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 Post subject: Suboxone and the VA
PostPosted: Mon Feb 14, 2011 9:20 pm 
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Thought I would post this here also (it's in legal too) as I'm looking for guidance and legal info. Here ya go, any suggestions or input is much appreciated. Thanks

I apolagize for not posting an intro, just wanted to get this in and get opinions and suggestions. I'm a 100% disabled veteran. I had a bad jump in the army in 04 and was eventually put on 50mg oxycontin 2x a day and 4 5mg a day for a total of 60 40mg oxycontin, 60 10mg oxycontin, and 120 5mg percocet a month from my army doctor in physical medicine. I was on that routine for 2 1/2 years before I was medically discharged from service. I went to the VA the next month (army doc told me they would continue my prescriptions there) and she told me that they don't prescribe opiates, not even hydrocodone, for my type of injury. No new MRI, no nothing. I left that day and swore I would never go back to the VA. I eventually lost everything that was important to me, mainly my wife, she couldn't trust me anymore (blew thru everything we had saved).

After buying percocet on the street for a year, I went to rehab, dried out, relapsed, went back to rehab, dried out, relapsed again. In Nov 07, I had to choose between MMT or suboxone and I choose suboxone. Found a doctor an hour and a half away and things were great once I was on suboxone, no cravings, no w/d symptoms, I finally felt normal for the first time in years.

Fast forward to June 2009, I moved to Arkansas after recieving my disability benefits to try to rekindle my relationship w/ my wife now that I wasn't acting insane anymore. I went to the VA here and it took about a month, but the MH director at the VA wrote my suboxone prescription for the first time. She only did inpatient treatment so they would have me see a social worker for 30 minutes, then he would call her, then I would go down and pick up prescription at the window. We did that routine for about a year and then in June 2010, two more psych docs got the qualifcations and went to the course and were able to treat w/ suboxone.

So I hate switching doctors, but since she only did inpatient, she put me off on one of the two. He was a great psychiatrist (Sp) and addiction specialist. Nothing but positive experiences while he was at the VA. In November of 2010, he informed me he was moving to a private practice. I have medicare d (accepted where he was going) and he told me that I could go with him as a patient at the new practice. In January 2011 I come and he tells me that they haven't set his new schedule yet but he gave me the phone number and told me to call in two weeks.

Now the reason I was happy that I got this doctor instead of the other doctor. When I met him the first time, I told him that groups didn't work for me and 1-1 counseling was the way I wanted to go. The other reason he was great was he was ok w/ me smoking pot to relieve the pain. He was big on medical marijuana and was absolutely fine w/ me on it. The first time I saw him he told me if I would of got the other doctor and pissed hot that he would of taken me off my benzo's and cut my sub script in half. I was glad I got the doc I got. The VA set's all the appt's. During the six months I saw him at the VA, he never asked me to go to counseling or asked me to submit a UA. Then at that last appt at the VA in Jan. 2011 he read to me a note that was in the computer that said I was in violation of there substance abuse policy and that I intentionally skipped meetings. Nobody ever scheduled a meeting and I considered seeing him for an hour the 1-1 counseling, so did he. He told me he was going to talk to the guy who runs the substance abuse counseling (and wrote the note) because he said it could get him and me in trouble. I was kinda worried but knew that I was leaving the VA and going w/ him to the new practice.

Fast forward two weeks, I call his new practice to schedule my appt for February and they tell me that he told them to tell me to continue my treatment at the VA!?!? I asked her if she could have him call me, which he did all the time to check up on me, and she said no since I'm not his patient anymore. I was pissed. I called back and said the DEA says he still my dr until my prescription is used (30 days). They told me that he couldn't prescribe suboxone at the new place, which is also a MH facility and specializes in treating addiction. This really messed me up. I called a different location of the same clinic, and they told me that I would have to be seen before they can prescribe suboxone (no sh*t). Bottom line, I didn't get to transfer to his new clinic and instead was pushed on to the other doctor at the VA who prescribes suboxone (the one that I was glad I didn't get orignally).

So here I am, have an appt on the 25th w/ this doctor (the other doctor), I quit smoking about two weeks ago so I could piss clean if I needed to on the 25th. When you have labs (UA or other) at the VA, they send you a letter just like an appt w/ the time to be at the lab. I still haven't received one even tho I called his nurse and asked her to ask him to order it so I could piss clean and get my suboxone prescription. Called today and no labs have been ordered. Meanwhile, the last two weeks have been hell as far as pain, and not being able to smoke to treat my pain. It blows my mind that it depends what state you live in whether you can legally smoke pot for pain or it's illegal. Also want to say that my state (AR) will be the next state to approve MMJ. Legislation is in the works as I type this. I'm not going to risk him ordering a UA the day of my appt so I won't smoke until I know what he thinks and how he wants to go about my treatment.

