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PostPosted: Fri Dec 02, 2016 6:51 am 
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So I've been sober a week now, after switching to bupe last Friday.
My wife and I are headed to Florida Keys next March and April and I need
to find a way to convince my clinic doc to write a script for me to
carry me through.

This is a long promised, 2 month trip to my long suffering wife and even
if we have to go down there without a plan, we're going. I can always try
to find someone down there while we're there, but that would be stressful and risky. By
far the better option would be if home doctor would help me.

He's a nice guy as far as I can tell...have seem him only twice....but massively
over-worked. It's a crowded clinic with only 2 physicians and the routine
is they see everyone for 5 minutes before writing 28 day prescriptions.
Very much a kind of bupe dispensing factory.

I"ve already asked him about this...offered to do a FaceTime appointment
which of course I'd pay for while away, and would also take a drug screen
at a Key West lab. But he declined. He will however write a letter for me to
the effect that I'm a stable bupe patient which I could use to help
me find a doc in Florida for that short time.

I plan on sending letters to all the Key West Sub docs I can find, plus
a few in Miami, though that's a long way away and would only
be a not very satisfactory plan B.

One trouble with local doctor is I'm a new patient. Plus it's taken
me several months to finally make the jump to bupe. He seems to
look at that as inherently suspicious. I tried to explain that I delayed
in order to lower my tolerance in order to avoid PW, but as I said he's
overworked and tired and I don't think he understood what I was talking
about.

I'm a responsible looking and sounding 65 year old man, and I bring
my attractive, well spoken wife along to appointments to further the impression
of stability and trustworthiness. I've an appointment in two weeks
though I think I'll wait to the app. after that before bringing
it up again.

Anyone have any ideas? I can work on stockpiling Subs. I've 3 months
to do it and have started on a high dose, so there should be ample opportunity
to cut down....without telling him. ( I assume the drug screen doesn't
indicate how much bupe is in your system, just that it's present.) But I'm
not all that comfortable being dishonest with him. Plus, as overworked as
he is, he without thinking about it wrote me another script last appointment
right after I'd explained I hadn't jumped yet so I didn't need another
script at that point. So there's that.

Be grateful for any suggestions. This is a good time in our live's
for my wife and me. I've fulfilled the long standing promise to
get off the poppy tea and now we're about to do some long
postponed traveling. This is a small problem as problems go.
But it does require some sort of a solution.

All the best,

Godfrey.


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PostPosted: Fri Dec 02, 2016 8:49 am 
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Hello Godfrey,
Been following your story and induction , congratulations on making jump over to Buprenorphine. Feels great doesn't it.
I too go to a large clinic, 6 years now. Great dr. Good staff. I volunteer my time there as a group chair for newcomers. We have two meeting a week. Is there trust?, some..alittle maybe. However the rules are the rules and in no way shape or form would my dr or clinic break or do me a favor against a rule or step outside what would be considered outside the lines.
Im 58, look good,all that but most drs or clinics aren't going to bend. Just my opinion.

Your best bet or opinion is to stock and take the extra s with you. And will your dr at home be waiting for you when you get back? Will your spot be held for you? Id check into this also. You are on a high dose, 32 to 24mgs I believe. You could cut 4mgs a day easily without wd simptoms.

It takes time to build trust and someday maybe your dr will indeed write scripts with a refill or two. But in the begining it seems rare to me.

And fla in the winter can't be beat. Did it for years.


Razor


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PostPosted: Fri Dec 02, 2016 9:12 am 
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I'm sure you can find someone on NAABT's website. You just put in your non-personally identifiable information, including your zip code and willing travel distance and the doctor reaches out to you, yes that's right, the DR contacts YOU. It's really a great service. The doctors are all legitimate, as far as I know. I'm actually currently seeing someone who even accepts insurance, but he isn't the most knowledable about the drug, but it's better than nothing.


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PostPosted: Fri Dec 02, 2016 9:57 am 
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noob, I'll check out that website today. Thank you.

Razor, thanks for the pat on the back. I like the idea of stockpiling. But I worry the doc will
ask me who I saw...or whoI plan on seeing... in florida. If so and he checks, I'm screwed. Though I don't suppose he's got the time or inclination given his work load to start making phone calls.

