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PostPosted: Fri Jan 06, 2017 3:39 am 
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I've been prescribed MS Contin for the last approximately 20 years (tried at times to switch to Duragesic, Dilaudid, Oxycontin, etc, but MS-Contin always worked best). My most recent prescription was for 800 mg/day (half in morning, half at night).

Long story short, I lost my insurance. Then I found out how expensive MS-Contin really is!!!! Even though I was getting generic! Since I REALLY can't afford it, I resolved to try to live without it. When I tried to just stop, I got very sick. My doctor told me that I had to stop more slowly. I was able to taper to 200 mg/day (100 twice a day). When I went from 200 to zero, I still felt awful. But there was no way to taper more, since I only have 100 and 200mg pills and cutting them destroys their time-release.

I found an AMAZING doctor who treats patients without insurance. She said that after 20 years, it's too much of a shock to my body to stop so suddenly. She gave me a prescription for Buprenorphine, 8mg, 60 pills. She said to wait 36 hours after MS Contin (or as close to 36 as I could manage), then take 1/2 pill under the tongue every hour until I felt better. She gave me a GoodRx drug discount card and a list of pharmacies showing the price with the discount (from $114 to about $200 for 60 pills).

Here's what happened at the different pharmacies I tried:

(1) Safeway, $114 on coupon: I called and they said I had to come in to get a price. When I came in, they said they don't carry Buprenorphine 8 mg and cannot special-order it.

(2) Pharmaca Integrative, $114 on coupon. They said they don't take GoodRx cards for controlled substances. I asked how much without the card or insurance. The girl said $150. I asked if I could look around for a better price. She said sure, but that the $150 was already a discount - the regular price was almost $200, so she would put a note in my file with the $150 in case I came back.

When I came back after problems elsewhere (See below), a different girl took my script, confirmed the $150 discount price and told me that it would be filled the next day (today) at noon. I came back, 34 hours without MS-Contin and feeling awful. I gave my name and the tech found the prescription in her computer. The pharmacist asked me, 'Are you a cash customer?' I said, 'No, debit card.' She said, 'I meant, you don't have insurance?' and I said yes. She said she couldn't fill it for $150, that the price now was $780!!!! I said 'I can't afford that!' She shrugged and said 'I know.' I asked if I could fill ONE pill for $15 or so (and then I'd try to figure out the other 59 pills somewhere else) - she said nope, it was all or nothing.
I think she gave me such a crazy price because she just didn't want to fill it. The tech was more apologetic and said to try Costco.

(3) Costco: I called for a price and the tech said $130-ish for non-members. I said GREAT!
When I got there, the pharmacist demanded ID. I have NEVER been asked for ID when I dropped off other painkiller scripts, only when I picked up (and only in the last couple years). Even then, my husband, who has the same uncommon last name, was always allowed to pick up for me and show his ID instead.
I gave them my old driver's license (I don't have a current one, don't need one, and can't get one until l pay off an old parking ticket). The pharmacist said no, he needs a CURRENT driver's license to verify my identity. I asked if my husband could show his current DL instead - he said no, he needs MY current ID. My other cards (debit card, old insurance card, library card) weren't good enough. It must be an up-to-date California state driver's license and nothing else.
They always accepted my expired license when I was getting other painkillers. Never an issue.

(4) Walgreens. $180 with GoodRx. Immediately asked for ID. Didn't care (or notice?) that it was expired, but said he couldn't fill it because my current address isn't the same as the one on my old license (I've moved since then). I asked if my husband could show his ID with our current address - again, no. I asked if the address on my license would matter so much if I paid up front (I figured they were worried they wouldn't be able to contact me if I had them fill it then didn't show for pick-up) - he said he couldn't fill it no matter what.
My address changed three years ago - this is the first time that it's been an issue.

So that's FOUR DIFFERENT pharmacies that have totally jerked me around. I feel like if I jump through some of their hoops like getting a new license that I don't need (since I don't currently drive b/c of my disability), they'll just find another reason to deny me.

Is this normal? I've NEVER had trouble filling other, more dangerous painkillers!

