Finally made it to the Dr. Now what?

[krisgrace]

I went to the Doctor at 9 this morning. They told me before I went to continue to not stop my meds. I went in with all hope of getting on the Suboxone as soon as possible. We went through my story of my addiction. I tells me that since we do not have a detox facility (which is what he would prefer me to do); He would like me to taper down off my meds before giving me the Suboxone. I am taking Hydrocone 10/650 10x daily. He wants me to take that for 5 days then half of that for 3 days 4 pills the next day and 3 the next. One the last day he wants to see me again and then he will prescribe me the Suboxone. He also prescribed me xanax to help with the anxiety for the days I am lowering my dosage majorly. He says that if we jump head first into Subxone I will sufer for a few days. I am VERY confused. I thought you go into withdrawl for about 12 hours and take Suboxone and you will be fine after that? Why do I need the week of tapering very quickly only to have to go into full blown withdrawl anyway to start the Suboxone? I tried to ask him this becasue I do not understand and I know I am not the Doctor. He says that he is doing what is best for me and if I didnt like it to find another Doctor. He says he does not specialize in Suboxone and only accepts certain paitents. He is the ONLY doctor that accepts Insurance around here. I am really confused and feel like I cant really talk to him. He said that if I felt like I could deal with it to call him and he will give me the Suboxone and "let me suffer". Am I being difficult? Should I listen to him as he is the Physican. I just have been told different ways of people being treated with Suboxone and I am really not sure about this. Does anyone have any clue??
Thanks GUYS. I am so scared and I just want to QUIT, as soon as possible!

:praying

[ElegantlyWasted]

Not that familiar with opiate tapering/ subs... See if you can get a referral to an addiction specialist of any type; np, md, psychiatrist (someone who can prescribe meds). As to finances/ insurance try a social worker for the state and/ or muni you're in. Govt bureaucracy sucks, but if you cand find a competent advocate it could be awesome. I do know that opiate w/drawal sucks, but is not life threatening. Best of luck; sending ou some karma for ya.

[krisgrace]

Also I have tried the tapering and I really dont trust myself to stick to it. Doesnt he understand that I am an addict??

[christin1225]

Originally Posted by krisgrace

Also I have tried the tapering and I really dont trust myself to stick to it. Doesnt he understand that I am an addict??

This would be my reaction as well, Kris (thanks for the note of support BTW ).

All I can say (with all the sympathy that I can muster) is welcome to the world of Suboxone! I've come to believe that few doctors know what they are doing and that none of them practice in my area.

The tapering is going to be a challenge. Plus, putting an addict on Xanax is like playing with fire, IMO. Still, you've got to work with what you have. If the Xanax is optional, try going without it. Do you have someone who will dispense to you? You're going to have to be a "good girl" with the Suboxone anyway. You can look at this time of tapering as a practice (I know... it's a stretch... but you don't have much choice). It's not easy to not look for other ways to get high when you're on the Sub. We have to learn not to act like addicts. The Sub doesn't do that for us. We still have to do all the other things to strengthen our recovery.

As you pointed out, it makes more sense to have you go into w/d and just put you on the Sub. What he's doing makes no sense to me. My heart goes out to you. It's not easy doing the Sub route with a doctor that you don't trust completely, whose judgment you question. Been there, done that. It seems that we have to make due with what we have.

(Need to edit a bit: It's not just been there, done that. I'm still doing it, just to a lesser degree. At least my current guy takes insurance and he makes some attempt to listen).

[krisgrace]

Well, I have had a prescrption to xanax for years now and hardly ever get it filled so I didnt even fill his prescription. I figured if I needed it I would use the old one I had. I dont like the way it makes me tired. Anyway about the tapering issue. WHAT if I slipup? What if I take more? I dont understand how this is supposed to make getting on Suboxone easier?? I mean if I had the ability to taper myself and quit that fast wouldnt I have done it aready??
uuuggghhhhh
BUT, I guess I have NO choice. I really hate this.

