductible, so I use it all the time. It tells the prices for meds in your area; it does not usually include the small, independent stores, but all of the chain store prices are there-- and the coupons are incredible. I often have patients use it for Abilify, which costs over $900 for cash, but costs about $120 with the goodrx coupon.

I don't know if the coupons will save you money with buprenorphine, but the app or web site will at least tell you the prices at each store. I don't know the mechanics of it-- how they make a $300 script for Lunesta go for $34... but it works. Every now and then I've had a pharmacist say 'those cards don't do anything'. I'll say 'I know-- but could you please try it?' The pharmacist punches in the numbers from my phone, and then starts asking me where I found the app.

BTW-- in my area, plain buprenorphine, 30 tabs, costs about $70. I'm glad your doc finally saw the light-- because in the absence of injecting, they are the exact same medications. And frankly, even people who inject bupe vs the combination product say that they feel about the same.. but I'll save that for another post!




Awesome thank you very much Doc ! I pulled it up, the prices look much better than what I was paying for Zubsolv, depending on the pharmacy it looks like anywhere from $2.25-$3.25. I have been using a small independent pharmacy actually, if for no other reason than the day I first went into the doctor I was very sick and weak, and he mentioned that he was not 100% what local pharmacies carried the Zubsolv in stock other than one particular one he knows carries it, so I went there and have been going ever since. I will check with them to see if they can honor the GoodRX and if not, I'll have to go somewhere else. Actually I just rechecked and they have a card you can print out to hand to the independent pharmacies, and it says on their site, if the pharmacy doesn't "take it", ask them to call them, they can probably straighten it out, so looks like I might be gravy. Thank you again Doc, much much appreciated sir.





And no, no risk of injection for me. My story is pretty long but I might as well tell it. I have a ton of respect for you and your story, in fact I remember reading your magazine article many years back, when I first found this website I thought it was awesome when I found you were the same doctor. A condensed version of my story is below. It is very long. If anyone wants to kill a few hours.







I had injured my back at work in fall of '08. I am a sommelier and was in the retail booze biz at the time, one day I decided to help the boys out packing out cases (which I did not need to do, but I was actually bored.) Lifted a case like I have a million times before, something happened. Later that day, it was getting worse and worse. Next day I knew I was injured and told the boss, "I think I really hurt myself..." the morning after I went to the hospital, I literally had to crawl to get to the bathroom in the morning, the pain was quite literally making it impossible to walk. The ER doc told me, if I was REALLY injured, I'd have never been able to drive myself. I wound up getting the work's worker's comp insurance to set me up with an orthopedic group, a few tests told me I had an annular tear of L5-S1, so I should rest and rehab and this that the other. Over the next 1.5 years I had all sorts of stuff... ESI injections... branch block, radiofrequency lesioning, more blocks, more ESIs, etc.

Finally a different pain-management doc that the ins. co. sent me to, who was performing the radiofrequency lesionings said, "You not only have a torn disc but the joint is collapsing. So you have a problem, eventually you'll have a bigger, possibly very big, problem. You should consider spinal fusion. If you have surgery now, when you're 28-29, you're recovery will be much, much better than if you go until you're 38, 39... or worse, 48-49.... worst case is you keep putting off, you get to be 50, 55, 60+ and then you wind up having terrible pain so you NEED to have the surgery, and recovery will be terrible compared to having had it as a young man..." Well I put the idea on hold, and promptly lost my job in early '10 because my (foreign, naturally) boss absolutely hated the idea of the GM and highest paid employee doing the least amount of physical work. In his mind, most pay, most work! (Nevermind the fact as a sommelier , and incidentally the manager, I wouldn't have had to touch a case ANYWAY, even had I NOT been injured...) So after putting the decision off in 2010 as long as I could, I opted to have surgery.