Is this because I lost my insurance? Does being uninsured for a couple of months really earn me such contempt? I thought they made MORE money from people without insurance!

Does anyone know of a pharmacy in the SF Bay Area (or mail order to here) that
(1) carries Buprenorphine 8mg or can order it
(2) is willing to fill for people without insurance
(3) charges a reasonable price (and/or takes coupons like GoodRx!)
(4) doesn't demand ID, or will accept my old driver's license, or will let my husband show his ID instead.


I am so insanely upset. After each pharmacy treats me like the scum of the earth, I just cry and cry. At 40 hours off MS-Contin, I realized I couldn't get the buprenorphine anywhere and so I took a 100mg MS-Contin pill. I am back where I started last week!

It seems very crazy to me that it's harder to get buprenorphine than MS-Contin, Oxycontin, etc.

If it's impossible for me to get this medicine, buprenorphine, does anyone have a suggestion of how else I can get off painkillers? Here is what I have to work with (all were legally prescribed to me, but most of them other than MS-Contin are expired b/c they were given so long ago):
MS Contin, 100 mg - about 200 pills.
MS Contin, 200 mg - about 60 pills.
Morphine Immediate Release, 30 mg - a few bottles, expired (I never had much breakthrough pain)
Morphine syrup, 100mg/5ml - two 240ml bottles, expired.
Duragesic-100 patch - three patches, long ago expired
Fentanyl Lollipop, 1200mg - box of 30, long ago expired.
Soma, 350 mg - about 90 pills, long ago expired.
Ultram, 50 mg - about 100 pills, expired.
Lyrica, 75 mg - about 5 bottles of free samples, long ago expired

Lastly, does anyone know a way to LEGALLY donate unused narcotics to countries that can't get them? Or a hospital that would give them to poor/uninsured who can't otherwise afford them? Now that I know how expensive these meds are without insurance, I feel terrible just throwing them away. But now that I know the HELL of quitting painkillers (in 20 years, I've never run out or needed early refills or otherwise had a problem, so I didn't know that stopping would be so terrible), I don't want them anymore! Many are expired, but I've taken expired meds before and they usually still work.


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PostPosted: Fri Jan 06, 2017 8:24 am 
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Hello,

Others will weigh in, but I just couldn't not respond to this terrible story. It seems that if you can get
a current/correct ID you'll be good to go? Fortunately you've got enough of your ms contin to last you until
you can get that done, yes? So if it were me, that's what I'd do.

I'm very sorry you're having such a hard time. My drugstore...CVS....could care less about my scripts. Last
time I automatically handed the gal my license and she got impatient and handed it back But CVS is not a
discount drugstore. I pay 350 for a copay for 24 mg's daily.

I think the recommended course on the old drugs is to flush them. Someone please correct me
if I'm wrong..

Best wishes...

Godfrey


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PostPosted: Fri Jan 06, 2017 8:40 am 
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Before someone questions my decision to get off painkillers with, 'but what about the pain'?

A couple months ago, when I lost my insurance, I was truly convinced that I could not live without MS Contin, that the pain would kill me.
Dr. Junig's posts on Suboxone Talk Zone "Why Not Just Take Narcotics for my Chronic Pain" was extremely helpful in making me re-think that.

My first try, I went from 800 mg/day of MS-Contin to zero - not good. This gave me the impression that my pain really was overwhelming and could not be controlled without narcotics.

The doctor who prescribed the MS-Contin told me to 'go slowly' but didn't say what that meant, so I was decreasing by 100 mg per day for a 6-day taper - a little bit better, but still felt like pain beyond my ability to tolerate.

So I read a little more about tapering and decided to go MUCH slower - to reduce my dose by 100 mg, then wait until I felt more normal until decreasing again. That way I wouldn't be getting all the pain in one blow.

When I'd go, for example, from 300 to 200 mg per day, it felt pretty painful at first (including types/locations of pain that I'd never even had before!). But after 10 days, I felt just as okay on 200 mg as I had felt on 300 mg.

