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PostPosted: Thu Apr 30, 2015 2:51 am 
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even though i have been taking 8mg suboxone a day, (4mg strips 2X a day)
my dr would only give me a script for 90 strips
which was supposed to last me for two months. if you've done the math, you know that is not a
two month supply, only about 45 days. if i stretch it. no matter how i tried, i never made it to 60
days. so, i would have to borrow money from family and friends so that i could see the dr and
get a new script. on the few times that i could not get the money together, i was forced to detox. twice this happened. the first time for 4 days, the second for 3. so i went to the ER, hoping to get a little bit of help. after all thats what the good doc told me to do,
since he refuses to see me without his money.
besides, i think to myself, when i was abusing my pain meds the hospital relieved my symptoms, now that im trying to do right, they should be even more willing to help me out, right?? hell no!
instead of helping, they look down on me with their judgemental eyes, as if i am the worst piece of scum they have ever seen. and condescendingly recite, "we have a policy against helping you. sorry, but there is absolutely nothing we can do for you"
so let me see if i have this correct
(this is my actual story)
i was diagnosed with crohns disease. a debilitating, progressive, disease. meaning the longer it's in my body, the worse i will get, eventually getting colon cancer, and having all of my intestines removed, all the while i have chronic uncontrollable pain. you, the hospital, gave me these pills that took away my pain, and made me feel normal again. but because of the high addictive side of these pills, i became addicted to them. and now that i am trying to do the right thing by getting off of these pills, you cant help me??
this is what absolutely drives me crazy!!!
why do they even have this "policy" to begin with?
why is there no safe guard for those of us that have a "dr" who is more like a legalized drug dealer than a dr?? if i was still seeking pills, i could walk into any hospital, exaggerate my pain a little, get a couple shots of dilaudid and walk out with a script for 20-50 more percocets
but now that im trying to do the right thing and stay away from pain meds i am refused
and treated like scum


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PostPosted: Thu Apr 30, 2015 10:44 am 
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Carey,

Yeah, the medical community, and society in general, have a long way to go in developing a proper understanding of opioid addiction. We just have to keep hammering away with education. I carry some papers from NAABT and Dr. J's site in my car just in case I ever need emergency treatment.

Concerning your prescription. I noticed here, as well as another thread, that you mentioned "Suboxone 4mg"... it only comes in 8m and 2mg strips. I think what's happening is that your doctor is prescribing you 90 8mg strips and intends for you to take 1/2 strip two times a day. That would work out. I would definitely discuss this with him at your next visit.

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PostPosted: Thu Apr 30, 2015 11:08 am 
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if we're talking about the same thing
i was taking sublingual film
4mg/1mg

quick question if you dont mind

just realized the only real difference, besides the size of the film
is the 8mg films have 2mg naloxone
the 4mg films i was taking had only 1mg naloxone
could that added mg be the difference for me?


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PostPosted: Thu Apr 30, 2015 11:34 am 
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Suboxone film comes in dosages of 2mg,4mgs8mg,and 12mgs per dose. To bad they wont develope smaller doses for tapering.
...the 2mg an 8 mg films seem to be the norm though the others are available. .


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PostPosted: Thu Apr 30, 2015 12:16 pm 
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Hi Carey,

Running out early is very common at the beginning of sub treatment.

when I first started taking suboxone I too would run out early almost every month. I hated my addictive behavior of thinking that I needed more.

I would try to cut your dose strip in 1/2 pieces So you are still dosing twice a day but not as much. Psychologically this helped me with not running out.

Over time, I adjusted to the dose and i actually needed less to achieve the same effect.

If you have someone that you trust to hold onto these for you and give you the right dose each day. that might help.


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PostPosted: Sat May 02, 2015 12:11 am 
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razor55 wrote:
Suboxone film comes in dosages of 2mg,4mgs8mg,and 12mgs per dose. To bad they wont develope smaller doses for tapering.
...the 2mg an 8 mg films seem to be the norm though the others are available. .


I apologize...I did not realize they also made a 4mg and 12mg strip. I thought there were only the two, 8mg and 2mg.


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PostPosted: Sat May 02, 2015 7:53 am 
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Carey

Have you mentioned to the doctor that the script is not enough for 2 months? Maybe he thinks he is writing for 8 mg film...I can't imagine a doctor not giving enough. In NY there are no refills allowed (to my knowledge) so i go monthly.

The bottom line for me is i now pay less than when i was on the pain pills! I would pay cash for my pills and that would be at least 3 times more than i pay now. I never blinked an eye paying crazy amounts for the pills.