I was presented with a few options... I could have a few different versions of spinal fusion, the one most recommended was ALIF? Anterior Lumbar Interbody Fusion? through the front, (which at first I was like, NO MATTER WHAT I DECIDE, you are NOT cutting open my stomach, not going to happen, you guys are morons for thinking you can do spinal surgery through my front guts!!!), a different fusion from the back (which another surgeon agreed with the first, definitely worse to go through the back...) and I was also presented the option to have total disc replacement, Anterior Artificial Disc Replacement... this was rather new, I think it had only been on the market for a few years, but the surgeon said he had had much success and many great results, and unlike spinal fusion, I would lose no mobility at all... the whole reason for fusing the spine is to prevent movement past a certain point. But the prosthesis allows full (as near to full as possible at least) range of motion while theoretically removing all the pain of a bad disc. So I'm all about technology, I figured, this was the best to choose.


The surgeon said the surgery went perfectly. (They did go through the front. After a 3rd surgeon plus the vascular surgeon told me it was much better to go through my front, I acquiesced. Plus I was lucky in that the vascular surgeon who'd be doing my surgery was actually more 'famous' than the back surgeon, so I figured I was lucky in that regard.) The recovery from this surgery was pretty much the worst stuff I'd ever endured. It seemed like the surgeon's entire attitude changed after he operated on me, almost like he'd already "sold me the car" so didn't need to be nice. I was given shots of demerol and vistaril as pain control, which did NOTHING but make me sleepy. I had been taking percocets on and off for nearly 2 years by this point, (that was the only way I'd be able to keep working all the rest of 08 and all of 09, was pain medication) -- and I just had my guts cut open, disc cut out of my spine, and a prosthetic disc screwed into my spinal column. The doctor refused all the nurses requests to give me a PCA, refused a medical intern's request to change my medicine, and shouted down a med student who said there might be more he could do to stop my agony.... but apparently said med student's Mom or Dad was one of the highest ranking people in the hospital. Surgeon suddenly said, "Why didn't you just TELL me you were hurting!" and prescribed me a 25 mcg/h fentanyl patch. This in my opinion is where the real problem started.


Rather than prescribe me perhaps higher doses of oxycodone (OC etc.), morphine, hydro/oxymorphone, a PCA, any of that stuff, he went right to Fentanyl, because of course you can't abuse the patch, right? The fentanyl made a huge difference in pain, for about two-three weeks. I started noticing that percocet no longer had any effect, however. Then I realized the patch relief was wearing off, and I got put to 50 mch/h. This is the crux of fentanyl's problem... it *SKYROCKETS* your tolerance, faster than anything it seems, and as Dr. Junig is sure to remember, fentanyl withdrawal is *the devil* . HELL.


Eventually a few months went by after the surgery and the surgeon kind of was getting tired of me... "I don't know why you're still hurting.... the surgery went fine!" Insurance finally agreed to send me to their pain management doc they had sent me to a year or so prior, who is similar to Dr. Junig in that he was (apparently somewhat well-known and respected) anesthesiologist who went into pain management. A very scholarly, nerdy-type doc but i knew he was very smart. We caught up, I explained how I had had the surgery but rather than fusion I had the total disc replacement. He believed that was an error, as it is not nearly as well-received as it's made out to be, but obviously was not something that could be changed. He also believed my prosthesis was installed crooked, and was quite adamant it was easily proveable by taking my X-Rays and a ruler and measuring. The surgeon was equally adamant that was flat wrong, it was PERFECT... well... maybe a mm off.... then it was, maybe a 'couple of mm's off' but that's still in the range of perfect! -- Pain Doc says basically, you're probably having pain that is not going to get better, we bump up fentanyl to 75 mcg/h , 48hrs instead of 72 so I have less problems with patches falling off.... eventually up to 100mcg/h.

