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PostPosted: Wed Mar 16, 2016 5:41 am 
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I've been on Suboxone at 4mg a day since 2009 or so. I made the decision that my life is far better with it than without. Currently my doctor and meds are covered through Medicaid, (Washington), and I am required to go to an addiction counselor at least once a month. I've been going to my counseling office for a few years now and I've been doing so good that there was serious discussion about discharging me. If this happens, will Medicaid no longer cover my doctor and Suboxone? Honestly, I feel like I've gotten about as much as I can from everything the counselor's helped me with including coping strategies if there ever comes a time I feel I'm ready to leave Suboxone, (though I don't see that happening anytime soon), and the support I've been getting from the counselor, really, I get plenty of through my family and others in online groups, etc. So, there's always someone to talk with if I need it.

I know some people will think; "If you still need Suboxone then you probably still need counseling." (Well, the non-lifers might think that! Haha!) But, I'm not sure it's realistic to expect to be in an outpatient counseling program for addiction for the rest of your life. Obviously, I'm not including other types of support like online recovery groups, AA/NA meetings or alternatives; those can be beneficial your entire life. I just mean counseling through certified addiction specialists/therapists. Anyway, sorry for the slight rambling of this post when the question really is very simple. Lol.


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PostPosted: Wed Mar 16, 2016 8:49 am 
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Hi Skayda, Welcome, I am a social worker in nj and my experience with medicaid is that as long as you have a doctor saying that you are in need of the medication there should not be a problem. If you also have some documentation fron the counselor saying that her/his recommendation is that you have completed counseling successfully that would be good. If she suggested meetings than do that and get signatures so you have documentation that you did what the counselor suggested. Medicaid really just wants to see that you are following the treatment prescribed. Good luck and keep us posted!


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PostPosted: Wed Mar 16, 2016 11:16 am 
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Hey Skayda,
I'm not sure, but Medicaid might require the counseling to keep it active. Did you check that?
Happy


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PostPosted: Fri Mar 18, 2016 8:33 pm 
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WI medicaid does not require counseling, but it requires that docs attest that counseling is provided if it is indicated. I'm sure each state has specific rules...

I really resist the idea that every patient who needs buprenorphine needs counseling. Where do such ideas come from? Do all patients with other diseases require counseling? Why aren't all depressed patients on medication required to have counseling? Why don't all obese patients taking meds for diabetes require counseling?

Everyone seems to agree that addiction is a disease. And counseling has never been found to be effective in treating opioid dependence. Yet addiction treatment agencies constantly endorse regulations that mandate counseling. I don't know how much of it is based on ignorance, and how much is based on greed... but hopefully, 'evidence-based medicine' will be viewed as an appropriate approach to addiction treatment, as it is for the treatment of other diseases.


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PostPosted: Sat Mar 19, 2016 4:19 am 
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suboxdoc wrote:
WI medicaid does not require counseling, but it requires that docs attest that counseling is provided if it is indicated. I'm sure each state has specific rules...

I really resist the idea that every patient who needs buprenorphine needs counseling. Where do such ideas come from? Do all patients with other diseases require counseling? Why aren't all depressed patients on medication required to have counseling? Why don't all obese patients taking meds for diabetes require counseling?

Everyone seems to agree that addiction is a disease. And counseling has never been found to be effective in treating opioid dependence. Yet addiction treatment agencies constantly endorse regulations that mandate counseling. I don't know how much of it is based on ignorance, and how much is based on greed... but hopefully, 'evidence-based medicine' will be viewed as an appropriate approach to addiction treatment, as it is for the treatment of other diseases.


Well, I've completed two full programs of six months each along with having been in my current chemical dependency counseling program for two years and after a while it just starts to seem repetitive. I've learned all about relapse prevention and family issues and everything else under the sun regarding chemical dependency and the issues around it and even though I know I will need Suboxone for longer, possibly for my entire life, I don't think I really need counseling for it for the rest of my life. I get the feeling from those I've spoken with that a lot of people think that as long as a person needs Suboxone they need counseling because if they don't need counseling they obviously don't need Suboxone, which is ridiculous. Like you said; people on diabetic or other medication aren't told they need counseling since they need their medication. I guess I'm just afraid of being pushed off the Suboxone before I'm ready, (and there still might be a time I'll be there in the future because we don't know the future), due to the doctor or insurance; one saying "We won't pay for your doctor or medicine without counseling" or the other saying "Looks like you don't need this medicine anymore since you've finished counseling." It's stupid either way and I hope someday it will change.

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PostPosted: Sat Mar 26, 2016 1:04 am 
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The woman I spoke with at the new chemical dependency counseling place I called yesterday to switch to from one that doesn't take Medicaid to one that does told me that because I've been stable on Suboxone for longer than three years that I no longer meet the criteria for one-on-one CD counseling and that the rules were just changed about six months ago that people on Suboxone long-term no longer need counseling after awhile. The problem is some doctors still require it for their patients before they'll prescribe the medicine and for as long as they're on the medicine, like mine. So, what ended up happening with me is I was told I could come for mental health counseling instead since I'm bipolar and they said that would satisfy my doctor that I was in counseling because they never ask if we're in drug counseling, it's just 'what counseling services do you go to?'

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