[krisgrace]

I take it no one has any idea?!? *sigh

[Sugah]

I don't know a damned thing about suboxone, kris, except what I've seen others go through. I'm just chiming in with an observation that's of no practical use to you, so I guess it's my ego that's nudging me to pipe up.

An addict taper?? With addiction so much in the news and media, you'd think medical training would catch up, teach doctors the difference between dependence and addiction. I mean...my husband is a professional who has to take so many continuing ed. credits a year to maintain his license. I assume doctors are the same? And with the drug problems today, doesn't it make sense that addiction treatment would be part of this? Of part of the training for any doctor with the clearance to prescribe DRT?

*sigh*

Kris, I pray you find someone to hold your meds, dole them out on this taper, and grit your teeth to get through it. I can't remember -- could you not get into a detox to go CT?

Peace & Love,
Sugah (finished ranting, off to bed)

[Vintersemestre]

Alot of doctors tend to formulate their treatment plans based on little more than vague conjecture and blatant heresy so I wouldn't even try and begin to attempt and unravel why he did what he did or why they do what they do, I'll tell you bluntly, what he's told you to do may prevent needless suffering or it may be totally unnecessary and since there's no way of telling how you (in particular) will respond, he has erred on the side of safety, not for lack of caring, but for lack of time, unbiased research, corrupt government, global warming, starvation (only in Africa though, never happens in Asia or Eastern Europe), H1N1 and all the rest of it, he simply does not have the resources available to him to determine whether or not this may or may not be a problem for you.

[Vintersemestre]

Pardon me, I've overstepped my bounds. He may not have the resources. May not. Just like Mayday. Presumption of innocence is COMMUNISM.

[krisgrace]

Originally Posted by Sugah

I don't know a damned thing about suboxone, kris, except what I've seen others go through. I'm just chiming in with an observation that's of no practical use to you, so I guess it's my ego that's nudging me to pipe up.

An addict taper?? With addiction so much in the news and media, you'd think medical training would catch up, teach doctors the difference between dependence and addiction. I mean...my husband is a professional who has to take so many continuing ed. credits a year to maintain his license. I assume doctors are the same? And with the drug problems today, doesn't it make sense that addiction treatment would be part of this? Of part of the training for any doctor with the clearance to prescribe DRT?

*sigh*

Kris, I pray you find someone to hold your meds, dole them out on this taper, and grit your teeth to get through it. I can't remember -- could you not get into a detox to go CT?

Peace & Love,
Sugah (finished ranting, off to bed)

I did the CT 3 times. I always went back about the two week mark. And the taper I NEVER could do. I always justified taking one more now and skipping one later and It never happened like that. My boyfriend calls me weak minded for not bieng able to do it like that. I feel like a failure right about now.

[krisgrace]

I guess I have to do what he says and suffer in the meantime, only to suffer again to finally get on the Suboxone. You have to be off pills for 12 hours to start Suboxone. I am wondering if he did it to ease the 12 hours of withdrawl (which in my other previous taimes wasnt that bad).... Or if it was merely about the money. I have to pay an arm and a leg every visit. He was not informative and very cocky I might add. But, I guess at this point I have no choise but to do as he says.

[foglift]

Originally Posted by krisgrace

He says he does not specialize in Suboxone and only accepts certain paitents.

Maybe because he only "accepts certain patients" he may be testing you to see how much of a desire you have to stop, plus it does help to get you down to as low a dose pre-withdrawal. Just a thought

[krisgrace]

I am just so confused as to all this right now.

[kj3880]

Kris,
If this is the only doc you can get right now, I guess you have to play by his rules if you can manage it. But it sounds to me (I'm no doctor, though I have done a lot of research on sub programs for my own purposes), as if he is not a very experienced sub doc.

I can only share my experience in the hope it will help: The doc I had was very experienced in addiction treatment (30+ years), had an open mind, listened, wasn't at all arrogant, was personable, took his time (hour-long appointments), encouraged honesty even if you messed up (he always said "How can I help if I don't even know what is going on with you?"), and did not recommend pre-treatment tapering for sub patients. He knew what addicts are, and he understood why we were there. He also didn't mandate some really hard length of dope-sickness before allowing the first sub dose. We came in the morning, didn't dose that morning at all, and he started us when he noticed we were sweating and needed the bathroom. It was not bad at all.

