So I know this is my own doing because I missed 2 appointments with her, so now she personally told me she wouldn't see me anymore because of this. I am devastated. I'm in a treatment program where you Have to Have Personal therapy and go to weekly groups.I feel so stupid for confiding in her and telling Her things I've never told anyone. I feel like I was just a number or a paycheck to her when I thought she really cared and wanted to help me. I don't know what to do and am now afraid of getting kicked out of the program. Any advise would be helpful. And like I said I know this is ALL my doing.

The Medical community does not fully understand what opiate addiction is. It's a disease of the mind. A lot of Doctors could care less about their patients. You're just a dollar sign. It's just the sad truth. Are there any other doctors that prescribe in your area? I'd suggest getting a new Doctor. Especially if your paying out of pocket for treatment.

Opiate addict or not...there is no excuse for Doctor's to treat their "paying" patients like this.

_________________
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

You say on one hand that 'it is all your fault'... but then say 'you feel like just a number or paycheck'. Counselors, especially from the 'old-fashioned approach' to treatment, are looking for humility (among other things). Comments about being 'just a paycheck' are insulting to any counselor--- and a counselor who feels unappreciated or under attack is only going to put up with if for so long-- and after that, will start looking for ways to get you out of his/her care.

If it was truly 'on you', then you should get rid of the anger, apologize (and mean it), and admit that you have been projecting anger on someone who was trying their best to help. ALL doctors (and probably all humans) will go further out of their way for someone who appreciates their help. And therapists don't have anything to offer a person who believes he/she is just a paycheck.

I can see you going back and forth in your post, from the responsible person (I missed the required appointments) to the irresponsible, angry peron who blames someone else. Frankly, I don't like programs that force therapy.... but if those were the rules, then you have to abide by them.

Hey Subdoc, I would like to share my point of view.

Here's how I see things judging from what I've personally experienced and what I've witnessed others go through. When it comes to opiate addiction or just addiction in general.... it's not something that many physicians and counselors can sympathize with...because they themselves have never been addicted to anything. Some of them are even on the opposite end of sympathy... they're apathetic when it comes to opiate addiction. Some of them can be very cruel.

Opiate addiction is not one size fits all... some of us never had a choice. Believe it or not. Some of us have been forced into prostitution....some of us have been molested. Some of us grew up in foster care. Counselors and Physicians tend have the one size fits all mentality. They also seem to ooze and emanate pure arrogance and cockiness. They don't care about your background..."they've seen it all before" ironically that statement is so far from away from truth. They haven't seen it all....not even fraction. Another irony is that they themselves project preconceived notions onto their addict patients because of what they've experienced in the past.

But when a patient approaches a Doctor in the same manner... We're the bad guys. Were not aloud to be cautious around our physicians or counselors... They've got the white coat... they know whats best. Right? Wrong. When in reality most of the time...it's the physician that breaches the "patient-doctor trust". The sad truth of the matter is most physicians aren't too worried about their patients well being... If they don't have the funds... they don't get the treatment. Sad but true. I and many others are living proof.

Also, addiction treatment is still very young. We are literally in the trial and error stage of addiction treatment. I mean Suboxone treatment itself is very very young. So of course there's going to be a large amount of "niaveness" when it comes to treating addiction. With that naivety, comes a large amount of malpractice. When it comes to addiction, authority figures are put on a pedestal and us addicts have to bask in their "pseudo wisdom". If we don't... "GET OUT OF MY OFFICE YOU JUNKIE" "I'm the Doctor here, I went to med school buddy"... Manipulation 101.

I'm pretty sure you yourself are thinking... "that's not recovery talk"... but I say, acknowledging the truth isn't recovery talk? Shoot... so you're saying in order to recover I have to pretend the world is all butterflies and unicorns? I don't think I can shift my perspective of reality that low. The world is a fucked up place... we do drugs to cope with that fact.

The point I'm trying to make is... THAT A PHYSICIAN TREATING ADDICTION SHOULD NOT BE SURPRISED WHEN A PATIENT MISSES A FEW APPOINTMENTS... IT SHOULD BE EXPECTED NOT DEMONIZED. ADDICTION IS LIFE LONG...EVEN WHEN ON MEDICATION LIKE SUBOXONE IT STILL CONTINUES TO BE A LIFE LONG STRUGGLE. I'M PRETTY SURE YOU PHYSICIANS WHO DECIDE TO PRESCRIBE SUBOXONE KNOW BEFORE HAND WHAT YOUR GETTING INTO. MISSED APPOINTMENTS COMES WITH THE GIG. IF YOU DON'T HAVE THE PATIENCE TO DEAL WITH YOUR PATIENTS...THEN DON'T PERUSE A CAREER IN ADDICTION TREATMENT!