You wrote I could cut 4 mg a day. I assume you meant a month? Do you suppose my doctor
will apply pressure to get me to cut down (and thus write smaller prescriptions), or are they generally content
to let you take what you want?

I don't think the 2 months will be a problem regarding losing my spot.. He didn't say anything about losing my place, and they have a 90 day rule I believe. If you don't have an appointment for 3 months you have to start again as a new patient.

I've no problem with the clinic generally. Most of the staff are excellent. I've only had one problem with a receptionist who was downright nasty to me. I've learned long ago that the best way to respond to that is to
be unfailingly polite and pleasant in return, no matter how hard it is. And in the end she did help me, though it was clearly the last thing she wanted to do.

.Just to add, I'm down to 24 from the 32, and plan on taking 22 tonight. I doubt I'll miss it. And if I do I can always add it back. I know there's a 2 week period when it's suggested you don't worry about reducing, but with all I've been reading about these higher doses and the ceiling effect, I have the feeling I've lots of room.


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PostPosted: Fri Dec 02, 2016 10:32 am 
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Unti a new person really understand s just how powerful Bupe is I refrain from doseage changes here.It is wise to read as much as possible on the subject over in the Talkzone with Dr.Junig.
I say this because I was meaning 4mgs a day. Or everyother day or 3rd day. Your just now getting stable so I would take it slowly as you learn as much as you can on ceiling effect and such. 4mgs a month wont leave you much of a stock when you need it.

I agree with Killm with Kindness.works all the time.
And yes, you will most likely be asked How you got by in Fla without a script from him. Man, I hate this part of treatment. Sorry i couldn't be of more real help.

But your doin great Godfrey..
I guess talk more to the Dr of your plan. Your an honest guy,he may see that. Idk...


Razor


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PostPosted: Fri Dec 02, 2016 10:32 am 
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Hey Godfrey!

Awesome on taking a trip to the Keys, I've never been past Miami but man is it beautiful. St Augustine is also very beautiful. Anyway, like razor, my clinic wouldn't go for me being gone either missing an appointment, so ur lucky that ur Dr is cool with u going holding ur spot. If it were me, this is just me so not trying to convince u or anything, I'd stockpile any extra I could and use that during my vacation time. Concerning ur doctor wondering how u made it without seeing another doctor....I don't have any ideas on that one. Of course the best plan would probably be if u were able to find ya a dr for 1 month....but that seems like a whole lot to deal with. So I don't know, but it is good to be honest with ur doctor like u are, so that's good. Hopefully you'll get it all figured out and have a blast!

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PostPosted: Fri Dec 02, 2016 11:06 am 
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Hi Jennifer :)

We've been to south florida 4 or 5 times, including key west once before and it was so very lovely. We ca't wait to get back. I'm beginning to realize my doctor's probably already being pretty understanding with the promised letter and all. I hadn't even though about losing my place, but as I said they do have that 90 day thing so I should be OK, He'll write a prescription in late Feb for March, or most of Match anyway. So
that's the one month to figure out.

I'll do the stockpile thing so at least I'm covered if need be. That's obviously critical. I've got several months to find a doctor down there to see me on a one time basis. Even if we have to come back to Miami for one day. It's about a 3 .5 hour drive.. What a a pain with 3 dogs! Ah well, these are small things in the long run.

Razor, I'll go ahead and do that reading.. 4 mg a day sounds radical, but of course I'm interested. And yes, absolutely, I'll take it slowly.

I"m in the boston area and there's no shortage of treatment options. I've had no trouble making appointments at two different clinics and there are probably a dozen or more addiction psychiatrists in private practice reasonably close to home. If I ever lost my spot, I don't think I'd have too much trouble finding someone to help me.


Last edited by godfrey on Fri Dec 02, 2016 12:32 pm, edited 1 time in total.

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PostPosted: Fri Dec 02, 2016 11:29 am 
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I live in a small town but there's actually 3 suboxone clinics in my area (one of them is the one I go to). So it's actually a good thing but I've heard they all stay backed up with a waiting list. But if I wanted to drive about 45 min to Knoxville, there's tons or an hour to Corbin KY, there's more choices too. I couldn't imagine being somewhere where there's not options....and I know there's a lot of ppl that can't find one and that's heartbreaking. As far as methadone clinics go, gosh I wouldn't know where to find one of those in my area though.

