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PostPosted: Sat Oct 23, 2010 10:02 pm 
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I'm SO piiiisssed. I went to the ER for my tooth being infected. Well the doctor comes out and asks me if I'm on Suboxone. ......WHAT?! How the fuck did they know?! I did not disclose that info because I do not want it to effect the way I was treated as a patient, nor effect my treatment in (god forbid a trauma situation.) Cause like it or not, if someone sees a person is taking this shit they don't know your damn story or anything. They will do what they always do. Assume the worst. Plus he said that cause I'm on this crap they can't give me anything narcotic for pain. Ok, fine. Does this include if I happen to go in there for something more serious? Like say a broken bone or emergency surgery? Will I have to suffer in horrific pain just because I'm on fucking suboxone?! Jesus man, Seriously. Sorry, but this is becoming a MAJOR concern for me. How the hell did they acquire the knowledge of my being on Suboxone? That shit is PERSONAL. And once asked, it's not like I could lie. So humiliated because the doc was cute. Humiliated because they somehow knew. Am I red flagged now or something? If I ever truly need narcotic pain management will I be denied it? Is that even legal?! I know the stuff won't even get me high anyways. Please tell me there is someone here who knows what this is about. Even though I'm on this my tooth still hurts, it's going to need to be pulled too. What then? Send me home and make me suffer then too?


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PostPosted: Sat Oct 23, 2010 10:51 pm 
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Did you see the information that I provided to you yesterday about this? I get the feeling you did not read it, or if you did, you did not pay much attention to it as I somewhat laid out what your options are with your tooth and why. You could have also "suggested" or at least asked about the things I listed to the ED staff - although if they are worth their weight, they would have known what to do on their own without you asking.

So, to start with, take a deep breath here. Try to calm down. There is not a conspiracy going on or anything and it's not like you have some sort of neon sign above you saying that you take Suboxone. I would bet a couple thousand bucks on the fact that the state you live in has a statewide narcotic monitoring database. These have become more and more popular and common in recent years and it would not surprise me at all if every state in the United States has one soon. In fact there already are plans to link the various state databases together to form a national database. I'm pretty certain that your state has one and that's what went on here. Anytime you fill any controlled substance prescription, that information goes into the statewide database. Only healthcare providers and pharmacists have access (in most cases). Unfortunately, a toothache is one of the common "excuses" or complaints that drug seekers use when going to the ED, so as a normal course of action, they very likely checked the database trying to find out if you have filled other scripts for Vicodin or Percocet or something in the past weeks/months. Instead, what they found was your script for Suboxone. That is all that went on here.

You really should have let them know about your Suboxone when they asked what medications you were on. The fact that you "hid" this from them makes you look very suspect. In fact, I would not at all be surprised if they think that you stopped taking the Suboxone and are trying to get high again and that's why you came into the ED. I know that's not the case, but I'll guarantee you that thousands of people went to EDs today all across the United States to try to scam pain meds. Yes, it's that bad out there. They see this in the ED all of the time. So you got off on the wrong foot with them by not being honest.

Besides that, as I tried to tell you last night, if you are on Suboxone, opiates are not going to work. They could have given you a truckload of narcotics and with Suboxone in your system, it would not have worked. This is just the reality of being on Suboxone. You have to stop the Subs for typically three days minimum in order for narcotics to work. What can they do for your pain? Well, again, I laid all of that out for you in that other thread that you started. There are options for your tooth. I certainly hope they gave you antibiotics and one or more of the other items that I had on that list. If they did nothing for you, that is unfortunate as Toradol would have worked pretty well for you.

So, take a deep breath. Try to calm down. All of this will work out. If nothing else you have a pretty good experience with what not to do next time - and what you should do. For God's sake please tell your dentist about the Suboxone before he pulls your tooth! I totally get that sometimes we are not treated like we should be when we admit that we are on Suboxone, but if you go to the ED in pain and you also take Suboxone, it is a HUGE deal. You have to tell them. Had they not figured it out on their own, they would have tried and failed to treat your pain using opiates that would have done nothing for you because they would have been blocked by the Suboxone. And he was cute too? LOL WTF???? I don't think I've heard that one before.

I hope that helps.

