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 Post subject: Need advice.
PostPosted: Sun Sep 05, 2010 10:24 pm 
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Hello everybody, I am new to this forum and have quickly found of how informative and helpful it is. I also have been losing alot of sleep and worrying way too much lately so I decided I would come here for some advice from other people that can understand.
I have been on Suboxone for a while, off and on for the past year or so. The first time I was prescribed it it was actually through a research study which was all completely free and kept me on Suboxone for about 8 to 9 months, and well after that time and after a really hard taper I screwed up almost immediately the day after my last Suboxone. I was doing illicit opiates for a month or two and just couldn't handle that lifestyle anymore, so I decided to seek out a private doctor for a more personal and helpful type setting. I found a doctor who seemed very caring and great, I started again on Suboxone and have been on it only about one month at this time. Everything is going great so far and I have no problems with relapsing while on it and am very hopeful and happy while on it.
The only thing that has been plaguing my mind lately is that my last visit he has already brought up my tapering schedule which he plans on starting next visit, he wants me to be completely off in a couple of months and I simply am totally, 100% not ready for this, I plan on having a talk with him to explain everything I am feeling next visit. It is so costly though to visit him and he wants me to get blood work to continue which is an extra 120 dollars, on top of the doctor visit AND the medication. I am really really terrified to taper so quickly and I want to stay on Suboxone for a while longer until I feel mentally that I can take this head on, and right now I don't feel that way at all. So I am just wondering how to approach this, I have a really hard time explaining myself to doctors at times because I feel very intimidated, although I know everything there is to know about Suboxone and understand every risk involved in staying on this medication for longer durations. Now I don't have any plans to be on it for years to come, but all I know is in my heart I cannot handle this yet and I dont know if I will be able to for a little while. I would really appreciate any advice anybody has on dealing with this sort of predicament. I'm hoping my doctor will be understanding but I am worried that he will shut down my feelings and tell me that his way is the only way, especially because I will have to pay this extreme amount of money only to begin a taper that I am not ready to begin. Suboxone has changed my life in a very good way, it not only helps my withdrawals but it has triggered a hopefulness in me that I havent felt in the last 5 years since I began abusing drugs, I once felt that I would never get out of this, I felt so depressed that I didnt care about my life and didnt want to live any longer. But once I have begun this medication it has made me such a more determined and happy person that I am not ready to go back to a different mindset at this time and I am scared.
I really appreciate any help.


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PostPosted: Sun Sep 05, 2010 11:00 pm 
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Hi James and welcome. I'm so sorry to hear about your situation. Have you considered it might be time to start looking for a different doctor? Of course this doesn't preclude you having that conversation with your doctor, because you still should. At this point your doctor (I'm assuming) has no idea of your fears and struggles. At the very least I think you should tell him how you're feeling and give him the opportunity to help you once he knows all the facts.

I don't believe you're alone in being intimidated by your doctor. I consider them to be a sort of authority figure. It's taken me quite a while to learn to be assertive with my doctors. Sometimes it helps to make a list beforehand of the things you'd like to say. That way even though you might get nervous, you won't forget anything.

I understand the struggle with finances as it relates to sub treatment. Are you without insurance? Have you heard of the patient assistance program? There's some info about it posted in the "Links" section of this forum.

Are you getting any help from a therapist or counselor of any kind? There are many that will work with uninsured people, so please don't let finances (or lack thereof) prevent you from finding one. They can help in learning to deal with life with healthy coping skills instead of reaching for a pill when things go wrong. It can help you in attaining a healthy, positive life.

Lastly, you said, "I know everything there is to know about Suboxone and understand every risk involved in staying on this medication for longer durations". I'm just curious what long term risks you might be referring to.

Sorry to be so wordy. Again, welcome.