U know it's ironic because when I was a lot younger way before my addiction started, my best friend's mother (who's a nurse practitioner) was trying to start a suboxone clinic in our small town, and went to the mayor at the time to see if they'd be ok with it. They shut her down so fast refusing to let it happen. I guess they thought it'd bring too many horrible addicts around lol. So she actually went across the state lines and started the clinic there....and that's the clinic that I now am a patient at. Isn't that ironic? When I went in for my first appointment, my friend's sister was the office manager lol. Of course she's no longer there and heck I don't know if her mom still runs it but it's just strange that it happened that way for me. She was a very smart lady and cared about helping addicts.....little did she know that her daughter's best friend at the time would be a life that medication saved. I think about that sometimes & remember how that clinic was getting started :)

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PostPosted: Sat Dec 03, 2016 9:49 am 
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It's sad we live in a time where communities say "no" to a place like Sub doctors offices...because "oh those horrid addicts will start hanging around"...when in all likelihood, the addicts are already there. Likely, the people thinking that way have a cabinet full of norcos and oxycodones, and feel a backache coming, and run to grab a pill. They don't realize the demon they are feeding ...until it's too late.

I read a story about Alabama and shutting down the hopes of a clinic opening (I think it was methadone...but I'll link the story so everyone can read it). It's sad we had the backwards thinking in politics that we have...
But just look at the US now and what's happening with politics. And some still can't understand why things happened the way they did... It's because it's not working. It hasn't worked in a long time. And when it did work, it only worked for a select few... I hope to see some changes with addiction help becoming more widespread. One can dream I guess....but I really hope it changes so people stop dying every single day from this.

http://www.al.com/news/index.ssf/2016/0 ... abama.html

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PostPosted: Sat Dec 03, 2016 2:27 pm 
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I didn't read your article, Jonathan, but I just went through an assignment for my class that involves methadone clinics. The research actually shows that crime goes down in areas where methadone clinics open. I found several scholarly articles regarding this phenomenon.

Godfrey, I didn't read through every single post, but is it possible that you could fly home mid trip to go to an appointment? Maybe try to find the cheapest flight possible up to Boston? I know that would be inconvenient and add to expenses, but it might be the best alternative. Boston is my favorite city, btw. I grew up in southern Vermont, so a trip to Boston was such a treat!

Amy

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PostPosted: Sat Dec 03, 2016 2:53 pm 
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Hi Amy,

Yes, it's one possible solution. Be one helluva expensive appointment though :?
Not to mention exhausting. Planes, train (busses actually), and automobiles and all the associated
expense and hassle.

Right now I'm leaning towards trying to find a private practice addiction psychiatrist. They're
more money than the clinic, but likely more willing to have some flexibility after a few longer appointments, longer than the 5 mins I'm getting now anyway. I have this possibly naive notion that if I can just get someone to get to know me a bit there shouldn't be a problem.

One thing for sure, I know I have to start stockpiling just in case. I'm really trying not to worry about it.
If I were more comfortable being dishonest I might go to a clinic in key west or perhaps miami and tell them
I was moving down there, so it wouldn't be just a one off. I hate lying though. I'm really not good at it,mostly
because I'm paranoid about getting caught. I admittedly was an entirely different person 30 years ago.


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PostPosted: Mon Dec 05, 2016 9:13 pm 
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Hi Godfrey! Planes, Trains and Automobiles; one of the funniest movies I've ever seen in my life!! Oh wow. BUT Your predicament, now that's no laughing matter. It seems your mind is made up though. You two are not letting anything stop you from this trip. And I don't blame you. It sounds wonderful. I just don't know though if it has anything to do with the Dr. trusting you. I'm pretty sure your Dr. sees what a fine gentleman you are though, none the less. I don't have anything else to add except for Welcome to our world! Finally!! So happy you induced. Your friend, Bamagirl -----------------------------------P.S. Stock Pile Godfrey, stock pile


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