By the way, anyone wanting to see that other thread that I am refering to where I listed information about what can be done with tooth pain, here it is:

http://suboxforum.com/viewtopic.php?p=1 ... ght=#18967


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PostPosted: Sun Oct 24, 2010 1:07 am 
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LoL but he WAS cute, hahaha. :P Seriously though, that makes sense. I didn't mean to come off sounding so paranoid but it spooked me out, they even have my damn email somehow and I KNOW I didn't give it to them. Though I did my pcp. Meh. Well I guess it's a good thing my tooth was obviously infected, I can see how it would look bad, but there are a lot of people who choose to keep that they take Sub private. It's bad enough having the stigma of an addict, no? I did get antibiotics, and I already knew that narcotics wouldn't do jack for me being on the sub. It wouldn't have mattered, I just got annoyed because of just that-it didn't matter. I just needed the antibios. I said to him, eyyeeah I'm well aware of that. I'm not looking for anything expect to get the infection gone. I'm taking 800 mg ibp, and using clove paste. I wasn't trying to hide my info to get more drugs, that would be dumb, and I wouldn't want to restart my sobriety all over again. Plus risk getting kicked out of the sub program.

That said, what if something bad were to happen? would they deny anyone then I wonder? Part of me wanted to ask, but figured it best not to until I could find a proper way to ask without sounding like I'm "looking" I also went and read your other post, and I'm just worried that if I tell the dentist I'm on sub, I may end up with nothing for the extraction. I've been through it before and know it hurts big time. I worry a lot about the whole pain factor, and read those horror stories on here. I want to be honest, but know for sure it will effect my treatment and how they are to me as a person. I want to be seen as a person not as another pill head. Oy I donno, I just took another 4mg of sub for my tooth pain glad I had some extra. :/ Thanks for your response, appreciate it.

Anyone out there: Has anyone ever done a pros and cons list for sub before on here and posted it? Also for some reason I wasn't seeing my replies for whatever reason.


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PostPosted: Sun Oct 24, 2010 11:15 am 
With all due respect, Donh, I think there IS reason to be paranoid. My husband is going through a huge ordeal right now with an online medical records situation. His employer has an "industrial health" provider that he is required to use through work for things like being OK'd for respirator/air pack use. It turns out that this provider is being "bought out" by the same medical group that bought out his PCP. All of their medical records are going electronic, and it turns out his file can be accessed by either provider. This is a problem, because the industrial place works for management, and has a reputation for declaring people absolutely fine after being hurt at work, to avoid workman's comp claims.

Over the last 3 days he has been laid up at home with extreme back pain, but will not go to the doctor because admitting to his PCP that he has back pain now could very well result in him being denied coverage for any future injury he could incur at work (he works in a very dangerous profession). Also, even though he isn't an addict or anything, there are certain personal medical issues that he would prefer not to share with his employer's doctor. (Understand that the employees are REQUIRED to use this doctor for work related medical precertifications).

One of the MD's from his PCP's practice called him at home to discuss the situation and ended up bascially admitting that he couldn't 100% guarantee that his private records couldn't get into the hands of "management's" doctors, even though in theory they shouldn't have that access.

In other news, I went to a walk in clinic for a throat culture, and the PA there pulled up my file, and right there in front of her were the Dr. visits I had had related to my painkiller addiction over a year ago. (Different office, but again owned by the same practice).

Also, someone just posted here that his Sub doc called his back surgeon withoug him ever telling the Sub doc who his back surgeon was, and whether or not he was actually going to have the surgery.

So, bottom line, I know for a fact that medical records, in addition to just the DEA database, are becoming accessable to anyone you "sign on the line" to allow to treat you.
My husband and I have done a lot of research on this, and the situation, at least in our state, is that the technology has gotten way ahead of the privacy controls and discussion of medical ethics that should go along with it.


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PostPosted: Sun Oct 24, 2010 11:26 am 
I also want to add to the above post: If you doubt that a doctor who signed the hippocratic oath could be that company friendly, consider this...The corporation I used to work for had an on-site doctor that anyone who got hurt on the job had to go to. One of my colleagues had a crate of glass fall on her leg. She went to the company doctor, who told her she was fine and sent her back to work for the rest of the day. Later, she went to the ER and her leg was broken in 3 places, she had to have emergency surgery and pins put in, and was in a leg brace for the better part of the next year.


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PostPosted: Sun Oct 24, 2010 4:14 pm 
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Now see? This bothers me too. Of course the company doc will say she's ok, they don't want to get sued or have to pay up for treatment,etc.