I'm also worried about the note that the substance abuse counselor put in the computer. If my other doc didn't fill people in or put a note in the computer himself, i'm going to be looked at like I'm trying to get over by not doing monthly counseling for the last 6 months. So i'm going into this blindly and extremely dissapointed that my prescribing dr (suboxone) wouldn't even give me the courtest of a phone call to tell me that he won't be able to treat me at the new clinic.
The only thing I can hope is that my old doctor talked to this new dr and explained my situation.

Everything is free at the VA, but i'm about ready to get psych care elsewhere. Does anyone know the requirements for the VA and prescribing suboxone, or where I might be able to find them, I have a feeling there just stringing me along and my anxiety has been off the charts the last two weeks due to this and the pain i'm in. Thank god I have extra benzo's from getting my refills in a couple days early but I don't feel I should be going thru this. I didn't have these problems w/ a civilian sub doc. I saw him, paid him, got my script and went and got it filled. I don't know what to do, I'm assuming (hopefully not) but can't get my mind off it, that this doc is going to tell me I can't smoke to treat my pain and be on suboxone.

If you've taken the time to read this, thank you from the bottom of my heart. I appreciate any suggestions or comments on ways I can move forward, I don't mind leaving the VA, but I would like to stay if my treatment plan can be worked out. I've been on the exact same medications for the last year and if I go to that appt and he says what I expect he is going to say, I will leave and seek treatment elsewhere.

If you have any questions i'll be happy to anwer them, guess this is an intro too. Thanks for the great site.

Chris


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 Post subject:
PostPosted: Tue Feb 15, 2011 8:10 am 
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I really have no idea what your talking about, I came here looking for help. Thanks

Chris


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 Post subject:
PostPosted: Tue Feb 15, 2011 8:20 am 
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cbvet: Don't let it bother you. This is just a moron - child - that was banned from here a few weeks ago and evidently has a dynamic IP address that changed so he got back in (for the time being). I'm sure they will ban his current IP address shortly.

It is interesting, however, that I've read and heard a lot that when a young person starts abusing drugs, their brain stops developing at the age they start the drug abuse. For example, if they started drugs at the age of 15, even though they may now be 25 (again just for example) they will act like a 15 year old. They have the intellect and intelligence of a 15 year old - and that is due to the drug abuse. Evidently this is an actual example that we are seeing of this phenomenon, in the actions of this poster.

I'm sure someone will be along shortly to provide a more intelligent and on point response to your questions.


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 Post subject:
PostPosted: Tue Feb 15, 2011 8:25 am 
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Thanks for clearing it up. I thought that that person thought I was somebody else.

Chris


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 Post subject: update
PostPosted: Fri Feb 18, 2011 4:21 pm 
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Thanks for the replies. Figured I'd give an update and get opinions.

This past wednesday, the 16th, I got a call from the local VA clinic and they told me that the dr. I had an appt set up w/ refused to see me due to multiple violations of the substance abuse contract. I drove an hour up to that VA and went to the patient advocate. We went over the letter that the counselor wrote in my file. He used words like "it looks like", "it appears to me", "based on the file", basically absolving himself of any consenquences for putting it in my file. We went thru my whole file (the patient advocate and I) and the violations were not going to group and there was a UA I failed in August. My psychiatrist put in the computer that if I failed another UA than he would have to take me off suboxone. He never ordered another UA, even tho they were suppose to be done monthly. So I was in violation because I didn't take monthly UA's. I mentioned the counseling in my first post but I was also in violation for not attending weekly group. Again, both the UA's and the group sessions are something that the psychiatrist has to put a order in the computer for. The patient advocate sent me over to see the counselor who put the note in the computer.

