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PostPosted: Sat Oct 29, 2011 1:19 pm 
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Does the doctor you go to do this?
When I began Suboxone treatment, I had to sign a form saying I'd abide by the rules. And I did sign and I do abide. Appointments are once a month, and a drug screen is done. If you tested positive for anything, you have to come in every 2 weeks until you're clean, then back to once a month. This office also does random drug tests and pill counts. During the past 18 months I've been a patient, I've been called for randoms maybe 5 or 6 times. I've been clean and always have the correct number of subs. My last regular appt was Oct 5th. Everything was fine I was given my Rx and made next appt for Nov 5th. I got called to come in for a random on Oct 19th and I did. Then I got called AGAIN this past week on Oct.26th to come in the next day. I couldn't, I had plans and was about an hour away. I called and left a msg as soon as I got their msg saying I couldn't make it there by 4pm when they closed and that maybe it was a mistake? being that I was just there the week before. She called back and said no, not a mistake and if I didn't come in I'd be dismissed! She said a nurse would be there till 7pm, to get there by then and it would be fine. So I did. My next appt is this coming Sat (Nov5th) where i'll be tested again. That's 4 tests in 4 weeks! Does that seem fair? Do other practices do this? Each drug screen costs me about a 100 bucks. Come on now, that's ridiculous. I asked the secretary why I was being called 2 weeks in a row, she said the doctor wanted to see if my THC level was *coming down*. HUH? Okay so I smoked a joint on oct 8th, but I went in for my test when I was called knowing it might be pos for THC, I didn't try to hide it. What was the purpose of having me come in again, and be charged again, when she will no doubt reprimand me at my next appt next Sat. I know i shouldn't have smoked, I KNOW! I'm also waiting on CT results and blood work and other tests to see if this mass that is growing on my pancreas is cancer :( So I smoked a joint, because it's the only way I could eat and sleep because I'm so nervous about the pancreatic cancer. I have a small child, i don't want to die. I was wrong to smoke weed when i'm on suboxone and signed a form saying I wouldn't use illegal drugs, but I had my reason and I would've taken the punishment of having to come back every 2 weeks till I was clean. But to try to trap me like that? especially since I've been excellent since I started subs and am always negative for anything (except for when I had surgery and the sub doc totally screwed me over by not stopping the subs ahead of time and I was in terrible pain ... but I had an RX for those pain pills and my sub doc was aware I was taking them). I'm sorry, I'm ranting. I admit I shouldn't have smoked a joint but I did and am going to accpet the consequences. I was SO upset about the pancreas thing, a friend offered me a joint on my bday and well, it worked to calm me. Temporarily. It's the way the sub office is treating me over ONE bad drug screen, not to mention the co-pays!
Soooo, I'm curious ..... do all suboxone docs do this, random drug screens and pill counts?
Also, can anyone recommend a sub doc in western/upstate NY? I want to switch. Between the messing up of my surgery last Jan and now this crap. Thanks for reading.


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PostPosted: Sat Oct 29, 2011 1:29 pm 
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ALSO: wanted to add ..... a few months ago I went in for my regular appt and the doc told me that drug screen I had the month before was pos for Dilaudid. I did not take any dilaudid or any pain pill at all! I swear on my life, on my childs life, I did not. She didn't believe me. I've never even had an issue with being pos for anything (other than when she knew I took percs after hip surgery). She said the tests don't lie. Oh but they do!!! I swear i did not take dilaudid! I'm thinking that when I left my specimen in the little window in the bathroom, that someone came in right after me and saw it there because maybe the nurse didn't get it in time, and switched. That's all I can think of, it was pretty crowded that day. Or the lab made a mistake. In any case, my doc did not believe me and I had to come back in 2 weeks not 4 (so there's another office visit and drug screen co-pay). So I'm sure that's not looking good in addition for the pos THC a few weeks ago. But still, I did not take dilaudid.
Just wanted to add that to my prior post.
Sorry for rambling. It's so frustrating. I'd think the docs are there to HELP me, not treat me like a criminal. I'm a sub patient because I chose to get off the opiates and change my life. I'm not there because I was court-ordered. i'm there voluntarily and I don't like this randon testing thing, 4 times in one month.