Over the next 2+ years things were okay. I would visit the pain management doc every 3 months, usually I'd see one of the two PAs, I tried many different combinations of medicines (I had read about opioid rotations and keeping the body and the receptors fresh etc. My doc did not really believe in that, but supposed it wasn't HARMFUL if it made me happy, but he'd just as soon I'd pick a medication and stick with it.) I tried things from extended-release-pellet hydromorphone Exalgo , to Opana ER (oxymorphone), even eventually tried the new-formula OxyContin (I hated that to be honest, never seemed to do anything. I never tried the earlier version, but the newer version was the least effective med I had ever tried.) Always came back to fentanyl, because nothing controlled pain and increased my mobility like the patch (I could play basketball with the patch on, literally changes the way I could go about life.) But always after a few months would want to GET OFF the patch, because it seems to catch up and the withdrawal is just *intense* and the patches are always falling off early or sweating off or not lasting as long as they're supposed to etc.

So moving right along. I had not seen the ACTUAL pain management doctor in about 1.5+ years, I'd wave in the office but the PAs would see me, then I'd leave, no problems. Early 2013 the actual doc came in the room for the first time in again, nearly 2 years. Hey Doc, LTNS, etc. How are you, how am I , etc. "What's going on in your life..." I mention that I have decided I am going to move down south with my Father eventually... he's retiring, I'm going to basically start over, and we're going to team up and build a house together... this is not soon, a long ways off, but just what i'm planning. it's almost like you could see, I suddenly changed from being a long-time-"customer" to nobody. "Oh. OK. Well I think we should try to do some injections and possibly radiofrequency lesioning on you to try and fix your back pain... I'll set you an appt for the first nerve block next week.." ------ But but but... I thought you told me, the source of my pain was clear, it was post-surgical problems that had nothing to be gained by cooking the nerves to squirting novacaine on them etc. IE the procedures aren't going to do anything for me, I'm a long-term medication person.... "Well no problem if you want to titrate off the meds we can do that too... We'll start today, down to 75 mcg/h"

Wait wait wait wait wait. Hold on. What just happened.

"Well if you don't want to do the procedures I am not sure I can help you anymore..."

"Ok do the stupid procedures."

"Ok sweet. See you at the hospital next week!"


I let them do the stupid nerve block, which if you say "Oh yeah it made me feel so much better" THEN you have another appointment for the radiofrequency lesioning. This supposedly cooks the nerves that transmit the pain, theoretically blocking the pain completely for a couple-a-few-months or more. Obviously this didn't help me. He himself was a huge proponent of the fact my prosthesis is askew, there is nothing to be done except medicate myself for tolerance of the pain etc.

Next month I go to the appointment, the doc wants to know , how did the injection go?! Lots of relief?! So we'll schedule the RF session... ? When I explained, no, .... no help... and how do I say this... I thought you had said... I'd never be having these procedures (where you have to fast completely past midnight, no water even, and wake up a 5AM to get to the hospital, and get IVs stuck in you, and wait half the day for your turn, and then get knocked out and needles stuck in your back, etc...) again and I was a long-term medicine person... it's not that i'm only here for the medicine, but really, that's what I thought I was here for. (I am sure I put it differently than that, but, it was clear to me he was not treating me the same.) From then, it was clear that all he wanted to do was either make money on me, or get me out. If I was leaving ( which was not going to be for a year or more, it wound up being a good 1.5 years+ from the time I told him we were planning on moving eventually. I thought he'd help me get a doc down where i'd move, everything was gravy etc.) Did I mention, he decides to "titrate me down to see if that helps my pain??"

So I am suddenly cut to 75 mcg/h. THEN COMES THE REAL FUN.

next appointment I am told... "Oh... we have some bad news. You tested positive for heroin last visit...'

I am no saint. Never have been, never will be. But I have never used heroin in my life. * I HAVE NEVER EVEN SEEN HEROIN IN REAL LIFE*. I believe I was in two places in my life (different times) where people had heroin or were doing heroin. Both times when I found out heroin was being done, I left. Until I started on opioid analgesics after my back injury, I DIDN'T EVEN KNOW HEROIN and pain medication were in the same family! *I did not use heroin*.