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PostPosted: Sun Sep 05, 2010 11:29 pm 
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Thank you for your reply :)
I definately will have this conversation with him, It just is a little frightening because I have no clue how he'll react until the time comes and because of the 3 visits I've been there I havent seen him more than 10 minutes each time, which in my opinion is not very acceptable. I mean this is a pretty serious issue and all he does is walk in say how are you, you look good and writes me the script. I do not have insurance, but I am taking advantage of the Assistance program, I have called, had the forms faxed and my doctor gladly filled them out and I hope I will get accepted. As for counseling, I am not against it and I would love to find some that would help me out. I am however using the Suboxone hotline and I do have a Care Coach that i talk to weekly so that does help me quite a bit and I have addressed this with her. I will take part in meetings and look forward to it.
As for the risks, I really just meant the dependance part I suppose, I feel like if I explain to him I would like to be on it in a maintenance fashion for a while he will stress that it is dependant and I think his opinion on it is that it is a short-type stepping stone to get off of Opiates, as for me I know I will need to maintain a sober lifestyle and want to use Suboxone as well as counseling and meetings as that type of maintenance. I know it will benefit me. I guess I wont know until I actually speak to him, he is a very nice man and I have not had a problem until he explained the sudden taper that he wants me to begin. I know that Suboxone is a partial-antogonist so I will not have the same dependance that I would have on Methadone so I am just saying that I am willing to continue on it, maybe even long term if thats what works for me even though there is a risk of dependance, but I think either way that risk is there taking this medication. I would rather be able to handle this dependance than my previous one any day, and feel if properly handled it can be done much easier.

I guess i cant know everything there is to know about it, lol.. but I have many handbooks ive received and researched it very well so I feel I have a good grasp on it. Is there really many other risks in being on Suboxone long term besides dependance?


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PostPosted: Sun Sep 05, 2010 11:42 pm 
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Ditto to everything hatmaker wrote. My own bias is toward long term maintentance, as the relapse rate is very high when people stop buprenorphine-- which is what we would expect, given the life-long nature of addiction. You will here me get upset every now and then, James, when someone says 'I was addicted to oxys, and now I fear I am addicted to Suboxone.' I make the point that 'addiction' is the mental obsession to use opioids; physical dependence is a different issue. It is the obsession that does all of the damage. Simply needing to take a medication every day is not a real big deal with other illnesses, and it shouldn't be such a big deal for opioid dependence, given the fatal nature of the condition.

Anyway, that is where I come from; there certainly are people who frequent this forum who want to taper off buprenorphine, and more power to them-- it is not for me to tell people what to do. I strongly recommend, though, that people have a safety plan in place, and be very careful. While it seems like it would be easy to just go back on bupe if there is any trouble, a person's insight is messed up during a relapse, and people sometimes do things that cause big problems, even in a very short period of time. Not to mention that our loved ones are often just settling in to trusting us again... and another relapse could be the straw that breaks that camel's back, causing our loved ones to give up on us.

As hatmaker said, I suggest finding a new doc, but keep the old one as long as possible. I am going to put a quick post on my blog, Suboxone Talk Zone, about why some docs treat people for very short periods of time-- read it tomorrow. It has to do with money-- no big surprise....


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PostPosted: Mon Sep 06, 2010 12:11 am 
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thank you for the reply, I am looking at new doctors in the area. But that itself presents a new problem for me because I am unemployed, most new doctors charge an outrageous first-time fee, upwards to 250 dollars around where I live. My doctor now is the cheapest I could find and he was around 120 the first and now its 80 every visit which is almost impossible to find, and I have called dozens of doctors. I get alot of help from my close family to be able to afford this. I feel the same way as you, so I have to fight with all my power to find the best help I can get to suit my needs. I will make sure to do all the research I can to find docs. The first time I was looking I used suboxone dot com to locate many docs in my area and was suprised that a couple of them were offended when I called looking for this type of help, the receptionists atleast. They told me that "Dr. "So and So" does not do that kind of treatment and I dont know why their on that website", in a rude tone. So I wanted to ask is it acceptable to ask to speak to the doctor over the phone when calling for that information? I just dont want to be treated like a criminal.
I feel like all of the people struggling with this problem are sometimes the people in the worst financial situations and alot of doctors use it to their advantage charging extreme prices for people to simply get some help... It just doesnt seem right.


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PostPosted: Mon Sep 06, 2010 7:24 am 
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There are three other doctor locators online. The one that's linked to this site is suboxone-directory.com; then there's NAABT.org, and samhsa.gov. There are doctors on one, but not on the others, so it might behoove you to check out the other three.

Maybe your doctor will surprise you and agree to long-term maintenance, you never know.

With regard to any long-term risks, I only asked because some people attribute problems to sub that don't exist. So I agree with you on the dependence issue. And being dependent on sub doesn't bother me in the least - I'm also dependent on my beta blocker, just as diabetics are dependent on their insulin.

I sincerely wish you the best with your doctor. Keep us posted.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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