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PostPosted: Sun Oct 30, 2011 4:04 am 
If they are making $100 off you for each drug test and you haven't fucked up at all, then this is DEFINITELY NOT normal and you need to switch doctors. Immediately.

Again, the only way I could see that being normal is if you regularly piss dirty.

My doctor u/as every time I go in, but never calls me in, and never any pill counts. Actually, I have never heard of anyone on Sub getting pill counts, only people on real heavy painkillers, and it isn't common.


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PostPosted: Sun Oct 30, 2011 10:08 am 
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My sub doctor is also my primary care doctor (but then I'm also on sub for pain control) and doesn't do any UA's or pill counts or anything like that. But I do know some sub doctors that do have their patients sign contracts and do all those other things as well. I also know of doctors that would have kicked someone out of the program at the first sign of a failed UA, so take that into consideration when it comes to finding a new doctor - watch that you don't go from the frying pan into the fire. Just make sure when you start interviewing doctors that you ask a lot of questions and don't fire your current doctor until you know for sure you have a new one lined up. I've seen people end up with no doctors that way.

It does sound like to me that they are making you jump through some excessive hoops. Good luck finding a new doctor. I'm sure the way they are treating you isn't exactly helping you succeed at remission/recovery. I hope getting a new doctor changes that.

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PostPosted: Sun Oct 30, 2011 11:39 am 
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Thanks for the replies. I wanted to switch sub docs after the dilaudid issue, but when I called a few here either they were not taking new patients or they didn't take my insurance. That was a few months ago, so I'll be making calls again this week. I'm not sure that if I ask about random testing, will that be a red flag? Like, why is she asking that, she must do something she doesn't want us to know about.
I've made the decision that in either case, I'm going to start weaning. Currently I get 90 of the 8mg strips per month, one to be taken 3x a day. I'm going to ask next visit about cutting down, whether I find a new doc or not.
I'm really worried about this pancreatic mass I have going on, and the waiting and testing is killing me. God forbid I do have cancer, where does that put me with suboxone? I'm having pain that's manageable but if they continue to mess with it, no doubt I'll need something more. I don't want to get hooked on pain pills again of course.
I'm mad about a lot of shit, I'm worried about this possible dx of pancreatic cancer. I don't need my sub doc to be scamming me with all these visits and co-pays, but at the same time I need the subs right now. I'm at 3 of the 8mgs a day, how in the world am I gonna wean myself? My husband said I should call my ins and let them know about all these tests and how I feel about them, but what if they refuse to continue paying their part? At least I get billed for the co-pays, if they should start denying coverage for those, I'd have to pay full price up front which is over $200 for the u/a.
Sorry for venting. Again. I have so much going on and am so worried about cancer.


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PostPosted: Sun Oct 30, 2011 11:46 am 
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Oh that was something I failed to mention. Most sub doctors don't even take insurance! Mine, luckily for me, does, but most sub doctors are cash and carry. So your main issue is going to be finding a doc that will even accept your insurance. As for asking about testing, just ask what their treatment program requirements are. Just be simple about it and it shouldn't raise any red flags.

I'm so sorry that you're so worried about this cancer thing. Did a doctor actually come right out and say it might be cancer, or are you worried on your own? I know when we hear the word "mass" or anything remotely like that that we tend to jump right to the worst case scenario. For now, there's nothing you can do so try to put it in out of your mind. I know that's easy to say, but you're just driving yourself crazy for no reason.

As for weaning off 24 mg, you should be able to get down to 8 mg and below very easily - almost without feeling it and within about a month. You could probably drop to 16 mg and not even notice that. If I were you I'd just set aside those extra pills or strips just so you have some extras set aside.

When you're ready to wean we can try to help you through that as well. Hang in there and do try not to worry so much. And please let us know when you hear something.