I vehemently deny this to the doctor, he said, "Ok, well, listen, all I'll say is, if you're using heroin, STOP. " BUT NO I AM NOT. "Ok well.... "

So now my visits have to be every month, rather than every 90 days. I come in again in a month. I actually filled my breakthrough medication (which was on a different schedule than my fent patches, and was I believe at the time 15mg oxycodones maybe 2 a day or something like that) the morning of that month''s visit. (The breakthrough medicine would never last me a month, I admit it. Some days are worse than others, etc.) Because I had not taken any in a few days, and the drug tests test for not only stuff you should NOT have, but to make sure the stuff you SHOULD have, and I was worried it would not show up, I took a couple extra. One immediately upon filling, one or two more before my visit. I did not want to show up negative.

That visit was non-descript other than the nurse/receptionist confronting me IMMEDIATELY upon arrival: " WE NEED YOU TO TAKE YOUR URINE TEST RIGHT NOW" yeah okay, no sweat. Geez louise. You'd think I have become a criminal or pariah around here.

Next month I am told, "You have tested positive for heroin again. " "ABSOLUTELY AND TOTALLY IMPOSSIBLE" --- "I thought you'd said that. But the test was conclusive, there can be no doubt, and there can be no other thing ... the test shows it's heroin positively" --- I have never even seen this drug. I mean, years later, on the internet, why would I lie? A Man has to have a CODE. I was no saint in college and probably drank more booze than battleships need to float them, but I have never even LOOKED at heroin. << I went home and researched and there are some metabolite(s) of heroin that supposedly are only produced by heroin. So if that is in the urine, it "proves" you used heroin. This is difficult for me to believe because the only thing I took was (extra) oxycodone that morning and my fentanyl patch. So obviously something is not "the only way it can happen" if I didn't actually consume the requisite substance to form that metabolite.>>

After that the doctor clearly did not trust me anymore. I saw him a few more times.... each month I'd walk in the door and have a urine cup stuck under my nose. Maybe 2-3 months after that, we were talking about medication and dosage and scheduling, and we had what I thought was a very simple, minor disagreement. Not a fight, no major problem, just me saying "Well I am not sure I agree with that," and being told back "I don't care , it's not your opinion that matters" ... well then! i shut my mouth and left without any more problems.

Two days later I get a registered letter explaining for repeatedly violating my contract I was being discharged. Under the necessity of the law, he would continue to care for me for 30-days "in case of emergency" but I'd prefer it if you didn't take me up on that. I suggest you look for some alternative and holistic approaches to healthcare and pain. PS Enjoy the withdrawal sucka!" I was half heartbroken and half SO ANGRY.


I had the prescription he had written me in the office a few days before, to be filled in a few days. So I knew I had at least "some breathing room before withdrawal" -- so to speak. I want to make sure I convey my emotions at the time, because the decision I made (to do, basically, nothing... to not fight...to basically 'give up' , is something I not only regret tremendously but really cost me a ton, both emotionally, metaphysically, and certainly financially) ... I was so upset at this, I felt like, here is another time in life, I get screwed when I didn't even DO anything. If I had got drunk and did something stupid and wound up in jail, at least I would have been able to say, "Well you did it ... you drank, you did whatever you did, you earned it." But I REALLY, DID NOT EVER, still have never, even looked at heroin, let alone use it. And frankly I trusted my doctor a little bit more. I realize Joe Jerk Sixpack going to the doctor complaining about his poor hurts and asking for [insert random narcotic analgesic here, let's say oxymorphone] , the doctor is going to be suspicious, vigilant, and of course, going to be making sure this man really does have the poor hurts he complains about. I felt like, I was DIFFERENT. I clearly had a problem. You [the doctor] and I, and the surgeon, and the insurance company, and everyone else knows I had this major surgery, and you can look at the scar across my abdomen, and my x-rays, and see the prosthesis... Which of course this genius doctor insisted was installed crooked, and would remain askew in my spine pretty much forever.... so the mechanical pain I'd have would probably just 'be there'. So I'd need medication. ---- Now I want to make clear, I absolutely HATE the word "entitled" or "entitlement". Generally, 99% of the time someone says they're entitled to something, they're not actually entitled to it or it's a ridiculous situation. Having said that, I felt like, if there is a class of people who are 'entitled' to significant pain medication, I was in the club.


