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PostPosted: Fri Apr 29, 2016 7:34 am 
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I've been on Suboxone a number of years. I tried to wean off before getting pregnant in August. I was switched to subutex in an out patient program covered by pregnancy Medicaid in nc. The coverage has been a weight lifted off my shoulders during this pregnancy which has been enormously stressful. Last year, my husband and I lost our jobs making paying for treatment impossible without mcd.

The program that prescribes my subs is very strict; weekly Dr visits (bc of my close due date), weekly program and 12 step meetings, and occasional med counts. They also plan on switching me back to Suboxone immediately after birth, which would be fine if I didn't have to worry about prior auths. I'm so worried that mcd will take forever to approve it or will flat out refuse to pay for Suboxone and I'll have a gap in coverage while caring for a newborn.

I'm already worried about NAS and running out of meds during my hospital stay (since I get a very rigid Monday-Sunday supply). I've tried getting assurances about coverage, but I'm not sure how accommodating my clinic will be. I hope I make it through this weekend and go into labor Monday afternoon lol.

Another issue is that my husband is very resentful that I'm still on bupe bc I told him I was weaning right before I got pregnant (he assumed I was already off). He won't go out of his way to pick up scripts or anything. In fact, I think he expects me to go cold turkey after pregnancy. This has been a contentious issue during our entire relationship. I've tried defending myself to no avail.

I'm not sure what I'm asking, but I've been reading a lot of this board's posts and haven't seen this issue addressed. I'm terrified of losing my mcd coverage in a couple months if I'm denied for full mcd. I truly fear what measures I'll go to if I have to endure being sick while trying to adjust to motherhood.

Can someone give me any advice?


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PostPosted: Fri Apr 29, 2016 8:27 pm 
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I don't have a solution to the medicaid issue, since states have their own programs. I would call your state's program; in Wisconsin I've been impressed by how they answer the phone and actually get involved with individual cases. I realize that all people on buprenorphine are treated like second-class citizens, but who knows-- you might reach one of the enlightened few!

As for NAS, shame, and your husband, consider checking out my blog. I have MANY posts there about pregnancy, shame, NAS, etc.... if you go to http://www.suboxsearch.com and go to the part that searches the blog Suboxone Talk Zone, you can find all sorts of info. Just search for 'pregnancy' and you will get a list of things to read. Or just start here: http://suboxonetalkzone.com/withdrawal-in-newborns-lay-off-the-guilt-trip/

Over the years, I've met many people who were eventually pushed off buprenorphine, and then died from overdose. I don't keep track of the number, but I know that the total is over 8 people, because I can remember those patients. The risk of death is highest in the people who used IV heroin; people who never shot up, or never used heroin, are probably less likely to die from relapse. But in the midwest it is very hard to find a buprenorphine doc-- so people who give up their spot may wait for years to get in with another doctor. And during that time, many bad things can happen-- including failed marriages, hepatitis C, criminal charges, etc.

At the Federal level, physicians and scientists realize that the only real treatment for opioid dependence is medication-assisted treatment. But that knowledge is dispersed very quickly, even as you go down to the state level. In Wisconsin, an upcoming 'evidence-based meeting' has a flyer that describes treating addiction with meditation! So you can't really blame people out there for their ignorance. At the same time, your treatment is YOUR business--- and nobody has the right to tell you what YOU need to stay healthy. I realize it is more complicated than just asserting yourself--- but if your marriage has a 'balance of power' where your husband controls your healthcare decisions, I know that at some point you are going to resist being controlled. Better to make clear, now, where your decisions end and his decisions start.

As you will read in the blog post listed above, your baby will be fine-- even if he/she goes through a bit of NAS. Babies used to go through much worse without anyone even thinking twice about it. Let go of the guilt trip... and good luck with the pregnancy!


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

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