_________________
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

Thank you all for your replies. To subdoc I think it is, I never actually said to her that I was just a number or a paychec. although though we're my inicial feelings, and they were out of Anger. I do take complete responsibility for my actions. She is my therapist, not the doc who prescribes my sub. I wrote an apology Letter. Do you guys think that's a good idea? Since she doesn't have the time to talk in person right now. Thanks so much again for the replies.

I feel that is always the best way. Not only can you properly explain yourself, but she sees you took the time to write it. If she gets paid for each of these visits, I'm sure that's why. I have been in her situation before, it's not that we don't care, we love what we do and genuinely care about these people, buy this is also how we pay our bills and support our family. She also felt disrespected as well I'm sure, But yes, the letter is best.

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PUGS NOT DRUGS

Morning sun, I have no idea what fantasy world you are living in here but I can assure you I am an opiate addict. There are no two ways around it. I can also asure you that I have never failed to attend any scheduled appointment. Further if I would, there would be a very good reason and I'd most certainly call and cancel. It's just the right thing to do and how I live my life. It is in no way "part of the gig". Where on earth are you getting this fantasy that anyone should accept behavior like this and pass it off as acceptable due to having an addiction? That's just crazy.

As for patients being "just a paycheck" if that were even true, why then would the healthcare professional essentially wrip up that paycheck by "quitiing the gig" as you term it? When I'm getting paid from a client, I do all I can to continue getting paid by that client - unless of course I decide it is no longer conducive to good business. Like it or not, healthcare is a business. I know the whole obamacare crowd wants it not to be but it very much is.

Wow, talk about misguided.

Don

What I think we have to keep in mind here is that there is a very big difference between an "addict" and an "addict in recovery".

My personal belief....if you are serious about recovery, it shoudn't be expected that you would miss appointments unless there is a very good reason. I agree, having therapy be required isn't my idea of a necessity. But Dr. J is right, if those are the rules you agreed to, that's what you should do.

My comments aren't aimed at the OP, more so to Morning Star. It sounds like the OP realized that they made a mistake and is trying to correct the problem. I sincerely hope your doctor gives you the chance to prove that you are taking this seriously.

BUT, from personal experience, when you sign up for a program you know what is expected of you. I honestly believe that if you are serious about recovery you will follow the rules. I've seen too many people start treatment and not follow through. Still use, sell their meds, or just not give it a real try and after a few months drop out and go back to using. If a doctor just let these people stay in the program anyway, there wouldn't be enough spots for those people who really want to do the work to change their lives. Who are willing to do WHATEVER IT TAKES to get sober. How else should they weed out the ones who aren't serious? Who just aren't ready to get sober yet? Everyone should absolutely be given the chance to get treatment. But, at that point the responsibility to stay in treatment is on you.

This isn't to say that there probably aren't some doctors out there who shouldn't be a little more compassionate. I know that some are lacking in this area. But we have to be real about this. The fact is that the system isn't perfect. I believe it's getting better, and will continue to get better. BUT, in the mean time, we have to do what is expected of us to get help. If you don't like what is required of you, then find a doctor that fits your situation better. We can't blame everything on evil doctors and a corrupt system.

Bottom line....this country didn't become what it is by handing things out to people who weren't willing to work their ass off to get what they wanted. Despite the flaws, I still believe that we live in the greatest country in the world. Whatever happened to personal responsibility?

Q

_________________
No one can make you feel inferior without your consent. ~ Eleanor Roosevelt

I'm in agreement with Q on this one as far as personal responsibility goes. I believe that once a patient does something that breeches the trust of Dr/ counselor/ etc, or breaks the rules of their program, that person should me given an opportunity to straighten up and fly right, so to speak, and if they can't, then certainly their spot in the program would be much better given to a person who is truly ready for recovery and eagerly awaiting an opening.
missed appointments and no shows happen, no doubt, but I don't think that they should be considered ok, and part of the gig, just because were addicts. in my opinion, that type of thinking, just helps to perpetuate the stereo type that addicts are irresponsible and cannot be trusted. counseling, therapy, medication,etc are supposed to be help us toget away from the old irresponsible behaviors associated with active addiction. If someone misses appointments and doesn't give any notice then their time allotted could have served another person in need. The provider I see has a policy in place that if you dont give 24 hours notice of missing an appt, you will still be billed for that appointment, and I think that's fair, it's hard to fill that time slot, when not given any notice at all. even though, my doctor had this and other policies of accountability in place,I certainly dont feel like just a number or paycheck. I think the OP here did everything she could to try to rectify the situation, and I hope it works out for her and her treatment can continue.