So I was so pissed, I just used the medication I had, said to myself, "I'll show this mofo... I'll take it like the hard man I am , suck it up, go through withdrawal, and just be free of this stuff." Obviously, that did not happen. It was not long before I was in withdrawal and I had no options... there was no "prescription refill day" I could look forward to, I was not going to be getting another doctor because surely if I tried to go to another doctor, the insurance company would have said, " You got bounced for violations, why would we let you go to another??". (That was something particularly incensing me, I felt like my good name and trustworthiness were unjustly and unfairly ruined.) As I said, a Man has got to have a code. I come from a LEO family. I made a point to never use heroin in my life, I certainly was not going to start NOW, having lost my medical care and medication due to a false claim of heroin use and a doctor who suddenly started treating me different when he found out I would eventually be leaving. ..... So I started doing some emergency research, a forum somewhere suggested people in distress should try Poppy Seed Tea.

It actually really worked. I got a pound or so of seeds from a local Polish store, and after a bit of experimentation, it was eye-opening on how well it relieved withdrawal, and even kept me feeling good for an entire day into the next. But soon enough I needed more seeds...and I was making bigger batches and drinking more... and buying a lot of seeds... it got to the point I had to stop buying from the store because it was too obvious, what the hell is someone doing with all those seeds?! So I would order 50lb. bags online, and I'd use 10lbs. at a time, to make a batch that basically lasted 2 full days. Which meant I would need 3 orders a month.... and suddenly 2 years had gone by with me living on poppy seed tea. It sounds ridiculous but, it was in my mind the only option. I could not go to a doctor and do what, beg for pain medicine? No. Too embarrassing. I could not go to a Suboxone doctor because it would be much too shameful. I would not buy street drugs and even if I wanted to, from who? And how long could that go on? I hear any decent pain medication is literally through-the-roof price on the street, so a $100 pill is not going to do me much good.


Finally in November of '15, things came to a head....I had ran out of money, was charging up the credit card to buy the seeds but not being able to pay for them... got confronted by the family, had to admit it , and had a very rough week. Decided I had to go to a Suboxone doctor for help, because I simply could not go on feeling like death and could not do it alone. Luckily the doctor was very nice, and I have been gravy ever since.


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PostPosted: Sat Feb 18, 2017 10:37 pm 
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Hey Ser,

I'm sure more have/will read your unfortunate story. One respected member Godfrey also spent some time w poppy seeds, I recall and hoping he read you story.

I'm on the run trying to get to an event tonight but had a couple of thoughts. When your pain mgt Dr walked in after ~1.5 yrs, IDK, he may have been looking for an excuse to change up your relationship there and your moving was simply incidental. Who knows. maybe your dose started looking too high. Or some clinics changed to only prescribing meds if the pt was also getting more $$ procedures. Or their office was reviewed by DEA or... We have pain mgt stories here where folks get dumped or tapered down...
Have to ask, did the letter really say "PS Enjoy the withdrawal sucka!" or is that how you felt it meant?

Man, I understand on how quickly fentanyl ramps up. fast. That quickly ended up as my doc. And i too identify w Dr J after I spent 30 days in pure misery in rehab and left to start bup. I'm now off bup for awhile but I'll never forget that. Ever.

I'm glad you are here and glad you got on bup. Sorry your path to bup was long and so painful. Question - how is your disc replacement doing and its related pain? Many times, including me, we see pain pts and the pain we thought we had, well its just not there or barely there anymore. Others here, well their pain is only partially or not at all covered by bup.

That's all I got right now. Again welcome to a great place - of real recovery and hope. Wishing you my best, P

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PostPosted: Mon Feb 20, 2017 1:47 am 
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Wow, what an unscrupulous doctor! I am so sorry for the way he just dumped you! Couldn't be more obvious.

