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PostPosted: Tue Jun 21, 2011 12:14 pm 
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I got the idea for this post after my last visit with my addictions doctor. I've been having some problems with tapering my dose, so I explained the liquid taper method to him. He replied, "Well, see, there, you know more about this stuff than I do." Of course, it wasn't necessary for him to admit how little he knows about Suboxone. I've been aware of that for a long time.

I started to think that I'd like to see a list, as exhaustive as possible, of what Suboxone doctors should know (but we've discovered that they don't). What do you wish that your doctor knew? I'll start by offering what made my doctor's eyes WIDEN in DISBELIEF when I told him this past Monday:

[font=Lucida Console]Dear Doctor,
Doses of Suboxone under 4mg (including, but not limited to: 2mg, 1mg. and .5mg) are not PLACEBO doses. Patients DO experience withdrawal from doses this "low."
[/font]
(Yes, he actually said "placebo.") :roll:


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PostPosted: Tue Jun 21, 2011 1:27 pm 
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I would have liked my Sub Dr to have more knowledge of Subs pain killing properties how much pain is too much for Suboxone to work. I wasted 5 years of my life trying to get pain relief from Sub but my Dr always said the same thing give it time and keep up PT and your exercises. Than a couple weeks ago when I told him I am about to switch to methadone do you think I should continue my PT program and he said I quote “with both of your injuries you have severe weakness and there is nothing he can do for you but actually make your injury worst with the stretching exercises he does on your arm.” Are you serious you told me to keep going all these years and now that I am back on a full antagonist and getting pain relief it is a waste of time? I am so mad about this I am almost thinking of seeking legal advice because I have been enduring severe pain during those sessions for nothing but when I was on Suboxone it was a good idea. I feel betrayed and was just being told to do so for him to make money off me all these years. And now that I think about it I understand all the bullshit he feed me about why he won’t prescribe me methadone was not because what he told me but because all the money he was going to miss out on each month if I switched.


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PostPosted: Thu Jun 23, 2011 2:58 am 
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I'm sorry to hear that bBoy. It's totally reasonable in that position to be sceptical of your docs motives. I'm angry just hearing about it.

Fortunately, most of my prescribing doctors have been pretty good. It's when I've seen doctors outside the addiction treatment world that most of the ignorance has been.

There is a lot of heroin in my part of the world, and the moment a doctor starts to prescribe either methadone or suboxone they often become inundated with patients, so they have a pretty steep learning curve but catch on quickly.

It seems doctors here are taught these days in the addiction field that their patients are often the ones who know the most about the drugs. Kinda like what your doc said Christin. There was a student doctor sitting in one of my sessions recently, and my Doc said something like "I'm sure he (ie me) knows a lot more about these drugs than we do".

I said that was good reason for them to give me the script pad. My reasoning was not accepted.


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PostPosted: Thu Jun 23, 2011 8:30 am 
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I wish sub doctors knew more about treating acute pain (like post-op) for us sub patients. If we can find out the different options of treating our acute pain, why can't these educated physicians? We shouldn't have to educate THEM! For that matter, I also wish emergency room/dept doctors were more educated about suboxone in general.

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PostPosted: Thu Jun 23, 2011 9:46 am 
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Meh. When they yank out the ketamine infusion, I probably won't complain.


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PostPosted: Thu Jun 23, 2011 12:16 pm 
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I wish my Suboxone doctor knew how bad it hurt my feelings to be treated like money in her pocket. Even today when I think about her, it angers me. I am/was a sick person, trying to get better by going on Suboxone and to be treated like your less than human because you're an addict does NOT help.

I also wish she knew that it takes longer than 2 or 3 days to detox off of Suboxone. No word of a lie, she told me that it would take me 2 or 3 days to detox off of Suboxone and feel better!! Can you believe that shit??

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PostPosted: Thu Jun 23, 2011 1:07 pm 
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[i][b]


I wish a couple of things from my Dr.

I wish he would stop telling me there are ppl in worse pain than I'am.
I wish he would stop telling me to call his office when his office doesn't answer the phone or call his pts. back.
I wish my Dr. would be able to get out that one size fits all theory.

