Misc Physicians that specialize in detoxing patients?

[Shant]

Again sorry if this is the wrong forum, couldn’t find a better one for this. I’ve accepted that there’s no way I’m gonna be able to pull this off alone. When I asked my GP if he could refer me to an “addiction specialist”, he was unaware of any such specialization so I called medi-Cal to ask them and they couldn’t reallly give me an answer either.

I’ve heard that pain management doctors do that so I had my GP refer me to one and sure enough they don’t offer that service. Surely there must be a specialization for this?! With all the people hooked on opiates? Can anyone tell me anything? Thanks,

Shant

 

[Shant]

If there’s a better place for this thread please do let me know or just move it if possible, thanks. Sorry for the noobiness

 

[negrogesic]

If opioids are the issue search for a buprenorphine provider.

Buprenorphine Treatment Practitioner Locator

www.samhsa.gov

 

[Shant]

youre saying any doctor who provides suboxone should be trained to help me detox off the subs?

 

[Branggen]

youre saying any doctor who provides suboxone should be trained to help me detox off the subs?

Usually they are clinics that specialize in keeping people stable on opiates like suboxone and methadone, and should also have some experience with tapering or detoxing these patients. These are addiction clinics though and youll have to go to the pharmacy often to start with. Id ask your original prescriber for a taper plan which he may know how to do, or you can research yourself and see if he will prescribe it. Other than that its pretty much just detox centers.

I think it goes something like this, your origonal doc would try to taper you, if that fails you are labaled addicted if you dont have chronic pain, then you have to go to the sub docs where its less about getting off and more about being 'stable'

 

[negrogesic]

youre saying any doctor who provides suboxone should be trained to help me detox off the subs?

Wait, you're already on suboxone?

That link simply lists DATA 2000 waivered physicians who are technically able to prescribe suboxone. DATA 2000 is simply an online course (I took it -- it's a joke) that very topically introduces physicians to addiction medicine (in particular opioid addiction). Those on that list may or may not be accepting patients, and few will take medi-cal insurance. I believe it is technically covered by medi-cal but you'll have to do some digging to find a provider.

But again, are you already on suboxone?

 

[Shant]

I already have a private doc who prescribed me subs. I’ve git hundreds saved up. He prescribes me clonidine, Gabapentin, and Ambien as well. But I never thought to ask him if he can help me get off. He’s kinda shady. Like, for instance, he’ll let my mom pick up my script when she goes in for her checkup so it’s been months since I’ve seen him.

Right now I’m on the blue pills (fentanyl), gonna switch back to heroin tomorrow (far less addictive than the fentanyl pills if you can believe it). Plan to stay on heroin for a week to make damn sure the fentanyl’s gone, then try to induct again. But attempting induction scares the hell out of me after this last attempt. It seems like the depression gets worse with every failed attempt...

 

[JoEhJoEh]

There are a lot of physicians, mostly GPs that are helping you to get rid of your problem. Just ask your physician!

JJ

 

[Shant]

Sadly my GP always tells me “Shant you know WAY more about opiates than I do. I can’t even prescribe narcotics, I’d have to refer you to a pain specialist. He did that twice, to separate docs. Both of them said they don’t help people detox unless they’re existing patients.

It’s stunning to me.. maybe it’s time for the medical community to create a new specialty field. It would be both very lucrative and save a lot of lives.

 

[Shant]

Oh and btw, I saw my suboxone doctor yesterday. Told him what was going on with the fentanyl and 2 failed induction attempts. I practically begged him to do whatever he could to get me one more successful Induction. His response? “OK Shant, here’s your suboxone script and Ambien with one refill”. Literally in one ear out the other. Blows my mind...

 

[JessFR]

Frankly I think you're lucky to have a doctor who at least admits he has no idea. Id give anything to have doctors just be straight about it and not bullshit me.

If you're unable to induct on subuxone, I suppose methadones another option, but it has its own share of drawbacks.

