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PostPosted: Fri Aug 22, 2014 4:42 pm 
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I quick history... I was on pain pills, on and off, from age 18 through 30. Started taking suboxone off the streets to avoid withdraws. Went to the clinic as a much cheaper option. Little did I know they would put me on so much (24mg daily) for so long (3 years).

The doctor doesn't want to ween me it appears, because loosing me as a patient would hurt his wallet (I actually heard him say that while waiting for him inside a room!). I also am scared of asking him to ween me... well, because I'm an addict. I like the drug and want as much as possible.

So that is my two problems. How do I approach the doctor about this? What if he doesn't like the idea? I don't want to be on this drug forever. Self-weening isn't much as an option for me. I've tried many times with various methods. I need help.


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PostPosted: Sat Aug 23, 2014 3:18 am 
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Your doctor took an oath to protect and care for his patients. It's his JOB to help you ween down. I don't see how your dose has anything to do with how much money he is making anyway. Whether you are on 24mg or 2mg he is getting the same amount for your visits.

I also was unable to "taper" by myself. I had to have my doctor lower my dose or I would take all my suboxone, so that part I get. If for some odd reason he refuses to change your dose I would recommend giving your script to someone you trust and won't cave when you beg for more. I don't see this happening though because it would be malpractice for your doctor to refuse this request in my opinion. Hell giving someone 24mg a day for 3 years is malpractice in my book, but that is an entirely different issue.

Be firm in your request! I have a feeling you would feel much better on 8mg a day then you on 24mg anyway.

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PostPosted: Sat Aug 23, 2014 6:29 pm 
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I agree with Tikistyles. Your doctor should help you if you want to decrease the amount of sub you're on. It shouldn't matter to him if you're on 24mg or 8mg. He doesn't get paid according to how high your dose is. You will still have to see him every month for quite a while until you taper all the way off. And who knows? You may decided, for example, that you want to stay on 4mg/day for the time being.

I had no trouble decreasing my dose from 16mg to 2mg. I just took my time. I didn't feel any withdrawal symptoms until I was under 4mg. I think that most of your inability to taper from 24mg without your doctor prescribing less is psychological. Your opiate receptors are just as saturated at 12mg as they are at 24mg. We addicts are just used to having meds to make us feel better. If your doctor won't prescribe a lower dose, and you feel like you don't have the willpower to taper, is there a close friend or family member who would give you your sub every day. Could you ask your sister, spouse, mom, someone to give you only a certain amount every day? Maybe it would be easier to taper if you didn't have the extra around you.

Good luck!

Amy

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PostPosted: Sat Aug 30, 2014 3:23 pm 
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Sounds like the doc is a bit greedy, yes, but I would just come out and ask directly.


Last edited by sublongtime on Sat Aug 30, 2014 3:25 pm, edited 1 time in total.

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PostPosted: Sat Aug 30, 2014 3:24 pm 
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TikiStyles wrote:
Your doctor took an oath to protect and care for his patients. It's his JOB to help you ween down. I don't see how your dose has anything to do with how much money he is making anyway. Whether you are on 24mg or 2mg he is getting the same amount for your visits.

I also was unable to "taper" by myself. I had to have my doctor lower my dose or I would take all my suboxone, so that part I get. If for some odd reason he refuses to change your dose I would recommend giving your script to someone you trust and won't cave when you beg for more. I don't see this happening though because it would be malpractice for your doctor to refuse this request in my opinion. Hell giving someone 24mg a day for 3 years is malpractice in my book, but that is an entirely different issue.

Be firm in your request! I have a feeling you would feel much better on 8mg a day then you on 24mg anyway.


Why is it malpractice for prescribing 24mg a day for 3 years? (Not defending the doctor, but trying to understand what the clinical issue with that dose/timeframe is)


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PostPosted: Sat Aug 30, 2014 3:52 pm 
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sublongtime wrote:
TikiStyles wrote:
Your doctor took an oath to protect and care for his patients. It's his JOB to help you ween down. I don't see how your dose has anything to do with how much money he is making anyway. Whether you are on 24mg or 2mg he is getting the same amount for your visits.