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PostPosted: Sat May 02, 2015 8:30 pm 
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Tiki, why do you say that Bup cannot be refilled in New York? Federally it is a schedule III med which allows up to six months of refills. A state can increase that but I can't find any evidence of NY bumping bup up to CII. Are you sure about this? Is it possible your doc just won't allow refills? Perhaps someone can answer this.


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PostPosted: Sat May 02, 2015 9:09 pm 
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Donh

After i read your post i did a little digging and couldn't find anything on NYS not allowing refills on bupe.

There is allot of information for doctors & pharmacists saying refills are not generally a good idea for opiate maintenance treatment. Patients should be seen monthly for UA's & drug diversion via pill counts.

I bet it is also good for the doctor's pocketbooks. I have never met or heard of anyone getting refills on their bupe in the area i live in but it is possible & apparently legal to give up to 5 refills due to the schedule.

I learn something new everyday and i love it!


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PostPosted: Sun May 03, 2015 9:26 am 
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I'm sure there's ppl that do get refills on their sub, but like Tiki my doctor absolutely has never wrote for anything but no refills. That's in Tennessee. I'm sure it's not illegal to write refills but I've never seen any in my clinic. I wish I could have refills in order to have a break in that monthly payment but I guess that's just the way it goes unfortunately. My doctor is extremely strict. I guess they're afraid someone could abuse that type of freedom of going two months without seeing the patient. So I totally understand it I guess, even though I sure wouldn't mind it :)

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PostPosted: Sun May 03, 2015 12:21 pm 
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This is slightly off topic, but my doctor will write extra for me if I'm going on vacation for a month (happened last year). I can also make phone appointments with him or the PA instead of going into the office.

In fact, Dr. Edrich unexpectedly called me Wednesday evening, because I was supposed to have a phone appt. with the PA (Nicci) the next day and he wanted to help clear her schedule. So I was surprised to hear from him, but it ended up being really awesome. (Usually I see Nicci.) I was able to tell him that I got into the graduate program in addiction studies and he was excited to tell me about his latest new thing. He is going to be the director at an addiction clinic in downtown Denver, in addition to his private practice. He wants to be able to reach more addicts that way. Of course, I said, "Well, I'm going to need to do an internship for my masters degree!" And he said, "That's great! You'll have to let me know when you get to that point!"

I'm sorry I went off topic, but I also wanted to show the OP that there are doctors and professionals out there that want to help and are committed to helping us addicts.

Amy

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PostPosted: Sun May 03, 2015 4:07 pm 
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Much depends on the doctor and his motives. But much more depends on the patient. Have they proven themselves to be worthy of additional trust. I would venture to say in your case Amy you have. However, I can see how in some cases, with their license and practice literally on the line, some doctors would be reluctant.

At my last appointment I asked me doctor for 5-6 Xanax because I will have to fly to go to a class in a week (a flight I was on was on CNN due to making an emergency landing in Houston, and since then I've had to have Xanax to fly). He talked about all the warnings of using Xanax with bupe, but trusts that I need it and will use it responsibly.

I may be going to Alaska in July. If that happens, I will need to get an extra month's prescription like you did Amy.


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PostPosted: Sun May 03, 2015 5:25 pm 
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I think it really just depends on the individual doctor and the rules they have. I've been a model patient for over three years now, never failed a drug screen and never missed the required sub meetings my clinic provides. So I'm about as trustworthy patient as they come lol. My doctor is very strict also. I've saw tons of ppl get discharged over the yrs for even taking neurotins (sp?) So just from my experience, it's more or less the doctor's preference if u get a refill or not, not if the addict has proven trust. In some cases absolutely, but some just doesn't matter if ur a suboxone spokesman lol ur not gonna get a refill. Anyway just wanted to chime in on that one more time, I'm sorry I know it's off topic. Have a wonderful day everyone!! :) :)

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PostPosted: Sun May 03, 2015 6:32 pm 
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Like Amy I too hesitate to take a thread off in another direction but I also see a half dozen posts by the same person on the same day so they sort of are ready off in many directions.

Good discussion that I wanted to add to. As for the legal end of things Bup was always a C-V drug. Schedule five U.S. As low as you can get. When they approved it for addiction they moved it to C-III. The drug itself did not change. The danger didn't change. The politicians changed it. I believe there are a few states that placed it as C-II on their own but most of the U.S. allows refills and allows the drug to be called in rather than written. This only makes sense.

I also think we need to advocate better for ourselves. Believing or even saying the doctor is putting his practice and license on the line does not help us. Plus it's simply not true. What doc would risk his career to treat up to 100 addiction patients even at $500 a pop? It's not worth it and a poor way to make money as a doc. Don't add fuel to the crazy making fire by saying the doc is risking his license.