Amy

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PostPosted: Tue Feb 21, 2017 12:55 pm 
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Pelican,

Thanks very much for not only taking the long time to read that dissertation, but responding. I typed it out in two different sessions so it wound up being much longer than I realized.

I really don't know how to think on that doctor. I really did like him, I really did trust him, and I'm quite certain he's very well respected and high-up in the ranks. But I just glossed over the story as best I could , there were other little things that suddenly changed etc. I can be told "You will need these medicines for your entire life, so don't you dare feel any shame in it or let anyone look down on you. If you were diabetic, you'd need insulin for life, and not let anyone shame you, right??" for 3 years, and but things started to change and it's like I'm chopped liver all the sudden and then suddenly one day it's like "Bounce outta here you busted beeatch."

^^ Let me take that opportunity to say, no , the doctor never said "Bounce outta here you busted beeatch" or "Haha have fun with the withdrawal sucka!!" -- that was my own little artistic interpretation of the pointed, direct and basically cold/calculated words in the letter I got.



Now as far as the pain. Well, yeah. It sucks. It's not so bad some days, others, bad. Just recently in the last month or two I have been getting a lot of the old "weather related" pain on rainy or stormy days, whereas I hadn't been dealing with that much since I moved down south. The day I went to the suboxone doc for the first time, I was extremely weak from a week's withdrawal and my back was KILLING me (probably in no small part aided by the withdrawal) I had to sit on a bucket, back against the wall, in the shower, so bad. ... the doctor actually assessed me and said something like, "Listen, it sounds to me like you might be someone who has intractable serious pain caused by surgery that borders on a serious situation- even if you were a hardcore drug abuser, you might be one of the people we in the medical community have no other answer for but pain medicine. I certainly think you might need long-term pain management medical care and opioid analgesics, if you want I can help you out for a short while until you find a long-term doctor/medicine solution..." -- and I said no thanks. Because it's shameful enough to have had surgery, needed pain management care/serious medicine, LOST that care, resorted to poppy seed tea for two years, then wound up crawling into a suboxone doctor begging for help. What would I do? Start calling random doctors asking for pain meds? What if I found one and he said, sure, I can help you. Here are 30 Vicodin tablets (yuck). Or even, I'll prescribe you 25mcg/h fent patches for 72 hours. And I'm like, no, that's not enough, I was on 100 mcg/h every 48 hours, plus breakthrough medicine. Do I just "accept it?" Do I argue, get kicked out of another doctor? Or even worse, really, what if he says, Sure thing, whatever you need. But then I have to pay for them! My medicine bills were like $1000 a month sometimes, I think a few were even closer to $1500 . Insurance paid , and I'm sure it was cheaper, but it surely would be much, much higher than suboxone. Now having lost my insurance coverage when I lost the doctor, I am paying cash (and even this was killing me, first few visits were close to $200 a month, now down to $140, and 60 Zubsolvs were nearly $400, it's more expensive than buying a Cadillac car-payment.) So it just was a no-starter to me.


I do not doubt at some point in life, whether because of one particular accident/instance/event, or just a gradual and continual build-up, my back will cause me to be in a position where I'm thinking about serious pain medicine and pain management doctors again. Hopefully, that is a long way off. I am happy with buprenorphine. It dulls the pain enough to function, and as long as I'm not a tough guy or anything, I'm managing. Recently I've been painting the house my Dad and I are building together, and I have been going to bed sore and waking up extremely stiff and sore and hurting. But it's not THAT bad. Sometimes I just have to remind myself, good enough is often good enough, and be happy and thankful for what I do have.

Thanks again everyone.


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PostPosted: Tue Feb 21, 2017 11:25 pm 
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I just wanted to take a minute to say THANK YOU VERY , VERY MUCH to Dr. Junig...

