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Unread 02-12-2008, 05:04 AM   #1
Vico-Dan
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Default Newbie - what can I expect?

I won't bore anyone with the details as it's a story that is familiar to many - pain issues, escalating tolerance, physical dependency, etc...

I am considering Sub but have been very discouraged in my attempts.

The first Dr. I called wanted $700.00 total for my first visit.
The second Dr. I called told me that I should plan on budgeting at least $500.00 per month, every month.
The third I called, I couldn't get the receptionist to understand what "Opiate Replacement Therapy" meant nor did she know what Suboxone/Subutex or Bupenorphine was and haven't heard back from the person she would leave a message for to call me back.
The fourth Dr. I called only saw patients who had been referred by the Court system.

I did use the Patient-Doctor finder and heard from two doctor's reps, one is too far away from where I live. I work F/T and can't afford to spend an entire day away from work just for an appt. due to the long driving time involved, which is 2 hours each way, without traffic.

I should also mention that back pain issues prevent me from sitting for long periods of time, so driving long distances is not practical for me.

The other rep. that got back to me mentioned that "their program is out of my financial reach"

I live in the North part of the SF Bay Area (Near the Sonoma/Marin county line) and would like to find a Dr. in Sonoma, Marin or SF

I have insurance, but couldn't find anything out on the insurance company's web page, nor do I believe that would cover "maintenance", just detox. Calling them didn't help either, and I'm not 100% comfortable with the insurance company knowing about what I'm doing.

It shouldn't be this hard to find a Dr. and one who isn't IMO taking advantage of people in a difficult situation.

$700.00 for a first office visit? That's just outrageous.

Also, I've read that many Dr's require weekly visits and require patients to attend N/A, which is something I did when I was on MMT for 10.5 years.

Again, I can't take that much time away from work for weekly Dr. appts, nor can I always do N/A meetings for a variety of reasons I won't go into right now, but I did go when on MMT and was basically treated like a Leper when people found out I was on MMT, which made going counter-productive and put me in a position to not be 100% honest with my sponsor and other 12-steppers. The "Anonymous" part of AA/NA is a joke - everyone there talks about other people, mostly negatively in order to feel better about themselves.
It's like High School all over again, except everyone is a hypocritical addict.

I'm just trying to find a Dr. that is interested in helping people as opposed to gouging them, doesn't require me to visit more then 2x per month and not have to go to meetings more then 1x per week, if at all as mentioned, it's counter-productive. I've been to meetings many times. I didn't use in 10+ years on MMT not because of NA/AA, but because MMT worked for me.

Am I being unreasonable?

I should have stayed on MMT - I only had to visit the clinic weekly, was about to get a month's worth of take home doses, was paying only $220.00 per month and my only requirement was a 1 hour, one on one session with a counselor 2x per month and dropping an occasional UA sample which always came back clean because I didn't use once in 10.5 years on MMT

I've been off MMT for 5 years now and wish I stayed on. Compared to the hoops I had to jump thru at the MMT clinic, it seems like nothing compared to what is involved with seeing a sub Dr.

If I wanted to go back on MMT, I would have to visit the clinic every day which again is not possible with my work schedule and the time involved going to the clinic daily.

Apologies for the tone of my post, but I'm very frustrated with this situation.

Any suggestions?

Thanks.
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Unread 02-12-2008, 06:03 AM   #2
Cally
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Hello Vico-Dan,

I want to first congratulate you on saving your life. I have chronic pain and suboxone stopped my huge pill intake, the cost of doctors and prescriptions (AKA doctor shopping) and made it possible for me to find treatment to eliminate my pain.

I am in Southern California and the prices you have you have quoted sound very average. $700 for one visit should include a mini physical, blood or urine test as well as a consultation and your induction. When you begin suboxone therapy it can take days or weeks for you to adjust to the dose that works best for you, so budgeting $500 a months is quite reasonable. Your weekly doctor visits will become monthly then every other month etc.

Suboxone isn't generally included with you doctor visits. You might want to call a couple of pharmacies and get prices for suboxone. If you are going to being paying cash it helps knowing prices.

Call your insurance company and find out what you are covered for. Ask what your co-payment is for suboxone. It helps knowing what you are covered for. That way you won't have any surprises.

Many doctors will not bill insurance companies. That means you pay the full amount then you get reimbursed from your insurance company. I paid "cash" then was reimbursed. It was an easy process.

I know the process of finding a suboxone doctor can be very frustrating. It makes it more frustrating because you want help NOW and if feels like everyone is slamming doors in your face. Never give up, don't take no for an answer. The right doctor is there waiting for you.

The sooner you start the sooner you are going to feel so much better. If you see a doctor and for any reason don't want to continue seeing him you can always change doctors. Nothing is written in stone.

Keep posting and stick around. There are a bunch of wonderful people here that will help you and support you.
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Unread 02-12-2008, 11:56 AM   #3
NancyB
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Hi Vico-Dan and welcome.
Cally was very thorough with her response, I'll just add this. Doctors do not have to be on the SAMSHA list of certified physicians. It's estimated that only between 60 and 65% opt to be listed (we get our physician list on this page http://www.naabt.org/local/ from that public listing).

You might want to look up addiction specialists in your area and see if any of them are certified but not listed. Also give local hospitals a call and see if you can get any referrals.

I hope that you find a reasonable physician soon.
Nancy
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Unread 02-13-2008, 12:20 AM   #4
Vico-Dan
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Cally, thanks for your response.

It seems that I either can't afford this type of treatment and that insurance won't cover it.

Subutex/Suboxone is not covered by my insurance company.

I'll keep trying...
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Unread 02-13-2008, 02:03 AM   #5
NancyB
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Vico-Dan, the manufacturer has a program where they allow 2 patients per physician free medication.

Here's a link that gives the details:
http://www.needymeds.com/drug_list.t...&name=Suboxone

Maybe you could try to find a physician who could get you into the free meds program.

Nancy
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Unread 02-13-2008, 05:53 AM   #6
Vico-Dan
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NancyB, thanks but I don't qualify. I make too much money apparently.
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