Second, if we are to follow the suggestions that many of us need to be on Bup for the long term to perhaps life, monthly appointments are simply not reasonable. If you even get diagnosed at age 40 and stay on Bup until 65 that's 300 doctor visits. If you start at 20 and live until 80 that's 732 doctor appointments - JUST FOR ONE MEDICATION!!!! Is that really needed? Not for a stable patient it's not. The most important and sadly often the only main reason for the visit is the UA. You don't need to see a doc for this. Even third party testing can handle it. Need to touch base with the patient? Have the nurse call for a couple minute chat. Now, imagine if on top of Bup you are required to see a professional councilor too? How can anyone keep that up for years to life? How will insurance not start fanning payment for this?

Then many payients get down to a dose of 2 to 4 mg a day. So why was it nessisary to see the. Doc monthly to get 60 tabs/strips per month while on 16 mg/day and still be nessisary for 8 to 16 tabs a month. You were getting over seven months of med at a time before. Now you are getting about 15% that quantity but still need monthly visits?

I see my GP once a year for general needs including Lipitor. I have one or two additional blood tests in that time. He doesn't see me every month does he? Why should that be the case for Bup? Because it's a CIII controlled substance? Maybe but it's only a CIII because politicians pushed it up there.

I agree with many of you it depends on the patient and where they are in Recovery. I've been on3 month visits for years now. I've not had a single slip, no failed UAs, never ran out of Bup. If any of those things are to happen I'm sure I'd be back on monthly or less for a while. The same would happen if another chronic illness became unstable. When I dropped to 2 mg I had to do monthly UAs for a while due to increased risk of relapse at lower levels. Now I'm back to four visits a year and get two refills with my 8 strips for the month. My doctor is not putting his practice at risk. He is tailoring my care to my current condition. If my condition changes, my care will change with it. Does he do this for everyone? Doubtful. Does he need to do the same thing for every Bup patient? Hell no!

I think this is only reasonable. I think it's something we should start expecting. Should it happen after six months of sobriety? Probably not. But should someone stable for 8 years see the doc once a month - only to pick up a scrip? That's nuts and accomplishes little other than keeping healthcare costs out of control.

To bring this back to the title of the thread, we should expect safeguards. We should expect reasonable care. If we get to the point of believing that we are addicts so we deserve less and have to accept whatever we get - we will not get much. On top of that, if we have too many hoops to jump through, eventually we will say screw it, I'm getting off Bup so I don't have to see the doc once a month. So the very thing that we are told not to do, stop Bup too soon, may be forced to happen. It's all about balance. I may never go a year for Bup like I do with Lipitor and that is reasonable. So is three or four visits a year - for a six year completly stable Bup patient. Monthly visits, at least for me, is not. Thank God I have a good doc. But I'll tell you, if I change my behavior for the worse, so will he.

Don


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PostPosted: Sun May 03, 2015 7:52 pm 
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Subs can be helpful but the whole prescribing aspect of it is a big farce. I made a post a week ago or so about how I got a letter in the mail out of the blue saying how my dr is retiring in a month and they hope thats enough time to get a new dr or quit. Well I want to quit and I don't need anymore subs because knowing how shady sub programs are I saved up a rainy day supply for this very reason but what I do need is one last refill on the 2mg per day lorazepam that my dr has prescribed for 5 years along with one refill on clonidine. Those 2 rxs would cost me around 15$ and being that Im tight on money I had hoped that since Im not asking him to rx me anymore sub and that I have 5 years of complete compliance and not one relapse that the good dr might do me the small favor of phoning in those 2 for me just this one last time. Nope won't do it without the 100$ in cash, had a refill request sent over and have checked everyday for and they just tell me the drs office won't respond back. When someone is a millionaire and you have never been short one sent or never not payed on time for 5 years for something as expensive as sub treatment out of pocket and they will have no problem going to sleep at night letting you fall into benzo plus opiate withdrawal simultaneously because you don't have the cash one time (honestly even if I did come up with an extra 100$ I wouldn't even pay it now after I see how it is) then they are a despicable human being. This guy had me convinced he gave a shit all these years too and while Im very skeptical of people I still believed a small amount of him cared a little bit but nah he doesn't. Sorry for the rant it just burned me reading the OP was forced to withdrawal and told to go to the ER by the dr who could easily swallow his fucking ego for a second and just phone in the prescription.


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PostPosted: Sun May 03, 2015 7:58 pm 
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I believe that there are many hurdles yet to be overcome before this is recognized as a legitimate disease requiring proper treatment, and not just some moral deficiency. Some of those hurdles have to do with the DEA and state agencies that regulate prescriptions and the medical field, and I do believe some doctors have been harassed unfairly because they practice addiction therapy. It's wrong, but it happens. Dr. J has mentioned some things in his blogs that seemed to indicate that he has to be more careful in regards to buprenorphine prescriptions. So, yes, I believe there is greater caution around the prescribing of Buprenorphine than there is around other CIII drugs like Androgel or Xanax. I don't want it to be this way, and I hope that through ongoing education we can overcome it, but this is how I see things right now.