 

[Shant]

I think it goes something like this, your origonal doc would try to taper you, if that fails you are labaled addicted if you dont have chronic pain, then you have to go to the sub docs where its less about getting off and more about being 'stable'

I sincerely mean this with no disrespect, but fuck being stable. Overrated. Been stable for 20 years. It's time to get clean. My parents are in their 70s, my dad has 7 stints in his heart after a massive heart attack. I need to get clean while they're still around or I'll never live it down and probably just go back to being a junkie. I've got to beat this and soon. There must be a way.

 

[Shant]

Frankly I think you're lucky to have a doctor who at least admits he has no idea. Id give anything to have doctors just be straight about it and not bullshit me.

If you're unable to induct on subuxone, I suppose methadones another option, but it has its own share of drawbacks.

Yeah no methadone for me. I think it's safe to say I'm anti methadone as it was a 15 year battle to get off that shit. Hardest opiate to beat imo, hands down. Destroyed my testosterone levels, fucked up my teeth. But I'm stable on the suboxone now at 8mg. I'd like to start tapering immediately. And with suboxone you can go from 8mg to 4mg inside a week and not even feel it. But I'm not gonna make the mistake of tapering again unless I have a plan...preferably supervised by a doc. But I just can't seem to find one that does that. Blows my mind.

 

[JoEhJoEh]

Yeah no methadone for me. I think it's safe to say I'm anti methadone as it was a 15 year battle to get off that shit. Hardest opiate to beat imo, hands down. Destroyed my testosterone levels, fucked up my teeth. But I'm stable on the suboxone now at 8mg. I'd like to start tapering immediately. And with suboxone you can go from 8mg to 4mg inside a week and not even feel it. But I'm not gonna make the mistake of tapering again unless I have a plan...preferably supervised by a doc. But I just can't seem to find one that does that. Blows my mind.

Really??? Where are you from? Here this is no problem, they mostly get substitol, often much too much - then they sell it and buy coke..... hm - bad.

 

[JoEhJoEh]

ANd of course there are Physicians, a lot even: mostly General Practicians they take over also the substitution of the patients. But there are also a lot of experts meanwhile. Google it!!!

JJ

 

[Shant]

Really??? Where are you from? Here this is no problem, they mostly get substitol, often much too much - then they sell it and buy coke..... hm - bad.

I'm in West Hills/Canoga park area. San Fernando Valley. Why? You out here too? There's nothing we can't get out here. I've got an "escort" friend who can literally get anything. Even the oddball stuff like DMT, pure MDMA (she says they're called 'moon rocks'...whatever it's called, it's awesome), ketamine, fentanyl in pure powder form and those nasty blue fentanyl pills, etc...and that doesn't help matters. But that's why I prefer suboxone over methadone. Can't use on it as long as you make sure to take your dose on time.

People keep saying there are plenty of doctors who do that. Amazingly these doctors are totally unknown to my existing doctors (and I love my current GP so I'd never trade him out) or even blue shield. I guess I'll try googling docs in my area and hope they accept medi-cal. Only thing left to try. Thanks for the tip, appreciate it.

 

[JessFR]

Yeah no methadone for me. I think it's safe to say I'm anti methadone as it was a 15 year battle to get off that shit. Hardest opiate to beat imo, hands down. Destroyed my testosterone levels, fucked up my teeth. But I'm stable on the suboxone now at 8mg. I'd like to start tapering immediately. And with suboxone you can go from 8mg to 4mg inside a week and not even feel it. But I'm not gonna make the mistake of tapering again unless I have a plan...preferably supervised by a doc. But I just can't seem to find one that does that. Blows my mind.

As I said. It has its drawbacks.

 

[JoEhJoEh]

Then perhaps try it in a bigger city which has bigger hospitals and ambulances for problems like that - they normally know how you feel.

all the best.. oh before i forget - here there are specialised centres where you can go for changing needles, psychotherapy, detoxing, long term therapy, everything. I let a link here but I dont know if it is possible to read it in English, too? here:

Suchthilfe Wien

suchthilfe.wien

and

https://www.gruenerkreis.at/

Perhaps something like that, there are friendly people. Try it out! (of course not in vienna, just as an example.