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PostPosted: Sun Oct 30, 2011 2:05 pm 
RockerMom wrote:
Thanks for the replies. I wanted to switch sub docs after the dilaudid issue, but when I called a few here either they were not taking new patients or they didn't take my insurance. That was a few months ago, so I'll be making calls again this week. I'm not sure that if I ask about random testing, will that be a red flag? Like, why is she asking that, she must do something she doesn't want us to know about.
I've made the decision that in either case, I'm going to start weaning. Currently I get 90 of the 8mg strips per month, one to be taken 3x a day. I'm going to ask next visit about cutting down, whether I find a new doc or not.
I'm really worried about this pancreatic mass I have going on, and the waiting and testing is killing me. God forbid I do have cancer, where does that put me with suboxone? I'm having pain that's manageable but if they continue to mess with it, no doubt I'll need something more. I don't want to get hooked on pain pills again of course.
I'm mad about a lot of shit, I'm worried about this possible dx of pancreatic cancer. I don't need my sub doc to be scamming me with all these visits and co-pays, but at the same time I need the subs right now. I'm at 3 of the 8mgs a day, how in the world am I gonna wean myself? My husband said I should call my ins and let them know about all these tests and how I feel about them, but what if they refuse to continue paying their part? At least I get billed for the co-pays, if they should start denying coverage for those, I'd have to pay full price up front which is over $200 for the u/a.
Sorry for venting. Again. I have so much going on and am so worried about cancer.


Sorry, I guess I didn't see your second post. If you failed a u/a, then it isn't necessarily all that weird. Idk, I used to go to a clinic where they didn't do u/as, and about 8 months ago I switched to a private doctor and I have never failed one of his u/as (because he doesn't care about weed).

This doctor may be a hack. How long have you been on Sub? Most of the docs I have seen/heard about are fine with patients taking 8-16 mgs/day (and some even encourage that amount), but I don't know of one willing to let people stay on 24/day for a long time. I am also gonna mention that it is VERY SUSPICIOUS that he has called you in for extra pill counts and expensive ass u/as. Wonder how much $$ he is making off of calling you in every week. I have never heard of Sub patients (or any pain patients either) being "called in" to u/a, that is like some felony probation type of stuff. I've heard about pill counts for pain patients but only on appointment days or if they were trying to get a script changed mid-month.

I really hope you don't have cancer..but if you do, and you need full-ags to deal with the intense pain of having a mass and doing chemo, don't let anyone make you feel bad for that.

Wishing you a speedy recovery.


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PostPosted: Sun Oct 30, 2011 3:55 pm 
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I started on suboxone in May 2010, 8mg three times a day. It's now Nov 2011 and I'm on the same dosage.
This is all becoming more and more disturbing as I'm reading replies to my original question. All of the random counts and screens, esp 4 in 4 weeks,. Yep, she is getting away with something here. I have medicare btw. You'd think the clinic would be concerned with how much medicare fraud there is. I'm scared to bring it to their attention for fear of her either getting pissed off and booting me out of the program as well as medicare denying coverage. I've been approved till Feb 2012, then I need to have it authorized again.
One more question if I may ..... if a sub doctor should dismiss a pt from their practice (like I was threatened with if I didn't show up for last weeks count/drug screen), is that even ethical? Moral, legal, whatever? Because I'm on 24mgs a day and that seems like a lot compared to what I'm reading here. Can she suddenly say too bad, don't come back? Doesn't she have to at least continue to treat me till I'm weaned off? Or if I didn't show up last week, could they refuse to see me at the next visit? I'd be there for an appt next Sat morning, with none left. Doesn't seem right that can be done. I'm thinking it'd be dangerous to go from 24mgs one day to ZERO the next.
Again, thanks for all the responses. I'm sorry I haven't been more active here and seemingly was a lurker and only posted when I had an issue. I was not lurking I swear :) i just didn't come by as often as I know I should have, you all have SO much to offer i'd be crazy not to do so from now on. Thanks for helping me see that.