This has convinced me that Dr. Junig is right - that all those dose increases over the last 2 decades didn't really do anything for my pain in the long term. Maybe I got 10 days of extra relief out of them, just like I'm now having 10 days of extra pain going in the other direction. But after the acute effect, I was probably brought back 'to baseline'.

I've gotten from 800 to 200. But making the jump from 200 to zero is still overwhelmingly painful. I feel pretty confident that once my body re-adjusts to the absence of narcotics (like it's adjusted to the dose decreases I've already made), that I won't be worse off than I was while taking 800 per day. I'm just really struggling to get there and would appreciate any advice.

Buprenorphine sounded SO helpful b/c it lasts a long time, the dosing is EVEN (unlike trying to taper on immediate release morphine, which was very jagged), and the pills can be cut in half or dissolved in water without reducing their length of effect (unlike MS-Contin - when I cut them, they just don't last close to 12 hours. Dissolving them in water would probably kill the time-release entirely, leaving me with even more morphine IR, which is worthless).

That's why I'm so eager to find a way to fill this prescription and why I'm so upset that the pharmacists are giving me such trouble. Especially annoying b/c they had no problem filling my other narcotics over the years. Any advice would be greatly appreciated.


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PostPosted: Fri Jan 06, 2017 8:49 am 
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Thank you so much Godfrey!
I will try CVS next. Based on your price, it sounds like my rx would be $220 there, which I could swing.

Getting a new license wasn't on my to-do list b/c I can't drive anyway and I'd have to pay a couple hundred bucks for it. If I was SURE getting the license would change the pharmacists' minds, I'd do it. But it really felt like they were looking for excuses not to fill it.

Why did they need to see the license just to tell me what it would cost? I feel like even if I'd given them a current license with a current address, they might've just done the price bait-and-switch like Pharmaca Integrative did, or tell me that they don't carry it and can't order it like Safeway did (does anyone know if that's even true?) P.I.'s price was SOOO out of range of other prices I've seen (and so different from what the previous tech had told me) that I'm pretty sure they were just trying to get rid of me. I was admittedly not at my best, because I was in a lot of pain from 34 hours off MS-Contin. But don't a lot of people show up at the pharmacy at less than their best?
And why couldn't they let me buy one pill at that ridiculous price?

I really felt like I was being given the run-around b/c they don't like this drug. I've filled morphine, fentanyl, etc at the same pharmacies and they didn't mind that my ID was expired - it's still a government issued ID that's clearly me. That's why I find it hard to believe that this is a legit requirement and not just the pharmacists not wanting buprenorphine patients (or maybe not wanting uninsured patients? But isn't it easier for them to not have to deal with the insurance?!!!)


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PostPosted: Fri Jan 06, 2017 9:29 am 
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HI,

Here's a link with suggestions for other sorts of ID (other than driver's license). One of them I think
is a non-driver's license issued by the DMV.

https://www.cga.ct.gov/2012/rpt/2012-R-0247.htm

I honestly don't think you'll have any problem once you get your ID. To reassure yourself you could always talk to the pharmacy owner or manager to confirm they'll fill your script once you get ID. But people all over the country successfully fill their prescriptions every day. I have no doubt you'll get your script filled
somewhere. :D

Also, I doubt anyone here will question your decision to switch to bupe.It's the same decision most of us have already made.

Here's a copy/paste from the link I sent you

":NON-DRIVER ID CARD
A DMV-issued non-driver ID card is the primary alternative to a driver's license. The card costs $22.50 and is valid for six years."

Best wishes,
G.


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PostPosted: Fri Jan 06, 2017 3:21 pm 
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Hey KnockedOut!

For some crazy reason there's places that put more judgement on buprenorphine than oxycodone. That's ridiculous to me but it happens. You'll have to adjust to those judgments when u make the switch. It's not cool but we have no choice when ppl wanna act like that. It ends up pushing ppl away bk to using because pharmacies are making it difficult to fill.