The GoodRX website/card not only worked, *it actually wound up being CHEAPER than it advertised!!!*

When I pulled up the website, it allowed me to punch up the prescription medication I was looking for, the strength, the quantity, etc. It then displays many different prices, and allows you to tailor the display to your location. It automatically had selected 60 tablets as the quantity, when I am only being prescribed 45, so I had to adjust that, and also adjust my zip code. It then updated the prices and locations -- and there were some good price options listed, but the top 4 prices (and the top 2 were very good, but the next 2 were a decently-sizable step up in price) were all completely out-of-the-way for me, or even just no-gos (I live in pretty much the sticks of Scrubland down here. There is a decent sized city 30 mins away and a few big cities 90-120 mins away, but c'mon now...) -- at the bottom of the page, it said I could use a coupon for "independent pharmacies" -- and it said, "Click here to use the coupon at the independent pharmacies and pay between $103-$205" -- well FIRST off, the $103 was not the $83 they were offering at Krogers (two hours away minimum) ... and SECOND off, there is a huge difference between $103 and $205!!! Well regardless, I wanted to see what exactly I was looking at, so I clicked the link and was presented with an "insurance card" to print out and hand to the pharmacist. It said I was eligible to purchase my 45 Subutex (generic buprenorphine) 8mg tablets for $103.07 -- the "card"/coupon also says if the Pharmacy claims to "not accept" this, or has any problem processing it, to immediately call their number.

So when I got to the pharmacy -- not being the absolute stupidest person in the world -- I said, "Hey could you tell me how much this will be, since it's my first time filling this as I've switched to this generic version?" The girl actually knew right off the bat - "Oh they're $3.25 each, so, $3.25 x 45... a bit over $145...." -- so I busted out my GoodRX coupon card, and asked them to use that. She was all like, "Oh... well.. I can TRY IT... see if I can get the Pharmacist take a look at it... but ... if it doesn't work... are you going to pay for this or should we cancel the fill?" .... uh yeah babe. Fill it. Because we're going to make it work, but cross that bridge if and when we get to it.


---And wouldn't you know it, but when I came back to pick it up, the girl who had helped me was on lunch, and another (even pricklier) girl rang me up -- for $91.33 ! I called out to the pharmacist in the back ( a good guy, real cool customer, not at all judgmental and not at all the "I'm the King of the All Medicines in my Medicine Kingdom of this real-estate floor plan"-type of guy who many pharmacists are....) "Hey, it not only worked, it was even cheaper than the coupon/card said?!" and he just said, "Hey, I put it in, that's what it said, so hey, good for you right? No problems!" -- and it's of course not the most difference in the world, but hey, every dollar counts, and when you spent almost a year spending $600/mo on doctor and medication, and wound up dropping your dosage because it was just too expensive, this was a welcome relief!



SO THANK YOU VERY MUCH DR JUNIG. I would not have known about GoodRX without your post and it was a huge, huge help. They're apparently going to send me a card in the mail so I can use it for any other prescription I might use and I can use it on the buprenorphine every month. THANK YOU AGAIN Doctor Sir, truly - you made a big difference in my payment (Shoot, you basically saved me $55 a month!) and it takes a lot of worry and burden off my shoulder.

Thank you again doctor sir.


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PostPosted: Wed Feb 22, 2017 12:05 am 
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I'm glad it helped! I have no idea how they do it... I probably already mentioned some of the ways my patients have saved money. Abilify is usually over $900 per month, and if I order a double-sized dose and have patients break it in half, they get it for about $70 per month. Lunesta used to cost $300, but the coupon got it for about $30.

Now if only they could get a good deal on Vyvanse!

I'm also glad your doc finally saw the light on plain buprenorphine. There are 'experts' who write in their columns that buprenorphine makes people 'high' because it lacks the blocker. I just wrote about a story that made that mistake in the Huffington Post-- someone who was ironically writing about a CORRECT story that he labeled as 'fake news'. But I digress.

I noticed that you are a sommelier-- you can repay the favor by telling me the name of your favorite, inexpensive Cabernet to drink with a rib-eye steak, grilled medium rare. But unless you have a coupon, it has to be less then, say, $30!


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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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