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PostPosted: Tue Dec 27, 2011 2:47 pm 
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Hello all,
I have been using on and off for about 15 years. I did have one long break in there of almost 4 years but when that streak did end, it ended disastrously.
As of this writing I have been opiate free for 9 days. Worst of the WD has passed and I have no doubt I could keep going and manage to at least stay clean for awhile. But, I always relapse. I am considering trying suboxone as a "maintenance" medication to both help prevent those relapses (I know it's no miracle and cannot "prevent" relapse...but hopefully help) and to give me time to adjust some other behaviours, get back in to my old passions and hobbies, and try to find some joy in life not related to drugs.
I cannot afford to both continue using and save the required money for starting suboxone treatment. It is simply not possible on my income. So, I went through the fun time that is withdrawal, and after my next paycheck will have saved enough to afford that expensive first month of treatment. But, if I'm not currently in withdrawal, or on opies at all for that matter, is it even possible to be accepted? My extensive track marks should certainly put any questions of whether or not I'm actually an active user to rest but I'm wondering what the guidelines here are. Are there any? Is it simply the doctors discretion?
I hate the idea that I somehow must binge out and waste tons of money, while hurting my family just to convince some stranger that I really do need help. Plus, I just plain don't know how I could afford both drugs and treatment.
Thanks,
GovtMediaLiars (GML)


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PostPosted: Wed Dec 28, 2011 10:31 am 
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Hi GML and welcome to the forum. It sounds like you've put some thought into this and from what you've said, you do sound like a good candidate for sub treatment.

Just tell the doctor what you just told us and hopefully it won't be a problem. You certainly are not the first person in this situation. Many people have started sub treatment when they had no opiates in their system.

Good luck starting your sub treatment. Again, welcome and please keep us posted. :)

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PostPosted: Wed Dec 28, 2011 5:15 pm 
I freaked out about this for the couple weeks I had to wait to get into my initial Sub appointment, asking everyone I knew who might know the answer but still doubting their replies because I thought to myself 'this individual doctor may REQUIRE a dirty UA at visit one...'

I, of course, had plans about how I would usethe day before my induction appointment if I 'had to' to get on buprenorphine.

I finally just called my Dr. a few days before I actually started using again irrationally and explained that I will be about two weeks white-knuckled clean when I arive at my first Sub appointment, that the idea that I will be getting on Sub is the only thing making it somewhat tollerable for me to white-knuckle it for these couple weeks and I've been having a lot of cravings and desires to use exasorbated by the fact that I'm nervous that I may not be accepted into the program if I don't have a dirty UA at the time of the first appointment. Needless to say, my Dr. alleviated all my concerns. I've been on buprenorphine successfully for a couple years now! Call your Dr and speak to him/her or a represenative before you decide to use 'something weak' just-in-case you 'have to' test dirty! Trust me, it's NOT going to be the case, but go hear that from the horse's mouth. Good luck!

-T


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PostPosted: Wed Dec 28, 2011 7:45 pm 
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Thanks for the responses.
I feel a bit better and I suppose it is probably best to just bring it up when I start making calls to find a doc to accept me in.
I live about 3 hours drive from nearest sub doctor....and I don't drive so have to bum rides from others. So lots of calls will probably need to be made.
Makes it a bit difficult.

Thanks again!
GML


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PostPosted: Thu Dec 29, 2011 9:57 pm 
travispnorton wrote:
I freaked out about this for the couple weeks I had to wait to get into my initial Sub appointment, asking everyone I knew who might know the answer but still doubting their replies because I thought to myself 'this individual doctor may REQUIRE a dirty UA at visit one...'

I, of course, had plans about how I would usethe day before my induction appointment if I 'had to' to get on buprenorphine.