There isn't a clinical reason to think you would be sick on sub because your current opiate dose is rather high (if that is the case, in fact) that I know of. I don't understand his reasoning. I would just think he'd start you at a higher dose of sub if needed.

Most people on here do fine on a low dose, though, even heavy opiate users. Most people don't need more than 8 mg a day. I've heard of some that started on 16 mg a day, but they usually find they feel OK on 8 pretty quickly. It has a ceiling effect. It doesn't get you high.

I hope you haven't stumbled on a doc who thinks addicts are low-life scum, and that you are "lucky" to get care after "what you've done." He shouldn't be moralizing and trying to make you feel inferior. You're the customer. Can you shop around for a more experienced and personable doc?

Love,
KJ

[christin1225]

Originally Posted by kj3880

If this is the only doc you can get right now, I guess you have to play by his rules if you can manage it. But it sounds to me (I'm no doctor, though I have done a lot of research on sub programs for my own purposes), as if he is not a very experienced sub doc.

I wish that all Sub docs were like your doctor, KJ. Even my current doctor is very much underinformed and he's ten times better than my last doctor.

He also didn't mandate some really hard length of dope-sickness before allowing the first sub dose. We came in the morning, didn't dose that morning at all, and he started us when he noticed we were sweating and needed the bathroom. It was not bad at all.

I think that the ones who require a long time are doing so because they are having their patients induct at home. That's what my first doctor did.

There isn't a clinical reason to think you would be sick on sub because your current opiate dose is rather high

I tend to agree since Sub is like 40x stronger than morphine.

Most people on here do fine on a low dose, though, even heavy opiate users. Most people don't need more than 8 mg a day. I've heard of some that started on 16 mg a day, but they usually find they feel OK on 8 pretty quickly. It has a ceiling effect. It doesn't get you high.

I believe the ceiling effect is around 6mg (correct me if that's wrong, KJ). So, if you're taking 8mg, 10mg won't get you high and neither will 24mg (though you can become ill from too much). I take higher doses than 8mg because it works on my cravings better. I've tried lower and I've relapsed. Talk to the doctor about it, Kris. Whatever you do, don't go managing your dose on your own, even if you're lowering it. I swear that's the easiest way that our addiction gets us while on Sub. We start thinking that we can manage our drug intake. What a boost for addiction!

Kris, it's late and I'm trying to read through your thread quickly (sorry that I've been such a mess lately). Did you mention using an old script of Xanax? If so, I'm giving you my same warning not to allow yourself to be fooled into thinking that you can manage ANY drug without a doctor being involved. Don't give your addiction that shot in the arm.

As far as the tapering goes. Is he prescribing your oxy/hydro (sorry, forgot what you're on)? If you don't successfully taper, what's to stop you from starting your Sub? It's not as though a taper is going to bring your tolerance down so that it would affect what dose of Sub you'd be taking. At 40x what morphine is, that would be one hell of a taper! In other words, are you covered if you can't taper or are you looking at being sick?

I'll try being around a little more.


Hugs,
Christin

[Vintersemestre]

The thing I don't understand is why they get to be choosy about who's life they improve, isn't that a basal violation of their oath? We put them in their place a long time ago. We shoot to kill if they try to cross the border. True story.

[tiburon88]

Originally Posted by Vintersemestre

The thing I don't understand is why they get to be choosy about who's life they improve, isn't that a basal violation of their oath? We put them in their place a long time ago. We shoot to kill if they try to cross the border. True story.

Crossing the border and suboxine treatment are two different things.

tiburon

[Vintersemestre]

I meant um... we control our doctors. Much like one would control a herd of swine or any stubborn animal. They don't have a shockingly archaic dictatorial hand free to bend your life to their wit and whimsy. Ever let a wild hog free in your house? Righteous...