Very good thread here...and HQ, your post this morning was something i needed to read..Its always good to recall were I've come from and where i need to keep focusing on...thanks......raz...

I've been on both sides of this perspective coin...the unruly patient, and now, the rule-abiding patient. Both have their advantages and disadvantages. It depends on how serious you are with the program, which turns out to be advantageous ...I've fired a doctor because when I went in early ..he cut my dose. Sounds fishy, like maybe I took too much and ran out of Sub early?? Nope... It was an odd circumstance that caused it all...but nonetheless, I fired his ass and told his nurse an earful.
It's been about a year, but my 12 year-old daughter broke her ankle, and was seeing an ortho doctor in the very same building, as luck would have it, as my Suboxone doctor.
Keep in mind, both of these doctors were an hour drive from my home...because no Sub doctors are in my area. And the ER referred my daughter to an ortho, so we chose one that was in a familiar area to us... My daughter went in for an appt, and i called my Sub doctor to tell them "hey, my daughter has her ortho appt across the hall from you guys on Thursday..but my appointment isn't until next Thursday...is it ok if I come in when she has her appt, so I don't have to drive back the very next week?" Their reply was ..of course..no problem at all..come on in.

But when the doctor saw me...he went off on a tangent about taking meds as prescribed...wanted to see what I had left, which was an hour away at home...plus I had to accept a partial fill of my script that month, because Walmart pharmacy didn't have enough to fill the entire script...so I still had a refill of 25 sub films waiting to be picked up at Walmart...
Not only did this doctor accuse me of BS..he said that I couldn't have a refill left because I only had 1 refill since my last visit. When I explained the situation, he said they couldn't alter the script, and there was no way I had a refill left. So I was called a liar, and told I was not taking my meds correctly...
This REALLY pissed me off...I mean like, I wanted to follow this guy home and duke it out in his yard while waiting on the police to arrest me. If I had been guilty of the bullshit he accused me of, it would've been different...but I wasn't. I was oblivious to doing anything wrong until he got me in his office and told me an earful about coming in early...didn't matter WHY I came in early...nor did anyone want to hear it.
So when I got home, and picked up the final 25 from Walmart...I faxed in the proof..showing the amount of Sub, the date it was filled, etc to his office.
And I waited about 10 minutes...then I proceeded to call...and I went off like a madman on the phone. Looking back, I shouldn't have done that, and should've just went somewhere else the following month..but I wanted redemption, however small that might be. The office manager said she took the fax to the doctor and gave it to him to show him the proof..but he said nothing. When she told me that, I said "well, since that was his response, can you give him one more message for me? Can you tell that bastard I said to kiss my fking ass?" and I hung up. I already had mentioned to her that he wasn't the only doctor in Alabama who would prescribe Suboxone, and that I was already paying out of pocket with him anyway...so why would it matter to me WHO I gave my money to? So I showed them exactly what I meant by that, and went elsewhere.

And I've made it a point since I have been with this new office to never change my appointment...there was 1 time I had to move it from Tuesday to Monday...but that was because of vacation...other than that, I don't miss anything. I do what I should..and I try to abide by their rules.
Some of the rules with this office are waaay out there too...like keeping your old Suboxone wrappers. I did that for about 2 months, and they never asked me for them..so I quit...but they do make some patients bring in their old, empty wrappers to be counted. I guess a few of them that they are suspicious of selling or giving away meds...but I never run out too soon, and don't give them reason to be suspicious either.