I have lots of other things but for now that's my top 3 that make me crazy.

Thanks for bringing this subject up.

Marie


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PostPosted: Thu Jun 23, 2011 5:19 pm 
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That is a great point Hat, that Emergency Rooms had more knowledge on Suboxone. It is a drug that is widely used and I think anyone in the medical field should now have some educating on Suboxone. It is upsetting enough when the nurse asks you what is that and then gives you THE LOOK yes you all know that look but even worst when the Dr walks in and says “it says you are on a medication called Suboxone( of course mispronounced) I have to ask what is that” really all that money you are making you don’t know anything about opiate dependency treatment but you hands out hydrocodones like it is nothing.
That is actually something cool my methadone clinic does is it gives you this little card in case you have to go the ER stating all the medications to not being given to you no matter what. I think Suboxone Drs should also do the same.

Also another great point Romeo 2 to 3 days my ass you mean to 2 to 3 years. I know that is a little crazy but it does take up to 12 months for your brain to properly heel from drug addiction.


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 Post subject: ER Protocal
PostPosted: Thu Jun 23, 2011 8:20 pm 
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I definitely agree there should be a suboxone patient protocol for all patients that take this medicine when they present in the ER. I am so tired of explaining what suboxone is to nurses and even ER Docs. You would think they would be up on this.

For me my Dr always acts as though he is an authority on suboxone and if you disagree with him it does not go well. Most of the time I nod yes alot and then walk out with my script. He told us this week that his fees are going up $15.00 per person. I balked a little and said is he opening a new office? Which I know he is........they replied NO he just wants to get everyone at the same price as other doctors. My last doctor was $100 a month.......he is $175.

I wish he knew that R&B is not right about everything. He constantly talks about the rep and that she is coming to see us and takes whatever she says as true. Look I like him ok but I refuse to be open to him because I know he is only interested in one thing my money and getting me out as quickly as possible.

I have heard others say to find someone that is an expert in addiction to be my Sub Dr. I agree and think I will pursue that avenue. I also wish my doctor didn't have gates on the doors and windows and you have to be buzzed in. There is no privacy so you hear everyone's business. It's amazing how nice they are when you have the money for the appointment but if someone doesn't they turn into different people and you see the addict begging family to help them. There has been times I have been there and heard them on the phone with a perspective new patient and talk about rude......I hate the way they conduct their business. But it is up to me to change that ........every month I stress before I go to see him.

Jim


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 Post subject: I Wish
PostPosted: Thu Jun 23, 2011 11:01 pm 
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I wish all the doctors would spend a minimum of two hours here reading all the messages. Wouldn't that be nice?

But really, if only all the other doctors were like mine. He and his wife (only two there) are in it for the patient. He takes insurance and accepts their measly payment as paid in full, along with my co-pay.

We are moving in a few days and I had to find another Suboxone doctor in Nevada. The search did not go well for two weeks. Had to contact BC/BS and have them call some doctors to explain that they must accept the insurance. (they don't)

Had to cross reference the PPO providers with the Suboxone providers and start calling. Finally found one today that appears to be just mine here. I did some research and someone posted that he saved his life because of the Sub, and that he takes insurance.

There are fewer and fewer doctors now that will take insurance payment at all for this treatment. It just doesn't pay enough if the doctor spends the time with you like they are supposed to.

So I say "Thank God" that I was not only able to find one good doctor, but two!

And even my good doctor would benefit from reading this site. He knows a lot, but we know so much more.

Great subject.


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PostPosted: Sat Jun 25, 2011 12:36 am 
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Great posts, everyone. I also wish that my doctor would take the time to read some posts on a Suboxone forum.

I wish that my doctor also knew that, even though signing a contract to stay clean while on Suboxone might be recommended or maybe even be worthwhile, it's not practical to kick an addict out of the program for relapses. It makes your patients feel that they need to lie to you. Personally, if I had been honest about my lapses (alcohol, tramadol, flexeril) and had been kicked out of the program, most likely I would have had a full-blown relapse on my DOC.

