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PostPosted: Sat Feb 21, 2015 1:04 am 
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Hey,

Wondering if you all got a chance to check out the Huff Post article Dr. Junig recently posted. If not, here it is. It's a must read: http://projects.huffingtonpost.com/dying-to-be-free-heroin-treatment

So well written and it gives me hope for the future., that society and medical professionals will someday TRULY and FULLY understand the nature of addiction. Unfortunately, it seems that the majority of Sub doctors out there now don't fully 'get it' and are just in it for the money. My doctor is nice enough, but he clearly is clueless about the reality of drug addiction. Thus, visiting him is simply a formality for me to get my script filled. He is not helpful whatsoever. If he uses the word "will power" one more time I swear I will go off on him. I have a feeling that the 'training' the Sub doctors get to be qualified to prescribe is a joke...like a text book, watch a video, fill out a multiple-choice quiz type of deal. I wouldn't be surprised. Most of them are in it for the money. And of course, if you disagree with them or try to explain otherwise, you will in no way be heard because they have the 'M.D.' title and thus they believe they know everything. It's so, so, SO frustrating.

Every single doctor that wants to be able to prescribe Suboxone should have to go through much more training than they currently do. Also, to find out if they are even cut out for such a task. Many of them, in my opinion, are not qualified even if they tried. They need to be empathetic. Want to help. Understand us, even if they haven't been there. Read stories. Experiences. UNDERSTAND. What we all are going through is so complex and we all are so fragile. It's not as simple as just knowing the textbook 'definition' of the disease. It's so much more. NO patient should be FORCED to taper or quit Suboxone if they are not ready. I could go on. There is so much room for improvement it's incredible. I just want to print out this article and give it to mine at my next appointment.

I desperately hope the truth of addiction and how Suboxone treatment works is more widely accepted sooner than later, especially among the medical community.

Just needed to vent. Blah. :(

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"He will cover you with his feathers, and under His wings you will find refuge" - Psalm 91:4
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PostPosted: Sat Feb 21, 2015 11:08 am 
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Good points, Crystal. I run into docs all the time who ask 'when do you start tapering?' I usually say 'why would I want to start tapering?'

My only disagreement with you is on the issue of bad, money-hungry Suboxone docs. One reason there are so few good Suboxone docs is because for any doc, good or bad, there are many easier ways to make much greater amounts of money. I realize that what I'm about to say will shock people... but a typical psychiatrist salary tops out at about $200 K per year. That is a lot of money, but not in medicine circles. I should add that all docs-- psychiatrists and other specialists-- pay huge amounts of money to become doctors, taking out loans of $50,000 per year for each of the 4 years of med school, and often for 4 or 5 years of college as well.... But compared to the psychiatrist's 200,000, the anesthesiologist at your local hospital is making over $500,000 per year. The ENT or orthopedic surgeon is making $800,000 per year-- or double that amount if he/she is busy. The radiologist is making over $500,000. The dermatologist is one of the highest paid docs-- and if doing botox, is making 500K to a million or more. Heart surgeons? Millions per year if they are busy.

I had a patient who recently had an 8 hr spine operation. The surgeon fee was $150,000-- for ONE SURGERY!

I probably sound jealous, but I've been an anesthesiologist, and found that it just wasn't that good for me. But I want to correct an incorrect impression-- that subox docs are in it for the money. Realize that they are in the lowest tier of payment for people with medical degrees-- which is one reason why there are so few of them I suppose that there are also people (like me) who got into trouble with opioids, and left a higher-paid specialty; the NYT article did show that many Suboxone docs have been disciplined in some way.

The problem with adding even more training, though, is that 1). doctors are not good learners once they get out of residency; they tend to think they know everything already, and 2) I worry that nobody would choose to prescribe buprenorphine if the training were greater.

One other thought-- your comment about docs not listening, etc-- I agree with them, but apply them to docs in general. I myself get so frustrated when I go to a doc who doesn't listen to me, who talks down to me... I really wish that instead of the affordable care act, we had introduced market competition so that doctors had to learn to provide customer service, as other business proprietors do. The ACA did the opposite, locking patients into the doctors in their plan, giving docs no incentive to attract patients by acting like a human being.

Just a few thoughts...


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PostPosted: Sat Feb 21, 2015 11:21 am 
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Vent away Crystal 13,
While is is unfortunate that some Drs do not totally understand just how Buprenorphine works, many do. There is such a shortage of drs willing to work with addicts and Suboxone.
The Drs are in it for the money thing,well Drs make money,sure,but they could do better work in any other medical field than Addiction. I wish I could be more forthcoming with my own Dr. The price is right (60 dollars a month), but the model of treatment is very "one size fits all",meetings, .Ok sure I will and have done what has been asked of me to get this medicine. I just cant tell him how I truely feel about recovery. There are so many ways to do this. That article and other can show other ways.
Someday, maybe, the tide will turn, its starting to now as I see it. The US drug czar is on board, many in this country are starting to stand up and be counted.


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PostPosted: Mon Feb 23, 2015 11:34 pm 
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Thanks for your input Dr. Junig. It's always wonderful hearing from you directly! :)

@Razor - I feel the exact same way. We just gotta hang in there for now, I suppose. I try to tell myself to focus more on myself and what I can do for my recovery. Continuing to be a part of this community is definitely part of that. You all make me feel better, and at least we have access to a wonderful support system virtually, very grateful for that part. :)

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"He will cover you with his feathers, and under His wings you will find refuge" - Psalm 91:4
–Robert Green Ingersoll


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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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