I've seen and heard the tales, and one doctor that I started out with back in 2008 has changed his practice so much that I wouldn't go back to him last year when I was searching...and had to change. I called, and they told me their new, fkuced up system of taking Suboxone patients, and I said "no thank you"...if you're gonna start out like that, then I'm going to the wrong place and probably will be around a bunch of people who aren't serious to begin with in their treatment.
The first thing they said was "You gotta bring in a sponsor"...I was like.."I want suboxone, not alcoholics anonymous"...but she said they were doing it that way...
Makes absolutely no sense to me...if I was gonna choose a sponsor, I would choose someone who didn't G.A.F about what I did with my meds to go with me to begin with...so having that would be pointless. There again, people can get their drug buddies to be their sponsor...and when they leave the doctor, and get their script..they can swap sub for money or whatever they wanna do..sponsor sticks up for patient..patient sticks up for sponsor...Sounds like a pretty dumb, and pretty useless way of keeping track of people.
The only thing that made me think of them was the cost...it's pretty cheap. But even back when I went to this doctor, I took advantage of him..and it was before I got really serious with my treatment. I took too much, ran out early..changed my appt...and even pissed dirty for lortab once because I took some cough meds with hydro in it. It wasn't until I left and went to the doctor I was seeing until last year that I really took things seriously and got my reality check.

It's hard to see yourself doing wrong when you're doing it...but looking back ...it's easy to pinpoint..and sticks out like a black eye.

_________________
Adam Wayne P.
DOB: July 1, 1985
October 8, 2013

RIP little brother. Gone, but not forgotten.

Jonathan, I'm just catching up on all these posts I've missed over the months. I wanted to tell you that I literally laughed out loud when I got to the part about you hiding in the bushes waiting for the police. I can completely see the visual in my head. I can also completely relate to the emotion. You finally start to fly straight and work hard and be transparent and honest only to be given the side eye or be outright falsely accused. It goes with the territory. And it's a volatile one.

_________________
"Never feed him a lot. Never more than a spot! Or something may happen. You never know what!"

Sorry but alot of what your saying is completely ridiculous, missing appts all the time is one thing but when you are on a sub program for several years like I have been and pay the full amount out of pocket every time and have been doing so for going on 4 years sometimes I can't afford to take a 100$ out of my money that I need to eat/keep a roof over my head and pay it to my doctor for 5 measly minutes of his time, sometimes I have to call and put off my appts until I get paid and have enough to pay for the visit. And hah no your drs policy about billing you if you dont give more than a days notice is ridiclous as well, you said "its hard to fill those slots with no notice" which again is not true. Sub drs double, triple book patients in the same time slots so the can hurry you in and hurry you out as fast as humanly possible so I guarantee you if you don't make your appt theres at least one other person booked at the same time. Im so glad I have an understanding doctor, I guess in your mind the fact that I still smoke marijuana and come up dirty for it alot of time means I dont deserve my slot either and I should go suffer on the street and some other more "deserving" person can take my spot.

Sorry but it's not ridiculous, and just because you PERSONALLY haven't encountered a doctor that has these policies doesn't mean she's making it up or that it's ridiculous.

I have a dentist that....guess what...if you miss an appointment, it's a $25 fee the next time. If you don't wanna pay it....find another dentist. Think the fees are unreasonable..dont pay them. Keep finding new doctors each time you decide to skip or miss an appointment.

I would be quite offended if I posted the rules that I've seen in doctor's offices and was told that it's ridiculous. As ridiculous as it may be, it doesn't mean there aren't doctors out there that don't have these policies...and apparently they have the policies because someone has done exactly what they policy against. I think it's pointless to have people keep their empty suboxone wrappers and bring them back for counting to deter abuse or street sales..but that doesn't mean I haven't seen doctor's that have this policy in place.

_________________
Adam Wayne P.
DOB: July 1, 1985
October 8, 2013

RIP little brother. Gone, but not forgotten.