I also vote for knowledgeable pain management. I wish that my doctor understood that opiate addicts need pain management for things such as surgery just as much as anyone does. "Take advil and suck it up," is NOT the answer.

Also (for all those who are like my previous "cash only" doctor), it's ignorant and ... well, downright stupid, actually, to tell addicts that they should be able to afford your $400 induction fee and your $150 monthly fees (plus cost of Suboxone for some) and not to bother them about billing insurance because, while in active addiction, the addicts could afford their DOC, regardless of the cost. Doc, we are coming to you because we want out of active addiction, which is more than just the drug use. It's being willing to do anything to get our drug, being willing to hurt almost anyone in the process. Is that really what you are advocating for your patients so that they can pay your "cash only" fees? Come on, Doc, think your comments through before speaking them, please!


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PostPosted: Sat Jun 25, 2011 1:51 am 
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I wish doctors knew how scary it can be to be physically dependent on a medication that can cause pretty awful withdrawal symptoms. Then they would understand why it's so important for Sub patients to have a bit of medication in reserve just in case there is ever some delay in getting a refill, and they would be less inclined to jerk their patients around when it comes to getting those refill prescriptions.

I wish doctors would BELIEVE their patients when they report side effects of their medication. My doctor was actually pretty good, but I've heard so many people say that their doctors just dismiss their concerns about side effects...and then they end up having to figure it out themselves by researching the question online.

I wish doctors knew that less is more when it comes to Suboxone. Especially for people who pay out of pocket, getting that dose down can be the difference between affording recovery or not.

I wish doctors knew how to taper patients off of Suboxone. Starting with knowing when a patient is ready or not ready to taper.

I wish doctors knew more about comfort meds for Suboxone withdrawal.

This is a great thread.

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 Post subject: Just Admit It
PostPosted: Sat Jun 25, 2011 12:04 pm 
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As much as I love my current doctor and nurse. She still disagrees with me regarding the strength of Suboxone. No matter what I tell her about what I've read here, she says that most of their patients jumped from 1-2mgs and had little problems. Some jumped from 4......right.

I gave her this website address, Dr. Junig's name and webcam site, and still they haven't explored it. My opinion is that doctors and their staff just don't like a patient who seems to know more than them. It bruises their ego. So continue on we will, to give each other the proper information we need to recover properly. The doctor and staff still saved my life but it was you here who kept me on the right path.


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PostPosted: Sun Jun 26, 2011 12:03 pm 
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This doesn't apply to my doctor, but to what I've seen on this forum:

1. Doctors who treat someone who has a 40mg/day hydro habit with 16mg of Sub and the patient OD's and spends two days puking should lose their liscence.

2. I wish doctors could be banned from having patients do "do it yourself" inductions, especially with no information, like wait until you are in moderate withdrawal to start!

I think most of US could do a better job helping someone find the appropriate starting dose, and guiding people through induction than these "highly trained" doctors!


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PostPosted: Tue Jun 28, 2011 10:48 am 
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Lillyval wrote:
2. I wish doctors could be banned from having patients do "do it yourself" inductions, especially with no information, like wait until you are in moderate withdrawal to start!


I got my script at my "induction appointment" and, after filling the script at the pharmacy as directed, I parked for work and inducted in my car. (I had been assured that I would feel fine after inducting.) An hour or so later, my heart was racing. The anxiety was so bad that I was crawling out of my skin. I was sick. "Take the other half tablet," I was told when I called from work.

Although some of the symptoms with my first induction resembled a mild form of precipitated withdrawal (feeling as though my body temperature had risen to 200 degrees and being on the verge of sh!tt!ng my pants) some suggested that I may have been given too much. To this day, I don't know which it was. So, I definitely agree that "do it yourself" inductions are not wise.

Besides, should it ever cost $400 to induct oneself in ones car? :shock:

Now, about liver tests ...
I've read the Suboxone patient information pamphlet and have wondered about this topic. But, I've had two Suboxone doctors and neither of them ever suggested that I should have a liver panel done. I have no history of liver problems. Perhaps, I don't need to be checked or is liver testing something that I should wish that my doctor knew?


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