Here in Canada you can phone your local Party Office and convey salutations to the local Commissar if in need of assistance in subduing a troublesome doctor. Rest assured that when the red vans arrive with the yellow maple leaves and smartly uniformed federal officers cordon off the area that business is'a bein' takin' care of.

[krisgrace]

Originally Posted by christin1225

I wish that all Sub docs were like your doctor, KJ. Even my current doctor is very much underinformed and he's ten times better than my last doctor.

I think that the ones who require a long time are doing so because they are having their patients induct at home. That's what my first doctor did.

I tend to agree since Sub is like 40x stronger than morphine.

I believe the ceiling effect is around 6mg (correct me if that's wrong, KJ). So, if you're taking 8mg, 10mg won't get you high and neither will 24mg (though you can become ill from too much). I take higher doses than 8mg because it works on my cravings better. I've tried lower and I've relapsed. Talk to the doctor about it, Kris. Whatever you do, don't go managing your dose on your own, even if you're lowering it. I swear that's the easiest way that our addiction gets us while on Sub. We start thinking that we can manage our drug intake. What a boost for addiction!

Kris, it's late and I'm trying to read through your thread quickly (sorry that I've been such a mess lately). Did you mention using an old script of Xanax? If so, I'm giving you my same warning not to allow yourself to be fooled into thinking that you can manage ANY drug without a doctor being involved. Don't give your addiction that shot in the arm.

As far as the tapering goes. Is he prescribing your oxy/hydro (sorry, forgot what you're on)? If you don't successfully taper, what's to stop you from starting your Sub? It's not as though a taper is going to bring your tolerance down so that it would affect what dose of Sub you'd be taking. At 40x what morphine is, that would be one hell of a taper! In other words, are you covered if you can't taper or are you looking at being sick?

I'll try being around a little more.


Hugs,
Christin

The xanax is being prescribed curently from my pysc. So, I stand corrected when I said "old" prescription. I see is as old because I hardly use it, and I filled it so long ago.

The Suboxone Doctor prescribed me 10 mg hydro/660 acet. Vidoden. I suppose as he is the Doctor I will do as he says, even though I dont understand it. I need this to work and he (and the Suboxone) is my last chance. I am still really feel confused and just would have felt better if he would have explained he reasoning behind making me taper before I started the Soboxone.

Anyway I go back to see him next Thursday. I have no idea if I will walk out with a prescription then or have to come back...

[Cherybaby66]

it really concerns me that you are going to start taking xanax. REALLY concerns me. If you can do without it, Kris...I suggest you give it a shot. The benzos are so rapidly addicting and they are an absolute BEAR to get off of...worse than opiates in my opinion.

Vinter - Unfortunately, here in the states, we are not nearly as evolved of a species as the Canadians are. Our doctors rule us rather than the other way around. They are very rapid to dismiss "problem" cases from their practice. We have a very litigious society here and docs really have a low threshold for non-compliant patients. This will include the patient who questions the doctors orders. Very high rate of "holier than thou" going on in this country when it comes to our doctors. You think they treat their patients like garbage? You should see the way they treat us nurses...especially the addicted ones. Shameful.

[kj3880]

I agree. Our doctors here (with the exception of my addictionologist) are pretty arrogant, bossy, holier-than-thou. I think that the exceptions are the docs who've been humbled by addiction themselves. Those are the ones to seek out in this country.

I had to go to a new physician last week with my swine flu, and she treated me shamefully, complaining that I was "making her sick" by coughing and hacking "all over her office." I couldn't help it, that's why I was there. I covered my face, but she said "that sound is sickening." Very unprofessional. I will find a new doc when I'm feeling better.

[Vintersemestre]

Originally Posted by kj3880

treated me shamefully, complaining that I was "making her sick" by coughing and hacking "all over her office."

Too bad someone who can't vomit at will wasn't there...

They're just not allowed to act like that here and once you've found a doctor you can see regularly they can't refuse to see you for any reason.

[krisgrace]

I think I need to move there....

[hardup]

i was on the suboxen for a while and the withdrawal from that was killer 1000 times worst then the pills. if you take the sub try not to take it long. get into a program and set up a support system.