Obviously the idea is, the dea all pissy about us taking sub. Because it's a partial narcotic. What they don't see is the potential for abuse in't there. Basically,you can't get high from it!! Well the first few times, you can. But It pisses me of that because I get hurt or something that I have the newfound knowledge that, I will now have to suffer because I'm in some stupid data base. It's kind of scary to know that even if I ever NEED a more powerful pain killer than OTC I'm **it out of luck. I'm glad to have found out *before* sure this tooth hurts like hell, but I can deal. It's not a broken bone.

Apparently this doesn't seem to bother anyone else??? I'd rather turn to a legitimate doctor, but if I end up needing something in a bad way,(say after my tooth extraction, or broken bone,surgery) I'd reluctantly turn to my other sources. Plain ad simple. We are supposed to suffer just because we take sub? I don't get it. Never will. Don't they realize there is a higher chance of relapse this way? Sheesh. Everything is police state now. I guess I'm just confused. I understand we've all abused narcotics before, but when there comes the time for pain relief former addicts don't matter? Course, a lot of us got in this predicament due to long term injuries, etc. I probably should have thought more about grinning and bearing my addiction to Norco then jumping on this band wagon. I wonder if anyone else has regrets? Is there a more lively sub forum out there?

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PostPosted: Sun Oct 24, 2010 4:35 pm 
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Of course we deserve pain relief! And there are plenty of doctors out there who will provide it. It seems you ran across a really shitty one. I'm uncomfortable with a national database, although I'm always honest about my sub. It's the privacy issues that concern me.

The really interesting thing is that a former addict is NOT at a higher risk of relapse when they are given legitimate pain management. No, the higher risk for relapse comes when our pain is NOT treated, as hopeful said.

Hopeful, there is an NIH paper posted in the LINKS section about treating acute pain in bupe/methadone patients. You might want to read it and keep it on hand. I've actually given it to my doctor, as have others here. It's from a reputable source and can be very helpful. I'll let you read it and won't go through it all here.

If I went through what you did, I would be damn sure to go to a different ER or Urgent Care facility. Or maybe you just got a crappy doctor. Doctors can be uninformed and ignorant about some things, too. Not all will be open to listening to us, but some might be. We have to try, for ourselves and for the addict who comes after us.

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PostPosted: Sun Oct 24, 2010 4:35 pm 
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I'd like to add though, that being on sub has given me the freedom from nonstop obessing about opiates. So even though I have regrets and hope I never have an emergency situation while I'm on this, it's helped a LOT. In fact, it seems to help keep my moods more stable, and I'm not as depressed..man when I was on Norco I was. So, it's really a catch 22 isn't it? Lol. I can't down the sub itself, it's helped me in such a way I feel like my old self again, I didn't think that was possible. So I feel bad about sounding the way I did. I just don't want to be stuck one day needing pain relief for some emergency and them telling me to f off. Though, IV valium works wonders when getting teeth pulled...I wish there were more people to relate to out there regarding this.

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PostPosted: Sun Oct 24, 2010 10:16 pm 
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I def see both sides as of not wanting the whole world to know your on suboxone. but at the same time any dr who deals with you has to know your on sub so they dont put your recovery in danger 1 and 2 if they give you certain meds an you get sick then what if you know what i mean.

This one part of your post made me a lil worried.

"and I'm just worried that if I tell the dentist I'm on sub, I may end up with nothing for the extraction"?

What do you mean by this? knowing no pain meds will help what are you looking for? IM NOT SAYING YOU ARE but if you reread your first post then go to that post it sound like you are seeking some type of pain medication from your dentist when you have the tooth pulled.


But b4 you have the tooth pulled talk with you sub dr about uping your dose for a lil while till the pain goes down. i promise you sub will help i was on a very high dose of oxy for 4 years for a serious injury and my sub def helps with my pain issue. But at the same time im on 16mgs a day.


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PostPosted: Sun Oct 24, 2010 11:36 pm 
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I guess I'm confused Hopeful. Just what is it that you wanted this doctor to do for you? What is it that he did wrong? Perhaps I'm missing something here. Am I? From your story, you went to the ER with an abbess tooth. When asked if you take any medication you lied and said no or did not include Suboxone in whatever list of medication you did provide. Am I right? They then found out that you actually were on Suboxone even though you didn't tell them that. The doctor then told you that he can't (won't) give you a narcotic for pain because you are on Suboxone. Do you understand that he was not being mean to you? He was not trying to get even with you or punish you or even treat you like a junkie. He just may have not made it clear to you, but, just as myself and others have been trying to tell you, if you have taken Suboxone, opiate pain medication will not work for at least three days. Why would you want the doctor to give you a shot or pill (or anything else) that will not work? What would the point of that be? It's not your doctors fault that Suboxone blocks all other opiates and keeps them from help you. What would you expect from him - or anyone else?

