Bupe Told My Bupe Doc That the Bupe Dosages Commonly Scripted are Unnecessarily High

[KnowBudz]

Sorry you have such a negative view of our medical system. I hope you aren't jumping on the government takeover bandwagon! Lots of folks buy into the myth that doctors are rich hucksters that simply rake in cash, but that isn't realistic.

I certainly agree that suboxone is too expensive, like many new drugs. Methadone is cheap and effective, but in order to receive MMT in the States, we must submit to the clinic system and its insanities. I wish there were better alternatives, but increasing government involvement is NOT the answer.

 

[Pegasus]

Anyway,, so yeah I'm fully adjusted to 20mg methadone, so you u think that equates to 8mg Sub a day?

For what it's worth, when I switched from methadone to bupe, I was at just under 30mg methadone and switched to 1mg insuffulated/ 2mg sublingual bupe with no difficulty and only the slightest discomfort, presumably from the slightly different action of the drugs. That dose of bupe was more than enough, though... I was actually fairly intoxicated from it.

 

[KnowBudz]

I don't believe in correlations between amounts abused and effective doses of ORT meds. It is really common to hear waiting-room chatter about dose, "gee, if you take that much, you must have been *really* bad!" I've seen big strapping guys who IV'd heroin for years be stable on 50mg/day, while some skinny women that popped pain pills a couple years require 200mg/day.....it takes what it takes.

I also don't believe there are "equivalent doses" of bupe and methadone. Years ago, at one of my annual "physicals" at the clinic, I asked the doc (who was bupe-certified) about switching. He told me that, because of my methadone dose (270mg/day), bupe was "not for me". I believed him and never pursued it. Then, after being booted from the clinic sans detox, I turned to a bupe doc in desperation. She simply scripted me 16mg/day, and told me the other doc's statement was false. She said she had patients who were on bigger methadone doses than me who did just fine on suboxone. Despite doing everything wrong (especially not tapering off methadone and continuing to take both meds together), I got through a few rough days, and did fine.

 

[Blackvinegar2]

Sorry you have such a negative view of our medical system. I hope you aren't jumping on the government takeover bandwagon! Lots of folks buy into the myth that doctors are rich hucksters that simply rake in cash, but that isn't realistic.

I certainly agree that suboxone is too expensive, like many new drugs. Methadone is cheap and effective, but in order to receive MMT in the States, we must submit to the clinic system and its insanities. I wish there were better alternatives, but increasing government involvement is NOT the answer.

yeah I guess im just still extremely pissed at that dumbass doctor who basically in my eyes caused me to relapse. And believe me, im not one of those corny anarchist kind of people that hates the government and all that.. Im just pissed at my old sub doctor. And honestly im fine with the insanities with the clinic and everything. Methadone is so much better than suboxone, But of course methadone has that horrible stigma from all the ignorant annoying 12 step fags who bash it. suboxone is just as bad as methadone, only wayy more expensive and way less effective. Also, my bad man if I came off as attacking you in any way, Its just me being cranky from the methadone, keep in mind I just started 4 days ago. Methadone has always made me extra cranky than other opiates

 

[Pegasus]

^Well, that's fine to feel that way, but it is an opinion. Most people here will disagree with methadone being superior, but this is an opinion as well. Different strokes and all that...

 

[KnowBudz]

Glad to hear you are on MMT! For many folks, the structure of the clinic system is just what the doctor ordered. My feeling is that both drugs have their unique pluses and minuses, and should be available for use by any practictioner....without all the special rules. I can also understand being angry at a doctor, but blaming them for a relapse?

I can safely state that I blamed everyone and everything for my drug abuse and continued relapses....except the real culprit: me! Sure, shit happens, but at least in my case, no one ever held me down and forced drugs into me. My relapses were caused by shifts in thinking that started a process that ended with my choosing to take something.

 

[daddysgone]

yeah whatever dude. You must know everything right? Since you have met my old suboxone doctor and know how he works right? He was completely in it for the money dude. You think these doctors just have hearts and wan't to desperately help some drug junkie? NO WRONG!!! they are in it for the cash bro. Thats is all they care about! suboxone sucks, It is on of the biggest drug treatment scams there is here in america. Sure methadone clinics are just as worse for money, But at least they know what they are talking about, and you get an effective opiate maintenance drug for a reasonable price!

You clearly have deep-rooted opinions about bupe and bupe doctors, and I doubt anything I say will change your mind, but I do have to ask you something regarding a comment you made which seems to make no sense.

You state that bupe doctors prescribe such high doses in order to make more money. Now, this statement would be logical if the doctor was the one selling you the bupe....but don't you get your bupe from a pharmacy, and not your doctor???