JJ

 

[Playernm3]

I already have a private doc who prescribed me subs. I’ve git hundreds saved up. He prescribes me clonidine, Gabapentin, and Ambien as well. But I never thought to ask him if he can help me get off. He’s kinda shady. Like, for instance, he’ll let my mom pick up my script when she goes in for her checkup so it’s been months since I’ve seen him.

Right now I’m on the blue pills (fentanyl), gonna switch back to heroin tomorrow (far less addictive than the fentanyl pills if you can believe it). Plan to stay on heroin for a week to make damn sure the fentanyl’s gone, then try to induct again. But attempting induction scares the hell out of me after this last attempt. It seems like the depression gets worse with every failed attempt...

I was on fentanyl powder for 1.5years before I did anything about it. I have a sub doctor but they’re pretty clueless with the science of induction. Typical response is “wait 18 hrs until you feel like sh*t and take your sub.” They think it’s that simple. One time I waited 36 hours and tried 2mgs and went into PWD in 5 mins. I’ve been playing around with how to induct sub quicker without the PWD and this is what works for me. You’ll need (1) suboxone and (2) a strong full agonist opioid (opana, fent pills, fent powder).

As a caution - this is what works for ME and could be different depending on your individual chemistry.

So I like to go on small binges still (5-7 days) so as not to get too physically dependent. The last two days I’ll take a small amount of suboxone (.5mgs). Take the sub (and remember you have your receptors full with your choice of opioid). I wait 30-45 mins until you feel PWD come on. When that happens, I’ll take a bump of the full agonist and PWD goes away. An hour or so later I’ll do the same but with a higher dose of sub (1mg). Again, wait until you start feeling the subs fight for the receptors and take your full agonist again. You can do this a couple more times and then repeat the next day. You’ll notice the effects of the full agonist get weaker and weaker the more sub you have in your system (unless you’re doing massive doses of full agonists). I think what’s going on is the subs will rip out the fent from the receptors which causes PWD. But then when you take the fent it bumps out some or most of the subs. Since subs half life is so long you’ll gradually build up a decent dose of sub floating around your system. So when you’re ready to transition it’ll be much smoother since the sub is replacing the fent once it metabolizes and leaves the receptors. This way, after your last full agonist dose, you’ll have subs already in your system and won’t experience much, if any, WD and don’t have to wait 24-48hrs to induce suboxone. I’m still playing around with the protocol but it seems to be doing the trick. Just always make sure to have a stroll full agonist opioid on hand while you’re adjusting protocol to save you from the PWDs. Again, this works for me, it might not work for everyone so feel free to try this, BUT DO IT AT YOUR OWN RISK. Hope this helps.

 

[Keif' Richards]

Physicians are highly trained medical professionals and often specialize in helping individuals detox from substance abuse. They understand the unique challenges that come with detoxing, and are well-equipped to provide support and medical care to those struggling with addiction.

Good to know.

Doctors don't like to take on unnecessary liability and drug detoxification is considered a high-risk, high-liability endeavor. For this reason, detoxification is almost solely carried out as an in-patient service. To detoxify a patient at-home would be considered very "old-school", but that doesn't mean you can't find a doctor who will try it.

I've known people with long-established relationships with their medical providers say "hey, I think I have an Alcohol problem and want to stop" and they're given a prescription for 30 days of a Benzodiazepine, but this is extremely rare in the current climate and post-Opioid Epidemic, it's probably considered dangerous and unethical to do such a thing outside of a hospital, which to be fair, it is. If an Alcoholic decides to take his pills and keep drinking, he could die and this is not a crazy notion.

You would be very unlikely to find anyone to help you do this at home. The emergency department can help route you to a specific program or maybe even do it themselves, so I would start there. These days, hospitals often will dispense Buprenorphine starter packs to bridge patients to their first script-doctor appointment. There are options, but none of them will have anything done "at-home" aside from that Buprenorphine script.