Now, again, please help me understand if I'm missing something here. I just see you blaming the doctor and I'm not sure why. It is just a medical fact that if we are on Suboxone, opiates will just not work for us. Case closed. End of story. Now, I guarantee you that there are doctors out there that will work with you and do whatever they can to try to treat your pain in other ways. Opiates just are not going to do the trick. I will also guarantee that there are asshole docs and nurses that will judge you about the Suboxone. I get that. But either way, all of us are SOL when it comes to opiate pain medication. Pretty much our only choice is to stop the Suboxone for three or more days and then opiates will start to work. It totally sucks that in an emergency this cannot be done. It totally sucks that your tooth got infected and you were not able to stop your Suboxone in time. You can, however, change that when your tooth is pulled.

I'm not sure what else to say here. It sucks that those of us on Suboxone have to deal with this pain issue. It also sucks that we are addicts. Life is not fair. For me, personally, I would rather continue to take Suboxone and stay out of active addiction, no cravings, no getting sick, none of it, and suffer a bit should I need emergency pain medication. I think it's a reasonable trade-off. Just please don't blame your doctor for not giving you opiate pain medication. It was not because he was judging you or punishing you. It was because IT WOULD NOT WORK!


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PostPosted: Mon Oct 25, 2010 7:54 am 
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I'm just going to respond to some of the comments Lilly made about the worker's comp issues which may or may not be helpful.

First is that every state has widely different workman's comp laws so you really have to look them up for each state you are in and generally the laws are somewhat complex.

Second is that in most states the worker has the right to pick his/her own healthcare provider. Employers will have a doctor they prefer to use and they will recommend patients initially go to a particular provider, resulting in the worker thinking they actually HAVE to go to that doctor for their healthcare. Not true most of the time.

Third is that employers WOULD be entitled to view any and all medical records related to the work related injury. The medical office SHOULD redact any and all information related to addiction and/or sexually transmitted diseases, but I will tell you MOST doctor's offices do NOT do this. I could have filed a claim last year and intentionally did NOT do so because I know my employer would have seen the suboxone because one of my doctor's offices wouldn't have redacted properly. This is a HUGE concern to me. I would recommend approaching any of your doctors and letting them know you expect this information to be redacted from all records PRIOR to them being shared with anyone else unless you have specifically signed a release to share such information. This is a huge concern. I read about people's STD's and addiction issues every day in workman's comp and 99% of the time there are massive HIPAA violations. When something IS redacted by the medical office it tends to be the workman's comp claim number which is STUPID and is the LAST THING which needs to be redacted, not the first.

In terms of your husband not getting treated for his back pain for fear it won't be covered in the future, I am not sure how realistic this fear is but understand where it may have come from. All worker's comp is assessing a few factors.

* What is the direct impact of the industrial injury/occupational disease?
* What, if anything, is a pre-existing medical condition, NOT aggravated by the industrial injury?
* If a pre-existing medical condition was pre-existing and aggravated, is the aggravation permanent or temporary in nature?

The main concern your husband would have is how the state you are in treats these issues. Generally, people are quite safe going to the doctor several times over for back pain and if in the future they sustain a work injury, it would still be covered, but would also be limited to the impact of the injury. i.e. the employer would not be financially responsible to treat any residual effects of the pre-existing condition inless let's say your husband had degenerative disc disease causing the back pain at present, and then sustained a work injury which caused that condition to become painful on a permanent basis and then the employer would be responsible for that. But if the injury only caused the pre-existing deg. disc disease to be painful on a temporary basis, the employer would be responsible for reaching the worker to pre-injury status and any natural progressions of the pre-existing Deg. Disc Dis. (DDD) would not be covered.

Basically, your husband should be fine unless he receives treatment for his back pain on a regular basis and is being treated regularly up until the date of an injury, in which case, they will inspect very closely what new findings are a result of the injury versus those already present and not caused by the injury. They will know if your husband chose not to seek treatment for a painful condition because these things are often visible on MRI and/or x-ray and will reveal if it is due to old injury and will reveal if the condition is acute and a new condition versus an old longstanding condition.

Tell him to go in and get treated for his back. My guess is that your husband does some kind of construction and has heard horror stories from other worker's who didn't understand what was happening, why it was happening, and may not have been very honest about WHY their condition wasn't being covered. I mean who is going to outright tell you that they were scamming and got caught?