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PostPosted: Sun Oct 30, 2011 6:10 pm 
RockerMom wrote:
I started on suboxone in May 2010, 8mg three times a day. It's now Nov 2011 and I'm on the same dosage.
This is all becoming more and more disturbing as I'm reading replies to my original question. All of the random counts and screens, esp 4 in 4 weeks,. Yep, she is getting away with something here. I have medicare btw. You'd think the clinic would be concerned with how much medicare fraud there is. I'm scared to bring it to their attention for fear of her either getting pissed off and booting me out of the program as well as medicare denying coverage. I've been approved till Feb 2012, then I need to have it authorized again.
One more question if I may ..... if a sub doctor should dismiss a pt from their practice (like I was threatened with if I didn't show up for last weeks count/drug screen), is that even ethical? Moral, legal, whatever? Because I'm on 24mgs a day and that seems like a lot compared to what I'm reading here. Can she suddenly say too bad, don't come back? Doesn't she have to at least continue to treat me till I'm weaned off? Or if I didn't show up last week, could they refuse to see me at the next visit? I'd be there for an appt next Sat morning, with none left. Doesn't seem right that can be done. I'm thinking it'd be dangerous to go from 24mgs one day to ZERO the next.
Again, thanks for all the responses. I'm sorry I haven't been more active here and seemingly was a lurker and only posted when I had an issue. I was not lurking I swear :) i just didn't come by as often as I know I should have, you all have SO much to offer i'd be crazy not to do so from now on. Thanks for helping me see that.


Yes. Unfortunately, your doctor can dismiss you without warning and without a script if you violate the terms of your patient contract. Actually, they may be able to for any reason..but if you violate your terms, you won't win if you sue.

If you really did fail a u/a without using (I know that it's possible), that just makes it all the worse.

You need to find a new doctor..this really sucks, I am sorry.


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 Post subject: hmmm...fishy...
PostPosted: Mon Oct 31, 2011 1:37 am 
In 2001 I was among the first wave of buprenorphine patients in Minneapolis and my first doctor (the first Suboxone prescribing Dr. in Minnesota, actually!) He required me to bring my pills in each month for a count and would give me UA's once monthly for sure and would on occasion call me in for a 'surprise UA.' I'm sure some doctors still operate like this today, obviously yours does; thankfully my current doc does not! In asking him what to expect of his practice when I sought him out a couple years ago, I asked him how often I would be tested (because I was concerned about the cost) and he said never. He subscribes to my philosophy that as inaccurate and easy to forge in whatever way one wants UA's are that there is more or less no real reason to give them other than procedure for the sake of procedure. Also, for someone to tell you that you tested positive for Dilaudid specifically seems fishy unless it was a blood test as I'd be really surprised if Dilaudid was part of an office based panel test. Typically as far as opiates go there is one panel for opiates (which includes morphine, heroin, codeine, hydromorphone, hydrocodone), one specifically for methadone/propoxyphene and one specifically for oxycodone. Unless your doctors office has paid a lot of money for many, many panel tests with each opioid listed separately this accusation seems fishy to me.

As far as marijuana, I can see both sides of the argument. Yes, MJ is illegal so if your doctor is the type of person who will dismiss someone for this type of behavior, then, well, salud! I'd find a different doctor, personally. I don't use marijuana but I know it certainly doesn't cause the devastation that almost every other drug is capable of (including alcohol.) In a 'traditional' treatment setting it is one thing to have a hard-stance about marijuana, but in the case of buprenorphine maintenance it does not really make sense to discharge an opioid addict from an opoid replacement medication that is effectively keeping them off of opioids because they used a non-lethal drug that really isn't being treated with the buprenorphine.

Good luck in hopefully finding a new Dr.!
Travis


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PostPosted: Sat Sep 06, 2014 11:21 pm 
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Travis, hydromorphone IS Dilaudid.


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PostPosted: Fri Sep 12, 2014 2:49 pm 
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PhillipH,

Welcome to the forum! Instead of posting at the end of a very old thread (Oct '11), why don't you tell us a little something about yourself in the Introductions section?

It's up to you if you want to post or not. The big Welcome sign is still up for you!

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