I finally just called my Dr. a few days before I actually started using again irrationally and explained that I will be about two weeks white-knuckled clean when I arive at my first Sub appointment, that the idea that I will be getting on Sub is the only thing making it somewhat tollerable for me to white-knuckle it for these couple weeks and I've been having a lot of cravings and desires to use exasorbated by the fact that I'm nervous that I may not be accepted into the program if I don't have a dirty UA at the time of the first appointment. Needless to say, my Dr. alleviated all my concerns. I've been on buprenorphine successfully for a couple years now! Call your Dr and speak to him/her or a represenative before you decide to use 'something weak' just-in-case you 'have to' test dirty! Trust me, it's NOT going to be the case, but go hear that from the horse's mouth. Good luck!

-T


I'm happy for you, Travis, but the clinic I was inducted at most DEFINITELY required a dirty u/a.

I don't know if ALL places do, but mine did.


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PostPosted: Fri Dec 30, 2011 12:45 am 
Ironic wrote:
I'm happy for you, Travis, but the clinic I was inducted at most DEFINITELY required a dirty u/a.

I don't know if ALL places do, but mine did.


Obviously there is no set-in-stone rule, Ironic and I both had different experiences...I still wish the OP the best of luck and would still recommend contacting the Dr to find out either way rather than assuming or taking the word of people on the internet..

I can see why Dr's would require a dirty UA, however, the reality is that anyone with access to erowid.org can skew a UA either way...They might look good on paper, but are not 100% accurate.

A few years ago in my second to last stint in treatment, I went to the one hospital in St. Paul that was allowed to use methadone to begin people on maintenance or for opioid titration. I used heroin less than an hour before I provided a urine sample and I was told that it was negative for opioids so I could not receive methadone. Obviously this was a fluke and my next test confirmed this and getting methadone was the happy ending but the fact of the matter is that UA's can be skewed.

I can see UA's being more important for younger people who don't have long documented histories of opioid dependence possibly, but for someone who has been in and out of treatments, been hospitalized for OD's, in and out of methadone maintenance, clean for periods of time in institutions, etc testing positive for opioids at the time of induction shouldn't be a prerequisite for receiving opioid replacement therapy.

--T


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PostPosted: Fri Dec 30, 2011 2:13 am 
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I've just been being upfront and asking when I call the offices to compare prices and ask about other requirements.
I live in the boons and the nearest listed sub docs are roughly 2-3 hours drive either direction. But, it's about 3 hours to seattle in one direction and 2.5 hours to portland in the other direction. Both of which have an abundance of choices so I am making a lot of calls and just laying out my situation and my needs. I'm calling to compare costs and check for an open PAP slot anyway so might as well ask questions and present my situation I figure.
Thanks again.
Regards,
GML


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PostPosted: Fri Dec 30, 2011 10:40 pm 
Travis, you mentioned "skewed tests." I do not know of one way to "skew" a drug test to test + for opiates without having an actual opiate on hand. If you do, please share. With this in mind, I see no reason why a clinic or sub doc wouldn't want to see a dirty u/a..especially when your methadone clinic required it.

Also, what you described with the methadone was not a "skewed test." drug tests test for metabolites, not the drug itself. It can take a few hours for those metabolites to be created. This is why you passed the test an hour after using dope.


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PostPosted: Sat Dec 31, 2011 4:06 pm 
Ironic wrote:
Travis, you mentioned "skewed tests." I do not know of one way to "skew" a drug test to test + for opiates without having an actual opiate on hand. If you do, please share. With this in mind, I see no reason why a clinic or sub doc wouldn't want to see a dirty u/a..especially when your methadone clinic required it.

Also, what you described with the methadone was not a "skewed test." drug tests test for metabolites, not the drug itself. It can take a few hours for those metabolites to be created. This is why you passed the test an hour after using dope.


It was a 'skewed test...' The point I was trying to make with the negative test in treatment was that not only did I use an hour before the test, I used daily for years before the test and it was negative when it clearly should have been positive for opioids. Oh, and I do have at least one way to skew a test, one way that comes to mind is to use 'dirty' urine to test positive if wanted. What a dumb conversaton.

-T


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