When I was just beginning my treatment, I called around checking prices, I have no insurance either, and I called Kroger pharmacy. They told me that they couldn't give me a price unless I personally came in. I was like ok just forget it that's ridiculous. I called Walmart pharmacy and they priced it but it was very expensive. So I went with a small town pharmacy and have been pretty happy with them. I've never had to show my ID and my fiancé picks up my suboxone a lot and has never showed ID either..... which they know me but they didn't know him at first. From what I've read, a pharmacy can refuse to fill something if they want. I've read a lot of stuff about ppl having a hard time filling their suboxone and I don't understand that. It sucks that u are wanting help but because of pharmacies u had to go bk to opiates because u were sick. U did what u were supposed to do but still got pushed to the side. That ticks me off.

I really hope u don't get discouraged and try again. If I were u, I'd go get my ID because you'll need that eventually anyway. Heck a couple yrs ago, my license had expired before I realized it and was trying to take something bk to Walmart without a receipt, and they refused to take it bk because of my license being expired lol! I couldn't believe that, so u may be better off just getting ur ID fixed anyway. If that's what they require then it'd be absolutely worth it in the long run to do it. So hopefully u can get everything going, I know it's frustrating but suboxone can really help u.

Please let us know what happens :)


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PostPosted: Fri Jan 06, 2017 4:20 pm 
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Godfrey, Thanks for all your important efforts to help others here. Just great! Not sure how it works but Ive found helping others helps ourselves. Cool. Really appreciate and learn from you. Same for jennjenn !Thx.

Knockout, Welcome! A couple thoughts in no order.
I asked a pharmacist friend. More and more, a current ID is required. Even more so for bup bc a script for bup usually means addiction and yes, an addict even in recovery on bup is incorrectly perceived to be more complicated and risky than a 'pain' patient. And a cash customer may also be perceived to be less desirable bc often times they cannot afford the full script and instead require multifills through the month = more work w no add'l profit for them. Dislike real cash, the paper coin version, hard to safekeep till bank deposit.
No way to legally donate unexpired or expired opiate scripts to anyone. Either flush or return them to a pharmacy when they have their unused med drop off days. I took in 2 large plastic garbage bags filled w opiates w bottle labels removed.
Also, good for you, you're already reading around here. Hopefully you found info on a pain vs addiction diagnosis. Since you are currently a pain patient, far better to have a script for bup for a pain diagnosis - far less stigma at the pharmacy and in your electronic medical records. Some info from Dr J and docm2 who replied to a thread of mine where I asked on bup for addiction vs for pain. Also in other threads/posts. Worth learning about.

I am excited for you that you learned of bup. I was a 'pain' patient on all that you were except at the end was all fentanyl. I was convinced that I had pain and needed all the meds. Yet, I wasn't in that much physical pain. I abused it for physical and emotional pain and completely missed where I crossed into addiction years before. Wish I found bup earlier bc I deeply believe it would have stopped me from real life loss. Pelican

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PostPosted: Fri Jan 06, 2017 6:30 pm 
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Hey Pelican, that's very thoughtful of you to give me a mention. I'm even more gratified to see my name
placed so near the highly respected jennjenn...who among others was so generous and encouraging
when I first came around. As we used to say in the 12 Step group that saved my life several decades ago,
she...and the other regulars around here....are a power of example. I've said several times I don't believe
I had another 12 Step recovery left in me after my big relapse 12 years ago. I don't know where I'd be without this medication, and without this immensely helpful forum.

Dr. Junig was very kind to me at one point last year in responding to my questions, when I was feeling so lost in regard to what to me was the very scary prospect of switching to buprenorphine. I promised him I'd do my best to pay it forward, so to speak. He's very busy man and of course I doubt he even noticed, but I'm at a time in my life when i've got some extra time. And yes, it's a way to feel better about myself. There are many times when I need all the help I can get in that area. I do manage mostly to forgive myself. I just wish it wasn't a several times a day project. :?

Sincere thanks again,
G.


