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PostPosted: Sun Dec 22, 2013 12:50 pm 
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Hello folks, I'm not sure if this is the proper place for what I am about to share,but here goes.
Upon my last two visits to see my physician, she insists that the DEA wants everyone off of Suboxone.
I was on one 8mg Suboxone strip a day and I was maintaing just fine. Two months ago I was lowered down to 3/4 of a strip a day. I felt better at the 8mg daily. My last visit she said she could not bring me back up to 8 mg.

She went on about how long I have been treated etc and even mentioned that one of her colleagues is taking everybody off and mentioned that if he was my physician I wouldn't have been treated as long as I have been. My relationship is solid with my dr. She has always tried to provide, and has. I struggled on generic running out etc I would call and she would call in a RX.

I am the one who suggested trying the strips, just like I suggested generic buprenorphine to her for cost reasons and she had no issues.

Anyway has anyone else heard anything from your Dr's? I get the feeling that the DEA is going to make things worse, which I shared with her my thoughts on this, but it is like all the dr are on a different page or at least the medical community. We talked about diversion, it plays a big part of her point. In my area Most of the diversion is to avoid feeling like 10 lbs of shit in a 5lbs bag. I know there are opioid naive people who struggle with Hydrocodone and are over powered by Suboxone thinking they can taper Hydro by using Suboxone.

I am ok at 3/4 but not like I was at a full 8mg. I don't know if there are other motives to this I always felt me being my dr's first sub patient had solidified our patient dr relationship but I wonder now if it is becoming a double edge sword.

Please share you thoughts/expierencies if any.. Thanks..

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PostPosted: Sun Dec 22, 2013 1:19 pm 
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A added side note. I am venting a little above and with venting aside..to better hit home on my point is that her attitude towards Suboxone is doing a complete 180. I quote "the DEA does not want people on Suboxone long term or for life. I don't know what memos are going around in my area but things are definitely changing around these parts and I am afraid of starting the whole process over again if that will even be possible at this time. Anyone else?

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PostPosted: Sun Dec 22, 2013 1:46 pm 
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If there are secret memos, directives, smoke signals coming from the DEA or FDA I haven't seen them. There have been several other threads about Doctors wanting to change their practice but use the DEA as the whipping boy. They can have their opinion but should own it and be honest. Ironic, since honesty is so important in recovery. PAX


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PostPosted: Sun Dec 22, 2013 3:07 pm 
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The thing is that I don't think my dr would just make up a story about the DEA to try to get the doors
Revolving. I do know that some patients have been what her office calls I believe pink listed.
Basically I believe if this was a course she is deciding to take on her own, I believe that the fear of the DEA cracking down etc would not even be on the table. We both know the obvious meaning me and my DR, and if it was a choice to get people down on the lowest dose possible or even stopping completely, I don't believe she would scapegoat the DEA. It would be an easier pill to swallow. If the DEA is wanting this it is scary because choice is pretty much gone.

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PostPosted: Sun Dec 22, 2013 3:26 pm 
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I'm sorry you don't believe me, but I realize I am just an anonymous post on a blog. The DEA has had no communications with me since I got my waiver last year. There is some consideration to make Suboxone a scheduled II drug which may have some future ramifications but currently it is speculation on our part.
Within the professional community there are advocates for detox and/or brief treatment, but that is professional disagreement, not driven by the government.
Perhaps TWIN, Jonathon or Dr. J; who have commented on similar threads in the past; will weigh in. PAX


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PostPosted: Sun Dec 22, 2013 3:57 pm 
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Apologies if my last post came across as me doubting you. I was just adding or replying to what you posted in back and forth convo. My last statement came to me after reading your reply. I suppose I could say my reply could be looked at as thinking out loud. I know it's hard to get ones intentions, thought process in a 2 dimensional realm. In no argumentative tone why the DEA? I would think the same comments stated could be just as valid if it was said that my state is closing the Buprenorphine door.

Buprenorphine is being looked at as a drug that does more harm then good, that is the stereotype being constructed. My statement I'll make here just as I shared with my physician. "You would think the DEA would know better. What is the motive? My opinion it is that dependence along with addiction
Is it is not going to be tolerated as a disorder/disease.

It is the lack of education about the mechanics and the vibe that they don't even want to know,there a a lot of clueless professionals when it pertains to Suboxone. The ATF, DEA, FDA heck even the surgeon general. should put the time in just like I'm sure they did when it came to studying the effects of smoking cigarettes. It is the second class citizenship. Healthcare professionals don't degrade a person when they say "I am addicted to cigarettes and am taking chantix.

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PostPosted: Sun Dec 22, 2013 5:39 pm 
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Maybe these agencies target areas, smaller towns etc where half the population of all ages are on some kind of narcotic opiate. It seems logical that a prescriber with say several years of prescribing get's evaluated in the food chain, Just like a patient with 5 plus years of maintenance could. Just a gut feeling that there is more then meets the eye here. I've never seen my Dr so uneasy. There a changes happening which makes me think there could be a grain of truth above. I was talking to my CVS pharmacists a few days back. I used to be able to fill until my RX was due for renewal at any CVS. We'll now even though it is the same chain pharmacy, I can only transfer, as they call it now, twice. Now If you transfer from cvs to Walgreens, that transfer was allowed only one time. That is understandable and common knowledge.