Don't make assumptions about what I think about your smoking pot, that's your business and I don't care. I'm not really sure what to say about your reply to my post except that it's not ridiculous, many doctors charge no show, no call fees for missed appointments. I see my doctor, who's a psychiatrist, every other week for 120 to 150, depending on whether or not I'm drug tested, and see him for an entire hour. once I feel I dont need to have therapy as often I can go monthly, and then eventually less. my doctor is quite understanding also, and rx's mono product buprenorphine so I can better afford treatment, as I also pay cash for my treatment. he doesn't double or triple book. not all Sub doctors are money hungry and dishonest. the first two doctors I went to were like that and double booked and sometimes I paid 150 just for a nurse to hand me my rx. Then that doctor eventually walked out of the practice, abandoning 100 patients, the next doctor was no better and had even stricter policies like saving wrappers etc. I was unhappy so used the treatment match service at naabt.org to find a doctor that fit what I was looking for in a sub doctor.my post wasnt ridiculous at all. Part of recovery is learning personal responsibility. if a person must miss an appt, fine, but a phone call in advance is a common courtesy, and if a person makes a habitof no call/ no show then yes, that spot should go to someone more serious about their treatment. The patient cap already makes it hard enough for addicts to get treatment without people who can't even show up for their appointments without calling, taking up space in programs with limited spots to begin with. I'm sorry you're unhappy with the amount of time your Dr spends with youand that you're having difficulty paying for treatment while making ends meet at home. I'm in the same boat, but in these programs there are rules that are expected to be followed. it does sound like your doctor is okay if you need to reschedule appointments and doesn't mind if you test positive for weed because many programs disallow that and eject patients from treatment for it, so you ate actually lucky in that respect. but it's not fair for you to assume that I judge you for the fact that you smoke pot. I'm sure not going to judge anyone, I'm also an addict. your reply to my post is insulting as hell, and I stand by what I said.
anyway, you call and reschedule when you're unable for whatever reason to keep your appointment, so I'm not even referring to you in my post, I'm talking about people who chronically miss appointments without calling in advance so that someone else can have their allotted time. That's why many doctors officeles have those cancellation policies in place so that if there is a cancellation, they can call another patient to offer them the free time slot. some doctors even have printed on their appointment cards that missed appointments will be charged at regular office visit fee for no call/ no show. once, years ago, I called a dentist who was booked for three months, but asked to be called in case another patient cancelled, and low and behold a little over a week later that dentist had a cancellation and I was able to have that appointment time.

Im sorry for maybe being a little harsh in tone as I maybe interpreted the tone of your post in the wrong way. I just felt like the OP was in a tough spot and were upset and didn't want them to feel like everyones just like "welp its your fault you made your bed lie in it". Situations in life happen and sometimes they are more important than being able to make it to a drs appt and it seems some drs don't understand this.

Want to add here, why do you think that I'd want you to go suffer on the street because you test positive for marijuana? what have I said or done that would suggest such a vile thing? I don't believe that anyone deserves to suffer on the street, not even people who chronically miss appointments without calling to cancel. What I mean is that some people just aren't ready or serious about recovery yet, and because of the patient cap,a person who is ready and waiting for a spot to open up doesn't receive treatment because that spot is occupied by someone who isn't serious enough to even pick up a phone and cancel. And as far as guaranteeing that there are plenty of people who are booked at the same time as my appointment, that's absolutely not true. my psychiatrist/ sub doc has one hour blocks for appointments, and when I get to his office I'm the only one waiting as I'm usually fifteen or so mins early and when his last patient before me comes out of his office and I go in for my hour, there's only one person in the waiting room when I come out, so if I didn't go to my scheduled appt without calling my doctor would have an hour until his next scheduled appointment, time that could've been given to a patient waiting to get an appointment, but hard to fill without proper notice. my doctor's office doesn't have the turnstile type atmosphere that many sub doc's offices have. there's no waiting room full is people to call in my place if I dont show up for my appt. I didn't say a word about who is more deserving of treatment. All addicts deserve treatment, unfortunately, many factors, including the cap on the number of patients a doctor can treat with buprenorphine, prevent all of them from getting treatment, so there has to be a way to weed out those who are not really in a program to actually recover and only to get a script, from those who really want to do whatever it takes to get better.

You know, Lizzie, you haven't ever said anything on this forum that would make anyone believe you would have a harsh attitude toward addicts. I don't think that Buprecision ever meant for you to think that he did. I believe that Bup was throwing that out there with somewhat of a chip on his shoulder because he has run across plenty of people with that attitude toward addicts and especially addicts who don't get it right all the time. I don't think he meant to insult you. Any of us who have viewed a lot of your posts know that you're a compassionate person who wants to help their fellow addicts.

Bup, I think it's kind of you to stick up for the original poster since you thought everyone was down on her. It's clear to me that our posters like Lizzie weren't being unkind to the OP either. I know that it has taken Lizzie 3 tries to find a suboxone doctor that she is happy with. When you've had to work that hard for your recovery it makes it galling to hear that others may take their providers for granted a bit.

Thank you both for being here to advocate for our folks.

Amy

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Done is better than perfect!

hey Amy,I just happened to read your post after I posted my last one, so just wanted to say that I wasnt trying to keep it going by posting again,I just hadn't received notice on my slow phone that there were other unread posts before mine. I've since pm'd buprecision to apologize for the confusion. I hope there won't be any hard feelings , as I don't think bickering amongst each other helps anyone...... sorry bup.