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PostPosted: Fri Jan 06, 2017 6:40 pm 
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Godfrey, u have become very important to this forum! I am so proud of the progress that you've made. U help so many already and I think they can relate to u maybe even a little bit better because ur still fairly new and the newer members can relate to u. I just wanted to mention how helpful u are. I think we actually mentioned in the moderators section how far you've came! Awesome to see! Like u and pelican (who I've mentioned that I'm very glad to see posting again), I love helping other addicts, it's just something that I relate to do much and if I can help them I sure Will :) I think it's got a lot to do with when I first started suboxone treatment, I literally had no one to relate to other than my weekly suboxone meetings at my clinic. I needed more because I didn't know anything much about suboxone and I definitely didn't have friends I could talk to about it. So coming here just feels like home in a way.

KnockedOut, I really look forward to u posting more also. I think u will do just fine here :)

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PostPosted: Fri Jan 06, 2017 8:20 pm 
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Thanks so much Jenn. Of course very nice to hear :o


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PostPosted: Fri Jan 06, 2017 9:36 pm 
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jennjenn wrote:
Godfrey, u have become very important to this forum! I am so proud of the progress that you've made. U help so many already and I think they can relate to u maybe even a little bit better because ur still fairly new and the newer members can relate to u. I just wanted to mention how helpful u are. I think we actually mentioned in the moderators section how far you've came! Awesome to see! Like u and pelican (who I've mentioned that I'm very glad to see posting again), I love helping other addicts, it's just something that I relate to do much and if I can help them I sure Will :) I think it's got a lot to do with when I first started suboxone treatment, I literally had no one to relate to other than my weekly suboxone meetings at my clinic. I needed more because I didn't know anything much about suboxone and I definitely didn't have friends I could talk to about it. So coming here just feels like home in a way.

KnockedOut, I really look forward to u posting more also. I think u will do just fine here :)


Absolute ditto in the first degree!!! :D

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PostPosted: Fri Jan 06, 2017 11:16 pm 
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godfrey wrote:
Hello,

Others will weigh in, but I just couldn't not respond to this terrible story. It seems that if you can get
a current/correct ID you'll be good to go? Fortunately you've got enough of your ms contin to last you until
you can get that done, yes? So if it were me, that's what I'd do.

I'm very sorry you're having such a hard time. My drugstore...CVS....could care less about my scripts. Last
time I automatically handed the gal my license and she got impatient and handed it back But CVS is not a
discount drugstore. I pay 350 for a copay for 24 mg's daily.

I think the recommended course on the old drugs is to flush them. Someone please correct me
if I'm wrong..

Best wishes...

Godfrey


my local CVS, that is in the same town as the rehab facility i get my scripts from refuses to fill them! the fact that their home web page is plastered with information about opiate opiate abuse is such a lie. they won't fill for subs but they will for any other narcotic?!

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PostPosted: Fri Jan 06, 2017 11:23 pm 
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i'm so sorry you're having problems filling your script. i did at first to. my treatment facility is in the town i work in, so i assumed i could get them filled in town. Both CVS and Rite aid refuse to fill them Not just for me, the just won't. i had to drive 35 miles back home then 15 miles to my regular pharmacy. I also was in tears. I called my regular pharmacy, also a chain, but a smaller one, Medicine Shoppe. I asked if they carried them. They asked my name and if i was a current customer. Then they told me they had them in stock. My therapist mentioned that sometimes pharmacies won't tell people over the phone if they carry something because of all the robberies. I am going to file a formal complaint with my state's pharmacy board if i don't get an explanation from Rite Aid and CVS..

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PostPosted: Fri Jan 06, 2017 11:25 pm 
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some states let you log on to the dmv and change your address online. then you can print out the change of address and carry it with your license. we do this at work for customers all the time.

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PostPosted: Sat Jan 07, 2017 12:03 am 
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Just wanted to add-sorry if it's been mentioned. Guilty-I skipped a little ahead. You can get just a plain identification card instead of your drivers license. If you do not have one already, then you will have to go to the DMV. But you can get a correct address and not have to pay the fees for your license, that should help. They give you a paper copy the same day so it will work as current identification. I go to CVS-I have never had an issue getting my prescription and they have never asked for my id.
Walgreens is another story...