Donh - I'm not sure who you were referring to when you said, "I also see a half dozen posts by the same person on the same day", but if I'm responding too frequently or violating acceptable behavior, please let me know.

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PostPosted: Sun May 03, 2015 9:59 pm 
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This is an interesting conversation so i will add my 2 cents to the mix.

I don't believe ALL doctors are in it for the money. I do know sub doc's in my area have to keep a lot of records in case the DEA pops in. Monthly UA's, a copy of the script, impressions of that person's recovery, pill/film counts, 28 day appt's, all types of things we don't know about.

Doctors know we taper down but don't tell them so there are "extra bupe" floating around. Is it being sold? Is it given to a friend, relative etc. Maybe the patient sells some bupe to pay for the visit...who knows what really goes on. When the pain mgmt doctors closed up around here the street value of an 8 mg sub film went from $12 to $35 a piece! There were very few sub openings and people were desperate to stay out of withdrawal.

IMO, the Doctors know they are dealing with some people who had no problem stealing from an elderly relative so they could get their dope,pretty young girls who sold their body's for money for dope. They have to be careful IMO.

My addiction therapist & I talk about the guilt i have for letting myself get so addicted i could have lost everything, including my life...He works with addicts all day long & has a good feel for people. Often when we talk he tells me their are two types of addicts, those that want help/recovery & those that don't. One conversation was because i was hurt my doc wouldn't write plain bupe for me. I posted about it here, anyway the following month my doc asked me if i still wanted to try it and i said Yes so he wrote for plain bupe. He thought about it during the week after my appt and decided i was not a high risk for selling it. I guess people shoot it or snort it for a "high". Not all doctors are willing to make exceptions but just because they don't make exceptions doesn't make them bad or money hungry. They have been trained not to believe what we say and to stick to protocol. I now feel better knowing he trusts me but i am still an addict with the stigma attached.


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PostPosted: Sun May 03, 2015 10:11 pm 
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I'm very sure that donh was referring to the OP when he mentioned several posts on the same day. When Carey76 started on our forum she made several new topics asking different questions about suboxone. I noticed this too because it can be difficult to answer the same person on many topics, especially when we have a search function available to answer some questions. Still, we try to be welcoming and not make a big deal about that unless it becomes a habit. :)

I think that all of you have great points! Jennjenn I totally agree that with some sub doctors you could get a shiny gold star from God himself and you wouldn't earn privileges with that doctor. I think that some doctors are purely motivated by money and that some others actually believe that we deserve anything bad that happens to us for the sin of being an addict. I'm sure that my doctor would have given you some privileges by now.

I also think that Morphing is onto something when he says that there are doctors who feel the scrutiny of the DEA and other agencies more than others. Perhaps they haven't been very organized about their record keeping, or they've caught the attention of a state agency for some reason. I'm sure if your license to practice medicine or your DEA number has been threatened, you are very aware of patients that aren't in compliance with the rules of your office. I've heard from my doctor several times that he has made small changes in his practice in anticipation of new rules coming down the pike from one agency or another.

I agree with donh that people who are on a bupe product for many years with stellar compliance records should be earning privileges. Being in therapy for many years during bupe treatment may not be sustainable. Perhaps it should be up to the therapist to say, "Call me and set up an appointment if you feel the need or are having a problem, but for the most part you're done." Checking in with someone once every 6 months may end up making much more sense for stable patients.

Doctors like yours, buprecision, are the worst type. They have more in common with dealers than with other doctors. All they seem to care about is benefiting financially from someone who is between a rock and a hard place. They are either horribly jaded creatures or they never cared about the humanity of their patients in the first place.

Yes, the OP has a point. Where are the safeguards for us addicts? The truth is we don't have many. It is in our best interest to be vocal about our treatment! We need to advocate for ourselves and other addicts, especially those of us who are stable on our maintenance medication. We also need our addiction doctors and therapists and other specialists to advocate for us as well.

Most of all, I think we need to stick together and support each other instead of fighting amongst ourselves! How can we expect to affect change if we're squabbling over which treatment method is better or what the definition of "clean and sober" is? That crap doesn't matter! What matters is figuring out the practices that keep us from dying and then letting the world know that we need access to those practices.

Amy

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PostPosted: Mon May 04, 2015 7:02 am 
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Excellent summation Amy.
Thanks,
Morphing


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