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 Post subject: The Sad Truth...
PostPosted: Fri Feb 28, 2014 11:28 pm 
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Well, I think this may be the end for me. Someone just closed the blinds on my small window of hope.

This sucks. Really bad. Fuck!

Here's what I've come to learn about the "Suboxone Game"(Suboxone express).. It's not much different from the Heroin game... or a better more suitable comparison would be how the "Oxycodone Game" in Florida used to be. Hence the "Oxycontin Express".

Doctors don't get into the "Sub Game"( start prescribing buprenorphine) because they genuinely care about helping poor unfortunate opiate addicts... No they get into the Sub Game to make bank... Yes I said "bank". Mucho Deniro!

Today I learned a few lessons. Well, stuff I had already knew and suspected but didn't want to believe. Okay, so here's the thing. I'm pretty sure most of you here are aware of the ACA, and how it went into full affect January First correct? The whole point of the ACA was to establish healthcare equality... and most importantly to expand Medicaid. I'm not sure if any of you knew how Medicaid worked before but I'll give some brief information.

Before 2014, if you were older than 21, homeless, and without children....you could NOT qualify for Medicaid. In order to qualify for Medicaid you had to be under 18 living with parents or female pregnant with child. As of 2014 no matter how old you are or who you are if you make under 15,000 dollars a year, you qualify... HUGE HUGE HUGE UPGRADE in access to free healthcare for the needy. Also, there are bills in the ACA that state Doctors HAVE to take MEDICAID patients. Hence Healthcare equality.

But there's a catch... There is no guarantee Doctors will be reimbursed 100% by the Government when they take patients with Medicaid. So a lot of Doctors are really upset with this expansion. They refuse to take patients with Medicaid because they are greedy... their 80000 dollar plus salaries aren't enough...they want top dollar compensation for private procedures as well.

There's another catch each State gets to decide whether or not it even wants to expand Medicaid. Some states have opted out entirely and have decided poor people don't need healthcare. Thankfully California wasn't one of those states.

Also you should take note with the ACA, Medicaid has expanded it's substance abuse and mental disorder treatment. Another big piece of the ACA.

If you read my first post you'd know that I'm pretty much living in poverty and I more than qualify for Medicaid... or Medi-Cal as it's called in California. So I signed up and as of February 2014 I now have health insurance...or Medicaid, or as it's called in Caliofrnia, Medi-Cal. As soon as I got my benefit card in the mail I called every Suboxone doctor within a 50 mile radius. Not a single one of them accepts insurance period. Not even private self paid insurance. They all want CASH up front...500 dollars up front.

I was really disappointed. I don't even spend that much monthly on my heroin habit. I mean honestly what opiate addict can just come up with 500 dollars? Your addiction/disease must not be that severe. The really messed thing is that Medicaid DOES in fact cover buprenorpine treatment in FULL...both Doctor visits and prescriptions(I even got this confirmed from the department of healthcare services). But, from a legalized drug dealers point of view... why take the risk of 80 % reimbursement when you can get cash in full upfront? Hmmm

Who ever said there's no money to made with Suboxone is a fool. Imagine if you have just 60 patients at 500 dollars a pop... MONTHLY! That's 30 Gs! Some of the Doctors I called had even reached their limit of 100 patients!

My question to Doctors... Why did you get into the field of medicine if you don't like helping people? Was it really just for the pay check?

However...as of now since I'm insured, thanks to the ACA and Medi-Cal(Medicaid) I have FREE access to a Methadone clinic... but for starters....the clinic is a 30 mile drive away...60 miles round trip and I have no transportation. Secondly, once you go Methadone, you're Metha DONE! Not to mention, I have witnessed some horrors of people trying to kick methadone... it's Heroin times 100. Also, I have never done Methadone... and I really really don't want to do Methadone! It's a full agonist and just as addictive as heroin!

Buprenorphine has a MUCH MUCH MUCH higher safety profile! It has a ceiling effect and is practically abuse proof! It's really a no brainer.

With all that being said... I again, don't know what to do. Should I just say screw it and go on Methadone? Even though it may increase my potential to overdose times 100? I really don't want to go on Methadone... but if it's my only option. You know what they say.

I've already come to terms with the fact that I'm most likely going to be on an opiate for the rest of my life. I would much rather prefer to be on buprenorphine than anything else. So what should I do?

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my fortune is less
My future is shrouded in dark wilderness
Sunshine is far away, clouds linger on
Everything I possessed - Now they are gone


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 Post subject: Re: The Sad Truth...
PostPosted: Sat Mar 01, 2014 4:21 pm 
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The sad truth...I have no idea. I suppose the best solution is temporary, to figure out transportation to a methadone clinic to be stable while still trying to find a way to access buprenorphine treatment and then switch over when you do. I don't want to give you bad advice but if it were me that might be what I'd do. I would urge you to talk to the clinic though, find out if they by any chance provide suboxone as an alternative (some do, I'm assuming yours doesn't but maybe?) or just find out from them what they know about any sort of assistance you could get from providers in the area. This is probably a range of questions they've been asked before.

I'm sure others on here will be more useful to you but just so you know, I've heard of people who actually find good recovery in methadone. They're not thrilled about having to be on it or having to go to the clinic but for a few out there methadone has done for them what suboxone has done for us. And different people react differently to different treatments. You never know.