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PostPosted: Fri Jan 13, 2017 3:00 am 
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Thank you so much for the responses. I should've mentioned that I DO have valid, up-to-date ID (I have a US passport and a CA ID card) - I don't normally carry my passport with me, but I told them I could bring either, and they said it had to be an up-to-date CA driver's license.

Fortunately, my amazing doctor found a workaround so that I don't have to get it from a pharmacy at all (she can order it wholesale and dispense it to me). It's also much cheaper to do it that way. I'm so lucky I found this doc!

I'm not very sure where I fall on the pain-to-addict spectrum, but I'm definitely highly dependent on the meds. When I stopped abruptly, I felt really, truly awful. I could get bupe from my old pain doctor for pain, but without insurance, he would cost like $300 or more for an appointment. This addiction doctor treats patients with or without insurance for free.

I guess I don't deal very well with being stigmatized. Funny thing is that I've also picked up buprenorphine for some of my animals (it's used much more commonly for pain in veterinary medicine, I think. But animals get it as an injectable liquid called Buprenex which is a much lower dosage than 8 mg) - and they never asked for ID or had any issue!

I REALLY appreciate all the support. I was so upset and frustrated. I had been so excited to start bupe and get off the painkillers for good - and then I was totally thwarted AFTER I'd gone almost 40 hours into withdrawals. Without any way to get the bupe, I ended up taking my painkillers again - so it was like I went through all that hell for nothing.

I'm sorry I'm not responding to the individual posts - I'm a few hours into withdrawal and just not at my best.


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PostPosted: Fri Jan 13, 2017 5:18 pm 
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Hi Mouse!

I'm sorry you're not feeling your best right now. I wanted to address whether you are dependent on your opiate medication or addicted.

First, all pain patients build up a tolerance to opioids. Starting out with 60 5mg hydrocodone for a month turns into 60 7.5mg hydrocodone per month to 120 5mg hydrocodone, etc.

The hallmark of addiction is if you are using your medication to achieve a certain feeling besides just a lack of pain. If you are looking for that feeling of calm, or a burst of energy, or euphoria, etc. then you are in addiction territory.

Dependence is when you take meds simply to relieve pain, but you are on enough medication that your body needs to maintain a certain baseline or you will start to have withdrawal symptoms. You are not trying to achieve a good feeling, just a lack of pain.

An addict will take more medication than they are prescribed in order to feel good, calm, high, not depressed, etc. Addiction is a psychological dependence in addition to being physically dependent on the opiate medication.

Withdrawal feels bad for anyone experiencing it, both dependents and addicts alike. You don't have to be an addict to feel some depression from it, but addicts tend to feel a more soul-crushing depression that life will never be happy again. Yah! Not fun!

It may be premature to try to figure out where you are on the dependence/addiction continuum. Take care of your transition first and then focus on other issues. Good luck.

Amy

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PostPosted: Fri Jan 13, 2017 8:07 pm 
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Amy-Work In Progress wrote:
dependence/addiction continuum.


Amy,
what is dependence/addiction continuum?

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PostPosted: Fri Jan 13, 2017 8:33 pm 
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It's just my way of explaining that dependence and addiction occur on a curve that marks different levels of severity from mild dependence to the most severe addiction and every point in between. Not all addiction is at the same level or the same state. The continuum also shows how addiction progresses.

Here's an example:

https://www.google.com/search?q=depende ... uMz2KSM%3A

Try clicking on the link.

Amy

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PostPosted: Sat Jan 14, 2017 2:35 pm 
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knockoutmouse,

All good responses so far and I'm pleased you found a solution to obtain your meds. There are only a couple of things I want to talk about.

1) Do not flush any medication down the toilet. It is forbidden because it gets in the water supply through the water treatment plants. Every pharmacy will give you information on how to get rid of them. There may be a slight charge to handle them but I wanted to give you a heads up.

2) Please, never give any of your Suboxone/Buprenorphine to any animal. It will kill them. When the main ingredient in Suboxone, Buprenorphine, is used for pain relief it is given in micrograms, not milligrams. Even 1 mg can kill an innocent animal because they are opiate intolerant. Only give them what your Vet prescribes.

Good luck on finding good pain relief.

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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