I also was unable to "taper" by myself. I had to have my doctor lower my dose or I would take all my suboxone, so that part I get. If for some odd reason he refuses to change your dose I would recommend giving your script to someone you trust and won't cave when you beg for more. I don't see this happening though because it would be malpractice for your doctor to refuse this request in my opinion. Hell giving someone 24mg a day for 3 years is malpractice in my book, but that is an entirely different issue.

Be firm in your request! I have a feeling you would feel much better on 8mg a day then you on 24mg anyway.


Why is it malpractice for prescribing 24mg a day for 3 years? (Not defending the doctor, but trying to understand what the clinical issue with that dose/timeframe is)


I am not a dr., but the below was written by Dr. Steven Scanlan, an addiction specialist. It may explain a little bit why Tikistyles made that comment.
Of course this is just one Dr.'s opinion...but I wish I would have read it before I blindly started taking 12 mgs ....and ended up dependent for 8 years!

I have edited it a bit...

"One addiction may be traded for another as the FDA-approved opiate addiction treatment Suboxone is becoming one of the most prescribed medications in the country (#41 overall in sales in 2009 according to drugs.com). Called a “miracle drug” by some, Suboxone is estimated to be 25 to 40 times more potent than morphine.(1)

I am board-certified in psychiatry by the American Academy of Psychiatry and Neurology and board-certified in addiction medicine by the American Board of Addiction Medicine. I am the co-founder of Palm Beach Outpatient Detox (P.B.O.D.) in Boca Raton, Fla.

I once was addicted to opiates during my medical residency in anesthesiology and was detoxed with the help of Suboxone. Now I successfully detox my patients from opiates (e.g., morphine, OxyContin) using regulated amounts of Suboxone, and I also detox my patients from Suboxone addiction when that drug has been misused.

I have found that the optimal time to have someone on Suboxone is between 20 and 25 days, tapering down on the medication every few days. This makes the physical symptoms of detox very manageable, without causing the patient to become cross-addicted to Suboxone. I have found that Suboxone use for a longer period than this begins to cause a strong dependence on the medication.....

.....Suboxone detox makes the physical aspect of the disease manageable, but does not help with the emotional and spiritual consequences of addiction. Often patients are concerned about coming off Suboxone, but I educate them about how Suboxone is a tool to get them clean but not a suitable maintenance drug if a patient wants to get into recovery.

Suboxone is a powerful opiate-an anesthetic to emotional pain. It immediately alleviates anxiety and depression, and makes a person feel more emotionally stable. A lesser dose of Suboxone (2 mg a day) will block an estimated 80 percent of a person’s feelings, while higher doses can make a patient practically numb. Patients often say they feel great on Suboxone and since they are not getting high they want to continue on it. I tell them, “You are not dealing with your feelings because you are still not feeling-you are still numb. You need to start experiencing emotions to understand what you were trying to self-medicate in the first place. It’s time to live life on life’s terms.”

Duration of Use

When used in the short term, Suboxone is the best detox drug I have ever seen-it can immediately stabilize a patient’s life, and this can be done in an outpatient setting. When used long-term, though, it is the hardest medication I have ever dealt with in terms of detoxing a patient from it.

Suboxone does not work like natural opiates; it is created in a lab and interacts with the receptors in the brain unlike any other opiate. I speculate, based on treating hundreds of patients who have been on Suboxone maintenance, that when Suboxone is given long-term it causes abnormal adaptations to opiate receptors and other brain receptors. In my experience, long-term use can cause emotional deregulation, loss of libido, hair loss, and an abnormality in how the body regulates its response to stress."

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PostPosted: Sat Aug 30, 2014 9:37 pm 
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Oh ya, good ole dr Steve.. ya im All numb..I cant feel...im not this, im not that..you really wanta see him in action, check out his ads for nis rehab..
I true sub hater..

Simpley has I negtive view, must love the steps....


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PostPosted: Sat Aug 30, 2014 9:44 pm 
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Hey Butterfly, do you have a date that article was written? I've found Dr. Scanlan's more recent articles to be quite a bit more fair and balanced in his attitudes towards Suboxone.