If a doctor prescribes you more bupe then you actually need, how exactly does he benefit financially from this? When you see a bupe doc, you pay a flat fee. So whether he prescribes 2mg per day or 36mg per day, he makes the same amount of money. Obviously if he writes a script for a high dose, both the pharmacy you buy the bupe from, as well as the manufacturers of bupe stand to make more money, but the doctor himself doesn't see any of that money, and therefore has no financial incentive.

I do agree that docs prescribe far higher doses of bupe then is necessary in most cases (clearly I believe this since Im the one who started this thread). However, my strong feeling is that this practice of over-prescribing is the direct result of the mis-information that bupe manufacturers pitch to the medical community. Clearly the manufacturers stand to increase their profits if they are able to convince doctors that 16mg per day is an "average dose" for maintenance, when the truth is that 90% or more of patients could get by just as well, if not better, on 2-4mg per day.

So, while I do agree with you that if you want to get to the bottom of this widespread practice of over-scripting, you need to "follow the money", it seems clear to me that the trail of money leads to the drug manufacturers, not the doctors.-DG

 

[Captain.Heroin]

People that are on suboxone maintenance have been arguing with me on youtube comments lately, And you know what? Suboxone sucks. Yeah thats right, IT SUCKS. They tell me "have fun being a slave to methadone blah blah" and stuff like that. Well IMO suboxone sucks, And doesn't even really hold you over. Suboxone is good for someone with a vicodin habit, or a percocet habit. But when you are coming off a heroin habit, methadone is the way to go. Its WAYYY cheaper, The people at the clinic actually know what they are talking about, and know alot about the drug methadone, And methadone very very effectively holds me over. It doesn't really get me high, But it def gives me a buzz that I need to kill any cravings I have. Suboxone didn't give me this buzz and made me feel like why the hell am I on this suboxone if all its doing is just making me feel not sick in the morning and not doing anything for cravings? suboxone is a huge waste of time and money, I will gladly be a "methadonian junkie" than to waste money on a garbage maintenance drug! If you are on suboxone and it works for you, Then please don't take this message as negative.

Methadone would cost me a lot more money. I think most people would only find methadone cheaper if they had no health insurance.

If you are looking to get high, you're looking for a full agonist. Your mistake was trying Suboxone when you weren't ready to quit taking opiates. Your other mistake was lying to people who were only trying to help you.

Of course you don't like Suboxone. You can't really get high with it with a large opiate tolerance.

yeah whatever dude. You must know everything right? Since you have met my old suboxone doctor and know how he works right? He was completely in it for the money dude. You think these doctors just have hearts and wan't to desperately help some drug junkie? NO WRONG!!! they are in it for the cash bro. Thats is all they care about! suboxone sucks, It is on of the biggest drug treatment scams there is here in america. Sure methadone clinics are just as worse for money, But at least they know what they are talking about, and you get an effective opiate maintenance drug for a reasonable price!

So when you went to your Suboxone doctor, and lied about what opiates you were taking, did you decide to give him more money for getting prescribed 8mg per day?

Typically it doesn't work like that and you pay your doctor a flat rate, no matter what dose you're on.

How does a doctor prescribing you 8mg = you paying him more money?

Sorry you have such a negative view of our medical system. I hope you aren't jumping on the government takeover bandwagon! Lots of folks buy into the myth that doctors are rich hucksters that simply rake in cash, but that isn't realistic.

I certainly agree that suboxone is too expensive, like many new drugs. Methadone is cheap and effective, but in order to receive MMT in the States, we must submit to the clinic system and its insanities. I wish there were better alternatives, but increasing government involvement is NOT the answer.

Thank you.

yeah I guess im just still extremely pissed at that dumbass doctor who basically in my eyes caused me to relapse.

You caused yourself to relapse. Believe it or not, but you were using opiates before you got into Suboxone maintenance. How did you fare before Suboxone? No relapses? 8)

suboxone is just as bad as methadone, only wayy more expensive and way less effective. Also, my bad man if I came off as attacking you in any way, Its just me being cranky from the methadone, keep in mind I just started 4 days ago. Methadone has always made me extra cranky than other opiates

Suboxone is not a full agonist and has no NMDA receptor antagonist action, unlike methadone.

You don't really know much about methadone or Suboxone. If methadone is making you cranky how is that being effective? You're just not making much sense.

You state that bupe doctors prescribe such high doses in order to make more money. Now, this statement would be logical if the doctor was the one selling you the bupe....but don't you get your bupe from a pharmacy, and not your doctor???

Thank you x2.

 

[Pegasus]

I also don't believe there are "equivalent doses" of bupe and methadone.

It's definitely not an exact science comparing the two drugs, but there is certainly a degree of correlation between required doses...

