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PostPosted: Sat Jan 16, 2016 10:51 pm 
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There are so many obstacles you face when deciding to seek treatment. Don't let embarrassment or the concern over privacy be one of them. No matter what the circumstances were that caused your addiction, treatment is provided with compassion and dignity. Your care will be designed specifically for you with the goals of ending your addiction and getting you to recovery. I don't judge, I listen.

I am conveniently located in South Tulsa and accepting new patients for Suboxone treatment in early February 2016. My website is under construction and can be found at http://www.tulsasuboxonedoctor.com You may call me now for an appointment at 918-518-1636.


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PostPosted: Mon Jan 18, 2016 6:43 pm 
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Thank you for letting us know of your services. :)

I think that more doctors are starting to understand that addiction is chronic disorder and that relapse is part of addiction. No doctor would kick out a patient because they're diabetic and they let their blood sugar go crazy. Likewise, the medical community is starting to understand that it doesn't make sense to treat addicts punitively when they relapse. I'm not saying that there shouldn't be stringent rules, but that when addicts relapse, they need treatment even more, not less.

Amy

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PostPosted: Mon Jan 18, 2016 11:12 pm 
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I hope my services will be helpful. I've had several colleagues try to discourage me from doing this.


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PostPosted: Tue Jan 19, 2016 12:39 am 
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Please let me thank you from the bottom of my heart for all the people you are going to help! Don't let the negative doctors get you down! This is very important work and you will be actively saving lives!

I don't know if you've yet experienced starting a patient on suboxone/buprenorphine, but let me tell you what my induction was like. I had been getting monthly prescriptions of oxycodone from a pain management doctor. I would run out early, however, because I was abusing the meds. Although I do have neck and head pain, I was exaggerating the amount and severity to get my scripts. One month when I ran out early I took a good look at myself and where I was headed, then called a good friend and told her I was addicted. Then I called my doctor and told him that I was a fraud and a liar. He gave me a list of people I could call for help, including a suboxone doctor.

My suboxone doctor had me detox from oxycodone for 3 days, which I didn't really need since oxycodone is a short acting opiate. I only ended up detoxing for 60 hours, which was still more than enough. However, the great thing is that when I was inducted onto sub, I went from misery to feeling like a completely normal non-high person in the space of a couple of hours. I was amazed to feel so good and be out of withdrawals. That was part one of the miracle of sub for me. Part 2 was something I noticed within the first 24 hours on sub. The second part of the miracle was that I stopped obsessing over pills! I don't know if even sub doctors understand how amazing it feels to be free of that compulsion! It actually makes you wonder what to do with your time! I have tapered from a dose of 16 mg to 2 mg with my doctor's OK, but he is not pushing me to step off. I don't feel ready yet.

If you'll allow me, I'm going to give you some advice. I have been on suboxone and now zubsolv since October 2011. I am also two semester into a masters of Addiction Studies from the University of South Dakota online. Meaning that I have read a lot of current research on addiction, MAT, buprenorphine, etc. I also have a very open dialog with my sub doctor, and I've been a moderator on this forum since 2012. If I had to give you one piece of advice it would be to go to our sister site "Talk Zone" and read a bunch of Dr. Jeffrey Junig's blog postings and articles. If that's the only advice you take it will help you understand many issues surrounding opiate addicts and buprenorphine therapy.

If I could advise you in a couple more areas I would appreciate it. You are already starting out well by being willing to respect and listen to your patients. :) If you want to help a patient taper off buprenorphine with the fewest withdrawal symptoms, advise them to do it slowly and steadily. If the patient jumps off at 2 mg (which I think is what Reckitt Benkheiser suggests) they are going to be feeling bad for at least 3 weeks. If they get down to .063 mg they have a much better chance of stepping off without many symptoms.

It is very typical for sub patients to try to take more than their dose in the first few months of treatment. It doesn't take too long for us to figure out that there is no point in doing so because a different dose is not going to change what we feel. It's mostly psychological, but I don't know many patients who haven't done this at some level in the first few months. Expect this and try to keep your cool when the patient calls your office to admit what they've done. Try to make sure that they've learned a good lesson, but go easy on them.

If you require that your patients attend a support group or therapy, don't necessarily push them towards a 12 step meeting. There are 12 step meetings that are more progressive, but many of them would still advise your suboxone patient to get off their medication! Certain old-timers, for example, may try to convince your new patient that he should be getting off the sub as soon as possible. SMART Recovery and individual therapy with an addiction counselor can be good alternatives to 12 step meetings. The step work isn't the problem, just the attitude of some of the people.

Usually a patient will need to stay on bupe for 2 or more years in order to put their life back in order and develop new skills to fight their addiction. Dr. Junig has noticed that the people who feel ready to step off after they've made significant life changes may be ready to go off. These patients have rebuilt their finances, relationships, they are in steady employment, have made new non-using friends, and have cut ties with their former lives.

Of course, you don't have to listen to someone who is not really a colleague, it's up to you. I really do want you to do well and touch the lives of many addicts. Good luck!

Amy

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PostPosted: Wed Jan 27, 2016 11:22 pm 
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Amy,

I can't express how thankful I am that you took the time to provide me the advice that you've written. I appreciate that immensely. I absolutely want to have as many successful patients as possible and I want to do each one of them right.

I've had several suboxone patients recently in my main practice of anesthesiology; to be clear, they were patients of other suboxone doctors who came to me for their surgeries. I picked their brains to learn the obstacles they face with their treatment. I realize that I need to communicate with successful suboxone patients as much as possible; the ones I've spoken to have given me better information than the guidelines I learned on the Buppractice.com website.

I would love to successfully detox all of my patients off of suboxone within 30 days, but I know that is FAR from realistic. If the suboxone manages to stop their opioid abuse, that is a success that I am willing to celebrate. If and when those patients are ready to detox off of the suboxone, I will patiently wait for as long as that takes even if it never happens.

Recently, I learned that a friend of mine is on methadone and another is on suboxone. I am not sure why I was surprised since I have taken care of 100s of heroin addicts from different social classes in Baltimore almost a decade ago. Methamphetamines has always been the issue here in Oklahoma. However, I have noticed a surge of opioid addicts within the past year or so. I expect more surprises in the coming months as many of these patients come through the hospital and hopefully my suboxone clinic.

Please feel free to provide me as much information, advice, and pointers as you feel necessary. They can only help me, especially when they come from a person who has successfully recovered from opioid misuse and is passionate about assisting others.

Thanks again.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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