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 Post subject: suboxone/A.A/N.A
PostPosted: Wed Apr 29, 2009 7:57 am 
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I've been taking Suboxone for two months. My insurance has only approved me for 6. I'm already freaking out about stopping. My life has never been better. I have never felt so good. My parents have been getting on me about going to mtgs. so when Im done with Suboxone I have a back up to support me. Well, I dont want to go. I dont lie, cheat, steal, I dont act out. My question is will all those behaviors come back when I done with suboxone? I'm doing yoga 3x a week and Im good with that being my "back up plan" for when things might get rough. What do you guys thind about the mtgs things and the behaviors coming back after suboxone. I'd really like to stay on it longer but its like $450 a month and cant afford it.


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PostPosted: Wed Apr 29, 2009 9:19 pm 
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Hang in there.. Suboxone is supposed to go generic in the fall from what I read.. The cost *should* go down quite a bit if it does! Find a way to stay on it if it works.. I know its expensive but at least it going generic gives some hope.


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PostPosted: Tue May 05, 2009 7:46 am 
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Hi kmsboca,
From what I've heard and read, the Suboxone helps with the cravings. I'm really not sure about the behaviors you mentioned, although they may be a by-product of those cravings.
12-step programs can be very helpful to some people. Just keep in mind it's a very personal thing.

I'm not sure this next part is appropriate to post...!
I'm on Suboxone for both addiction and chronic pain. My doctor always writes my script for pain and not addiction. I don't think there is any limit to my insurance covering the medication, maybe because of the way he writes it?
I'm not advocating insurance fraud at all. Pain management is an off-label use of Suboxone though and maybe that will allow you to stay on it longer?

(Again, I hope by saying this it's not inappropriate. Call me out on it if it is.)

Good luck kmsboca!
Melissa


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PostPosted: Sat May 09, 2009 7:02 am 
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i was switched to suboxone myself in 11/08. as far as i'm concerned, it's a miracle drug (especially compared to methadone). my insurance gave me some guff too. having the dr. write the script wasn't enough. the insurance people also needed him to fill out a form (i was told it was several pages long), and fax it back to them. he had to fax it several times before i was approved for benefits. fortuantely, my family was able to lend me the money to fill the rX until the approval went through.

i was getting insurance through my job. i was unfortunately laid off mid 2/09 (the company was bought out and our new owners let all of us go). with no money, and nowhere else to turn, i had to start buying my suboxone on the street. just like buying drugs on the street, things rarely went smoothly. a couple times, i was sold methadone. a couple times, they just took my money and i got my ass whooped trying to protest. once, i was even sold a blow. go figure. a couple weeks ago, i was nearly busted by chicago's finest trying to buy suboxone.

fortunately, a friend told me about a program here in the city that is totally free. the only rules are that i attend group once per week, and that i piss clean. so, rather than worrying about not having a steady supply of suboxone, i only have to worry about trying to quit smoking weed (which has been harder than i thought it would be :-).

i guess my point is, try not to worry too much about your insurance cutting off your meds. either you or your doctor may be able squeeze more treatment out of your insurance company. if not, you only have to put as much energy into finding suboxone as you did trying to get dope.

so why do doctors go to school for all those years when treatments are dictated by insurance actuaries who are bound only by the bottom line rather than the hippocratic oath?

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PostPosted: Sat May 09, 2009 7:17 am 
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Downhomechunk'
You said a mouthful about doctors and insurance companies overriding medical necessity.
That alone would make an excellent topic!


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PostPosted: Sat May 09, 2009 8:48 pm 
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I'll take that as an invitation to comment-- I have been a physician for over 20 years now (wow, I'm getting old!) and I become more and more disappointed with the health care system over time.

As a doc I am often between a rock and a hard place (does anyone else say that, or is that something that my grandma made up?). As your doctor I am free to prescribe anything at -- and I wish that I could simply prescribe what I know to be the best medication. But ever insurer has a 'formulary' that lists the 'preferred meds', and if I order something not on the formulary, you will have to pay more. One frequent example is the drug Lexapro, an SSRI for anxiety or depression... it is a great medication, with few side effects and a fast onset, but citalopram is almost as good. Citalopram is $4/month, and Lexapro is about $120/month... I usually prescribe citalopram, but if not for the extra cost I would prescribe Lexapro. I hate to blame the docs for this issue (I blame them for other things!). To be honest, though, I don't blame the insurers either. I suppose I could blame the patient for having crappy insurance... but I guess that goes back to the employer in many cases...

When I was growing up in the 1970's and 1980's, people filed their own insurance claims. People would pay the doctor directly, often at the time of service, and then file a claim with the insurer after getting home or at the end of the month. It took some time, but the nice thing was that everyone knew how much they were paying for everything, and how much their insurer covered. Over time, clinics started filing insurance claims 'as a courtesy'... but that led to an attitude from patients that they shouldn't have to pay anything to see a doctor. Now everything is mixed up; people don't know how much things cost so there is no 'comparison shopping'. And two people will have totally different insurance policies, one that costs 3 grand per year and another that costs 6 grand per year, and both patients expect to get the same bill from the doctor.

I expect it to be much worse in the future; there are a number of signs that the future of health care will be something like the system in Canada where costs are controlled by queueing-- a nice way to say rationing. Yes, there is already a form of rationing going on... but nothing like what we're going to see in a few years, at least according to Tom Daschl's recommendations in his book (that we seem to be following). But I get worked up talking politics, so I'll leave that alone.


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