Now It could be the same chain pharmacy in a different town. Now I have to finish out RX at that pharmacy in that town no matter how far. I Also heard that New York is the First state to make Hydrocodone a CII substance. Also there are some new prescribing laws in effect or soon to be and buprenorphine is on the list of controlled substance changes. All this news kind of makes me wonder if there is a bit of substance to what this thread was originally about.

Now I have no doubt that some prescribers might embellish the truth or make there own rules but at least in my state the noose is getter tighter. I am guessing the next time I go for a refill I'll probably have to walk through the True Lies CIA X-Ray machine to receive refill at the pharmacy.

Anything here you guys already know? Not to beat a dead horse I am sharing some info I picked up to merit my concern that is all. Please correct me if I am off here..

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PostPosted: Sun Dec 22, 2013 7:03 pm 
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This kind of thing really bothers me.

If there were actually policy or an impending policy within your state it would just be a matter of Googling it. If you want to save some time and take my word and DocM's word for it, there is no new DEA order.

I'm not totally sure what's going on here, obviously, but I've seen a lot of prescribers use many things as scapegoats for their decisions rather than own them or back them in potentially uncomfortable and even time-consuming situations. The DEA is a likely scapegoat here.

I can assure you there is no law requiring buprenorphine to be tapered at any time, at any rate or ever. It's currently a CIII drug and as such covered under DATA 2000 and will be for the foreseeable future.

It could be that on a Saturday your DR was at a party where 'an expert' genuinely convinced him that buprenorphine was best used for X-amount-of-time.

Maybe he heard a horror story or read a NYTimes article and decided that he didn't want to have his practice under a microscope with that top-heavy load of previously stipulated or suspended prescribers.

A physician told me a couple years ago of a 'new law' that forbid the concurrent prescribing of benzodiazepines and Suboxone specifically and swore up and down that she had a 'letter from the DEA' she could copy me. I never saw a letter, probably because that law flat-out doesn't exist nor did the letter and she thought she wouldn't be questioned by anyone or would be taken for her word. Maybe she thought that she had interpreted something correctly but didn't. Maybe she had taken a rumor for truth. Maybe, more likely, she didn't feel comfortable continuing another prescribers benzodiazepine prescription and when the patient essentially wouldn't accept no for an answer she said even if she wanted to the DEA has tied her hands via a 'new law,' end of story. Either way that was HER truth and became the reality for the 100 patients that needed to utilize her waiver. Now that it's clear that there is no law, the prescriber in question still 'never prescribed benzodiazepines with Suboxone' from what I hear; not because of a law but because in HER clinical judgment it's never warranted and/or always contradicted.

Bottom line is, do YOU feel ready to taper at all, where are YOU at? Are there any other prescribers in your area?

Going on what you've said and my best guess, I really feel like your prescriber is simply not owning a decision he has made or backing his own clinical judgment because it would be more difficult to do than say his hands are tied. This wouldn't be too far off base and would actually be pretty stereotypical of my varied experience on the matter. If he's simply misinterpreting something, he's doing it to the detriment of his clients and you may want to at least look around for another option before he lets you know that 'a new law' or supposed DEA edict says that you have to be off by X-date.

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PostPosted: Wed Dec 25, 2013 12:15 pm 
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You know I've had a few days to think about my last dr visit after my original posts. I was
Thinking about my last visit with my dr. I thought or assumed she could be honest with me
As I reciprocate the same. I'm thinking maybe she thinks I've been on long enough, trying to see how I handle the reductions. I am saying this after reading through some post on this site about receptor repair. I feel my body has adjusted to the 1/4 reduction in dosage.

I'll stick it out and see what happens. My original point was that it was a jolt not having a choice in the matter not like in the past. Past reductions or changes in dosages were mutual after crosstalk. You know maybe it's just as well as I'm ok with reduction I feel my body has adjusted I feel like my levels are low at times. I know the reduction is definitely waking up the psychological effects of dependence that part had been suppressed for many years. My thread/post is Just a very long winded way of saying I'm afraid of reduction on someone else's terms with out discussion or I should say without consideration, and It worries/scares me about my future. Also I am noticing like I told my dr after first month.. I been having these feelings that I can just break down and shed ters for hours. This is new.

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PostPosted: Wed Dec 25, 2013 2:17 pm 
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These are not uncommon issues and if someone is tapered off on a timeframe that isn't their own unless they are involved in a program of recovery on a many-day-per-week basis as a substitute for the Suboxone that has been keeping their addiction in remission, the relapse rate is almost identical for those who have been on Suboxone for 7 months or multiple years then were 'forced off.'

Again, I'll say it, if you're no comfortable with the tapering, if you feel relapse is going to be likely without Suboxone, can you find a new prescriber who you can ask up front how he/she feels about long-term/on YOUR time-frame tapering, as there is no DEA directive that states that Suboxone patients can't be on the medication for more than X-Months.

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