So I went into his office (after waiting an hour and a half) and I told him how I felt about the letter he wrote. I asked him why he didn't speak to me or my psychiatrist about these supposed violations. He actually apolagized to me for writing what he wrote without speaking to my dr. to find out what was really going on. He said because I was "man" enough to come see him that we would be able to work something out. He then called the dr. that cancelled my appt. and again asked him to see me. He again said he wouldn't treat me. They talked for a minute on the phone and the counselor said "after speaking w/ the patient, it doesn't appear that he did anything wrong, but that the prescriber and the system screwed me". So he finally agreed to see me and I have an appt on tuesday the 22nd w/ the 1 doctor at the VA who can prescribe it. They also told me that I was suppose to go to group weekly during my first two years of Suboxone treatment. I followed w/ the fact that I've been on it for 3 1/2 years. Then he said that I had to go to group the first two years I was on Suboxone at the VA (the first year and a half was a private dr., before I had any VA benefits). So I don't know if they want me to go to group weekly till June (2 years w/ the VA) or if they want me to go to group weekly for the next two years. I'll find out Tuesday.

The way this has all went, the counselor writing the letter w/o speaking to my dr to find out why I hadn't taken UA's or gone to counseling, and then the dr. cancelling my appt and telling people he refuses to see me based on violations of the substance abuse contract, has led me to look outside the VA for suboxone treatment. I have an appt for an assessment w/ one dr, unfortunately it's not until April, then there's a suboxone dr. that practices in the city I live in that I'm going to call on Monday and see if I can see him.

So that's where I'm at today, I have an appt scheduled w/ the VA doctor next Tuesday, no doubt he'll write my prescription, and then I'm going to continue to try to find a new sub doc. Let me know if there's anything else I can answer. Thanks for your opinions and suggestions.

Chris


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 Post subject: Keep it up
PostPosted: Fri Feb 18, 2011 8:49 pm 
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It is amazing what you are going through. I am a veteran and I have never used the VA. I find it a little funny that even the VA prescries opiates like crazy but that doctor was not going to see you based on what the counsleor said. It sounds like your other doctor that just started his practice has other issues.

I am glad you went and confronted that counselor and demanded some answers......many would not and it worked to your benefit. If it was me I would see him in order to get the script but would definitely seek out a new sub doctor outside the VA. If you are ok with sharing what city and state you are in you might find someone on here that knows of a good sub doctor you could go to.I did that when I had to relocate to a new state and someone recommend my doctor I have now. He got me in within a week.

You may have to go to group for awhile and do UA's until you can get in to see a new doctor but we do what we have to do. If you didn't need that script I would definitely be jacking that doctor that was just going to let you go without getting the facts.....from you. You may also ask on this board if they do recommend a sub doc how they feel about marijuana so you can feel comfortable about that issue.

Anyway glad it worked for the meantime. I hope you find a doctor to work with you. Perhaps this VA doc will be better than you think. Good Luck

Jim


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 Post subject: update
PostPosted: Mon Feb 28, 2011 7:36 pm 
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Just an update, went and saw Dr. H on tuesday at 11am. I was told to be prepared to wait. Long story short, I was there for 7 hours. He did want me to quit smoking (and I hadn't in 3 1/2 weeks) and he was fine w/ the benzo's. Just said that he wouldn't increase them so don't ask. Overall, horrible. They wanted to wipe the slate clean, and I wasn't prepared to that. I got my prescription and left

I came home and did the patient/doctor match and was e-mailed by a doc about 2 hours away. His wife works there w/ him and genuinely good people. Said that if that was the only way of having relief in my back, then go for it. He also writes a refill so I only need to see him onc every two months because I've been on it so long (suboxone). On top of that, he offer's a great discount, $200 the first visit (might be reimbusred by ins.) but since I'm a transfer patient it would only be $100. She said it might not be that much because I'm a vet (she worked as a physician at the va). It's a 2 hour drive but to only go once every 2 months and the price isn't bad. I was stoked and when asked about how they felt about smoking, they said if it was used to treat pain and not stay high, they didn't have an issue w/ it.

chris


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 Post subject: Footwork
PostPosted: Mon Feb 28, 2011 10:30 pm 
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Well you were persistent and you did the footwork and it worked to your advantage. Sometimes I think things work out just like they are suppose to if we take the necessary steps to make it work. I am glad this worked out and your right what a great deal......I would drive 2 1/2 hrs every month with my first doctor and it was worth it.

Good Luck and let us know how your first visit goes.

Jim


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 Post subject:
PostPosted: Tue Mar 01, 2011 9:31 am 
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Chris - First of all, I apologize that no one responded to you after your first post. On occasion, this happens. I just missed it. It sounds like you may have figured it all out on your own. You are very resourceful. I would suggest that you keep looking just a little to see if you can't find a doctor closer using the www.suboxone-directory just to avoid any inconvenience, but otherwise. sounds like you found something that will work for you.

Good luck!
Jack

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Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

- Winston Churchill


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