Overall, I'm just so sorry that you're going through this. It sounds really unfair and there are good suboxone doctors out there, ones who got into it for the right reasons or at least because they were interested in how this helps addiction patients rather than just the money, though I don't doubt you when you say you've only come across ones that give a different impression. Some are simply greedy. I think our president meant well on this one but didn't think it through not being familiar with the financial issues surrounding the practice of buprenorphine therapy.
Anyway, I really hope things get better and you find something to help navigate you towards a peaceful recovery life : / I wouldn't leave the forum just yet, no matter what you end up doing you'll get some support here


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 Post subject: Re: The Sad Truth...
PostPosted: Sat Mar 01, 2014 5:00 pm 
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What area of California are you in? I might be able to help. You can PM me if you'd like.
My suggestion is to, rather than searching for sub docs, look online under your medical plan.. should be linked to coveredca.com..? Use your log in to your medical insurance coverage, if you don't have one you may need to register. It's easy. You should be able to search for doctors that accept your insurance. I'd start there and cold call all regular doctors who you know that accept your insurance in your area. You may need to make many calls but it's likely you'll run into a general doctor who will prescribe suboxone. I believe you can also search for drug & alcohol treatment which should include some sub docs.

For whatever it's worth, none of my specialty doctors take insurance right now. My dermatologist doesn't accept any insurance. The nutritionist I have to see during my pregnancy does not.. My OB doesn't accept my insurance. I think insurance is a huge hassle for them and I kinda can't blame them. It's not suboxone specific.


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 Post subject: Re: The Sad Truth...
PostPosted: Fri Mar 07, 2014 11:10 pm 
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GOOD NEWS! There may be hope for me after ALL!

YEAH BABY!

So, one of the Doctors I called didn't answer and I left a message... they called me back... and their office/facility takes MEDICAID/MEDI-CAL! Buuuuuuut... there's a 6 month waiting list!

So I went down and signed up immediately! It was a really cool place...it was some sort of treatment facility... but it didn't look like it was county or city run...I didn't talk to the Doctor but the nurse was really cool. She didn't look at me like a drug addict... she looked at me with compassion... as if I was a victim of circumstance and she was more than willing to treat me. It was a very very comfortable environment.

I was talking to the secretary and she told me how everything worked. So basically they have a 100 patients at a time in treatment... slots get open when patients either leave the program willingly or are kicked out. She said a spot may be open tomorrow, next week or it may take the full six months. But not to worry it never takes the full six months. She also said there were 30 people ahead of me. but not to worry...they go through patients like hand sanitizer.


I am so relieved. I already feel as if a giant weight has been lifted off my shoulders. Wow the treatment is working already LOL and I haven't even started. I'm really excited...haven't felt hope in a long time. Things are finally looking up for me.

I told her about my current situation and asked if it would be a good idea to get on methadone until a spot opens...she said she couldn't give me medical advice but off the record, she said it wouldn't hurt. So I think I might go the the clinic until a spot is available.


Thank God who ever owns this treatment facility actually wants to help people! The secretary also told me about 40% of the patients there are on Medicaid/Medi-cal. She also confirmed a lot of what I previously noted. Medicaid DOES cover Suboxone treatment....But Doctors want top dollar compensation...Cash.. up front. When I do meet this Doctor I'm going to shake his hand and say THANK YOU SO MUCH!

Imagine if diabetes was treated like opiate addiction... it would be so tragic. Because about 25-30% of diabetics gets their medication and treatment through government assistance programs.... like Medicaid.

Hopefully one day opiate addiction will lose all it's stigma and people will see it for what it really is...a disease.

Well anyway... I feel GOOD. I know this treatment is going to work... I'm finally going to be FREE!

_________________
My name it means nothing
my fortune is less
My future is shrouded in dark wilderness
Sunshine is far away, clouds linger on
Everything I possessed - Now they are gone


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 Post subject: Re: The Sad Truth...
PostPosted: Mon Aug 18, 2014 3:06 am 
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Did you finally get started on bupe? I don't live in CA but have found that some psychiatrists do RX for their own pts, take insurance and medical assistance, but are not on any physician locator. You just have to call around. We all are depressed or anxious at times or we would not have become addicts in the first place so consultation with psychiatrist not an outrageous idea ( in my humble opinion).


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 Post subject: Re: The Sad Truth...
PostPosted: Tue Aug 26, 2014 12:21 pm 
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Ya, I ended up being lucky and on my 2nd call had an appointment set up...all I did is said it was an emergengy and got in,so they must have not been on the 100 patient cap..It's not just a place for Suboxone though, it's a Pain Clinc, and I'm always like, damnit, all these people walking out with all the good stuff(it's not like a pill mill at all though) also a Methadone Clinic right next door,lol. It's like everything is in one place. If you can't get in for a while I would reccomend Methadone LOW DOSE as in 30-40mg(hell maybe less,if you don't mind me asking what is your habbit?) until you get to the Subs. 8mg of Subs equal 30-40mg of Methadone from what I've read, and they reccomend you taper to 30mg of the done anyway, so you wouldn't have to do some long ass taper if you stayed at 30-40mg...also most Methadone Clinics offer a 3 week taper plan also, unless you are just looking to be on maintaince.


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Dr. Jeffrey Junig, M.D., Ph.D.

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