 

[Cloud_9]

Just remember, everyone has different tolerances and ways that they will metabolize buprenorphine. When I went that route I was prescribed the max of 32mg/day and would take 24mg in the morning and 12mg in the afternoon and by the time I would wake up the next morning I could have a severe withdrawal if I forgot to take it every 12h or so and that is one of the reasons, along with the high price without insurance covering that I kept on methadone maintenance.

Then again, I have a broken liver it seems like.

 

[Johnny blue]

I haven't read the whole thread but, I agree on the high dosing. I haven't met a suboxone patient that didn't sell half of their script. That would be the one downfall aside from the cost because 9/10 they sell their bupe and use that money to buy a full agonist.

 

[Eight0Eight]

How are presciption charges handled in the US?

In the UK, you have to just pay for the script - around 6 quid unless your excempt. It doesn't matter wether the script is for 2mg or 2000mg of subutex.

I take it it doesn't work like this over there?

How would a doctor benefit from over-presvribing though? Surely the only person to benefit would be the pharmacutical companies?.

When I got put on Subutex, they weren't heavy handed at all. I got 1 x 8mg tablet, and 4 x 2mg tablets. I was told to wait until I was super sick then take 8mg. Wait a couple hours then take 2mg, then repeat until you are settled.

 

[Cloud_9]

How are presciption charges handled in the US?

In the UK, you have to just pay for the script - around 6 quid unless your excempt. It doesn't matter wether the script is for 2mg or 2000mg of subutex.

I take it it doesn't work like this over there?

How would a doctor benefit from over-presvribing though? Surely the only person to benefit would be the pharmacutical companies?.

When I got put on Subutex, they weren't heavy handed at all. I got 1 x 8mg tablet, and 4 x 2mg tablets. I was told to wait until I was super sick then take 8mg. Wait a couple hours then take 2mg, then repeat until you are settled.

In America you pay the entire cost of your prescription unless you have insurance or are on medicare/medical/medicaid and most of us here have bare bones insurance plans that won't cover medication to treat addictions even though they damn well are a disease. The first time I picked up a month's worth of suboxone I had to get the script in 1/3rd's because I didn't have the $380 it would cost otherwise.

 

[Tommyboy]

^^^^^@eight0eight
In the US if you have insurance, the price is a flat rate for whatever quantity the prescription is for. Its usually like $20 more to get the name brand.
I don't know how it works without insurance though.

 

[Eight0Eight]

OK.

That sucks.

But why would a doctor want to over-prescribe? Do they somehow get a cut or bonus from certain companies if he pushes their products heavily?

 

[smokeymcpot42088]

This thread is great.

One group of people says too much bupe is prescribed because we're all a bunch of fiend junkies who push for as much as possible...Theres people kissing the medical systems ass, saying every patient sells half their script....btw thats not true for me I can assure you,

than othesr thinks its because doctors are greedy and want to push as much as possible....are out to trick the patients and keep them chained to their office forever, charging redicolous amounts per monthly visit....eventually to cold turkey your ass onto the street as soon as they have a better paying replacement patient.

Both are True to an extent....it's the kind of relationship which breeds excessive dosages and curruption. Just an opinion

Its always fun to see where ya'lls loyalty lay on the subject too.... If you were wondering I think the medical system is horribly corrupt and doctors fuck people over constantly by misdiagnosing, ignoring symptoms, and to a lesser extent undermedicating and overcharging the meds (USA based post).

The streets have literally had more compassion for me than any doctor, I live in surburbia, blue cross blue shield, I cant even imagine how bad it gets for lot of people....but seriously, doctors are not the end all be all that people expect.

 

[asouthern]

i have never seen a doctor for bupe but was just curious if you have to go every single month in order for the doc to continue writing scripts. so if you are given a large amount bupe daily is it possible to just take maybe half of your prescribed dose, make it last two months, then see the doc again on the third month. again, just curious how these clinics tend to operate.

 

[SimplyOwnage]

Question, what's a Bupe?

 

[daddysgone]

^^^^^@eight0eight
In the US if you have insurance, the price is a flat rate for whatever quantity the prescription is for. Its usually like $20 more to get the name brand.
I don't know how it works without insurance though.

Incorrect. Perhaps that is how your particular insurance plan works, but there are an infinite number of insurance plans in the US, and each one has different policies regarding prescription coverage.
For instance, my insurance is not a flat rate, my plan covers half the cost of any prescription, regardless of cost. So if the cost of a med is $160 without insurance, I pay 80 and my insurance covers the other 80.
What made you think that all insurance policies work the same way your particular policy does?

Regardless, the fact is, if you live in the US chances are your insurance sucks and is embarrassing when compared to the health care benefits enjoyed by the rest of the modern world. -DG

 

[sixpartseven]

Regardless, the fact is, if you live in the US chances are your insurance sucks and is embarrassing when compared to the health care benefits enjoyed by the rest of the modern world. -DG

More like: If you live in the US, chances are you don't even have insurance.