For every doctor who will lie and say a worker is fine and can return to work, there are 10 who will lie and say someone can't work for the benefit of the worker. In my state, I rarely see a doctor who says anything for the benefit of the employer, even the doctor's who are in work clinics and are often recommended by the employer. In my state those are some of the most patient oriented doctors I have ever seen in fact.

Cherie

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PostPosted: Mon Oct 25, 2010 11:07 am 
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hatmaker510 wrote:
Hopeful, there is an NIH paper posted in the LINKS section about treating acute pain in bupe/methadone patients. You might want to read it and keep it on hand. I've actually given it to my doctor, as have others here. It's from a reputable source and can be very helpful. I'll let you read it and won't go through it all here.



I looked for it, but didn't see it. All I see under the links section is this:
Here are some links to my other sites:
The Suboxone Talk Zone
Fond du Lac Psychiatry, my practice


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PostPosted: Mon Oct 25, 2010 11:24 am 
Cherie - THANK YOU so much for responding to my post about privacy issues. I felt like I was getting off topic, but this has been a big concern for us lately, and not just because of the Suboxone and workman's comp isssues.

The fact of the matter is that every doctor's, dentist, walk-in or whatever office in our state now requires us to give them a photocopy of our driver's liscence. The say it is to protect US, and we don't object to giving them our ID, but they cannot assure us that they will keep it safe. In the case of the walk-in clinic that pulled up my addiction records right in front of me, they are in an office within a local pharmacy and keep info. in an unlocked file cabinet during the day while customers are walking in and out. And we've had the experience of having to give our driver's liscence # to buy Sudafed for our kid's cold and they keep it in a three ring binder at the cash register!

Also, we applied for a loan at a bank which required us to give them everything but our firstborn. We subsequently decided not to take the loan as we could get a better rate elsewhere. I asked for all our information back, and was told by the bank that they are required to keep it for 7 years. We're not even their customer. And what bothers me the most about it is that our kids' social security numbers are on our tax returns (that they have) and the biggest scam going right now is people stealing KIDS SS #'s because it usually isn't caught until years later when the child applies for his first college loan or something.

We have been unlucky enough to get "The Letter" at least five times telling us that a company that has our information has had a breach of security, lost a laptop or whatever, and our private information has been lost or stolen. The last time it happened it was our HEALTH INSURANCE COMPANY.

Very little information is needed to do a background check or otherwise tap into personal information. Name date of birth, and driver's lic. # can get you pretty far (see 3 ring binder next to cash register), and if you have the SS# it's an open door. We've even had retail stores ask us for our SS# because we were returning an item!

So I guess when we found out that our medical records were going digital and could be pulled up by any number of people (not just doctors and nurses, but insurance filers, receptionists, etc.) it was the last straw. We haven't even been assured that our file is password protected or is in anyway secure. Like I said in my earlier post, the MD from the office admitted that he didn't know enough about the technology to guarantee us that our info was secure.

So yeah, to say we're concerned about it is an understatement.

hopeful_sobriety - you probably stopped reading my rant about 3 paragraphs ago but just in case you're still here.....Getting pain relief (or not getting it) while on Sub is a huge concern for many people, and really like you even pointed out yourself, is one of the only drawbacks of Sub. For me, everything else about Sub is a positive. I was really worried about it for a while, but I got to thinking, at the age of 44 how many times have I really NEEDED narcotic pain relief? I'm thinking about 4 or 5 times in my life, 2 of which were childbirth.
I DID have the thing I feared the most happen, I got in a car accident and was taken to the hospital in an ambulance. Maybe I was lucky (I was) but the pain didn't really kick in until the second day, at which point I had stopped my Sub and was taking double doses of pain meds + ibuprofen. And I was OK. I've learned here that if I'm in acute pain, like for a gall bladder attack, to ask for Torodol, which Sub doesn't block. And if I had to have surgery I would stop my Sub 3 days ahead of time and make sure I had a pain management plan worked out with the surgeon ahead of time. If the surgeon had the attidue that he wasn't going to give pain meds to an addict, then I would find another surgeon. So I'm not as scared as I used to be.

And, yes, there's always going to be someone out there who's going to look down on us because we're addicts. I mean it's even happened to Dr. J who's an MD, PhD, medical director and all around smart and good person. The best we can do is stay in recovery, stick together and help each other. So on that note, I hope you can work with your dentist to get the treatment you need and deserve, and I hope you're on the mend soon.
Lilly


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