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PostPosted: Sat Aug 30, 2014 10:07 pm 
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Romeo wrote:
Hey Butterfly, do you have a date that article was written? I've found Dr. Scanlan's more recent articles to be quite a bit more fair and balanced in his attitudes towards Suboxone.


I found the article on medhelp, and there it is dated Sept. 2013...I didn't think he was slamming suboxone btw...if I did I would not have posted it (and again this is one doctor's opinion..not necessarily my own! What do I know? I'm just trying to learn here myself, and just saying if I had personally been forewarned how strong the drug is and difficult it was to get off suboxone, I may not have started in the first place or at least would have tapered much much sooner.

It is "ok" to learn what other doctors say, right? Or not? I'm still fairly new to this forum afterall so please let me know if it is not. ( Edit: Thanks! :D )
And in part of what I highlighted, he says that suboxone is one of the best drugs for stabilizing addicts.....I thought that was pretty fair. And I don't of course know his exact motives for writing what he did, but I did think it was interesting, and personally I know I WAS pretty numb while I was on suboxone and I know for a fact I used it to "not feel" my emotions as strongly- for me that was the biggest reason I took it. I don't think (but I don't know for sure) that he meant "totally numb" as in totally anesthetized...IDK, I just thought it might be helpful to someone who is just starting out taking subs and does not want to end up "trapped" like I felt for so long....just hoping to save someone some of the pain I went through, and to a certain extent still am going through.

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Last edited by ButterFLYING! on Sat Aug 30, 2014 10:38 pm, edited 1 time in total.

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PostPosted: Sat Aug 30, 2014 10:27 pm 
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ButterFLYING! wrote:
It is "ok" to learn what other doctors say, right?


My, my.....so "defensive." No need for "defensiveness", I was just "asking" a simple "question." :)

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PostPosted: Sat Aug 30, 2014 10:36 pm 
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Romeo wrote:
ButterFLYING! wrote:
It is "ok" to learn what other doctors say, right?


My, my.....so "defensive." No need for "defensiveness", I was just "asking" a simple "question." :)

:D Should have added my own smiley face- not defensive tone at all Romeo- I was sincerely asking! Since it is a dr. who started this forum, i thought maybe only his opinions could be sited here.

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PostPosted: Sat Aug 30, 2014 11:16 pm 
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ButterFLYING! wrote:
Should have added my own smiley face


Adding a smiley face wouldn't have toned down your defensiveness. It's ok to be defensive, dude. Happens to all of us at times. No biggee. I'm a big enough person to forgive you for being so defensive. :lol:

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PostPosted: Sun Aug 31, 2014 3:21 am 
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BF, there is an entire thread here about dr. Scanlan and his ideas about suboxone which includes the quotes in your post that dates all the way back to 2011 (the thread) not sure how old those quotes are. It's under misc suboxone issues and is the very first topic. This thread is started by an extremely valuable and intelligent member here,who btw, tapered off sub, hasn't been on in a while, but was well respected and helped many members here with their tapers and recovery when active. The thread is full of valid, fair, and fact based arguments against this particular doctor's ideas and methods. It's a relatively long thread but a good read if you're interested. so other Dr's ideas are welcome to be presented here, however, there may be disagreement,especially if they're basically sub bashing.


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PostPosted: Sun Aug 31, 2014 7:37 am 
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Romeo wrote:
ButterFLYING! wrote:
Should have added my own smiley face


Adding a smiley face wouldn't have toned down your defensiveness. It's ok to be defensive, dude. Happens to all of us at times. No biggee. I'm a big enough person to forgive you for being so defensive. :lol:


Imagine how desperately worried I was that you would forgive me. Thank you, thank you, thank you for forgiving me. :roll:

:lol:

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PostPosted: Sun Aug 31, 2014 6:06 pm 
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Can we at least admit 24mgs of Suboxone a day for 3 yrs is a bit excessive .... and probably a waste of Suboxone.....


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PostPosted: Fri Sep 12, 2014 4:12 am 
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Painter wrote:
Can we at least admit 24mgs of Suboxone a day for 3 yrs is a bit excessive .... and probably a waste of Suboxone.....


Even better how about someone tell me why it would EVER be a good thing for someone to take 24mg a day for 3 years.

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