Suboxone Conundrum

[dangermouse7831]

Hi there. I'm recovering from Heroin addiction. It's taken me a few tries to get here. For some background on my attempts, I posted a thread here a while back: http://bluelight.org/vb/threads/833174-Methdone-prescribing-question

Following on from that thread - I gave up on Methadone and had another crack at Suboxone. This time it seems to have stuck and I'm now close to 5 weeks off Heroin and doing really well Yay.

When I started this whole process, my understanding of the Suboxone program was that once you had settled on a dose you picked up your box monthly and stopped having to take it at the Pharmacy. I've now discovered how wrong I was.

Every state does it differently. In mine I get no takeaways for the first 3 months, and then progressively more until I can take home 29/30 each month after a year stable (this is obviously subject to conditions and the Doctor's discretion). Judging from the rules in other states, I am lucky to be where I am. I'm also very lucky the Suboxone ended up working as the rules for Methadone are MUCH worse.

So....all my family & friends live interstate. All my wife's family live overseas. I'm fortunately on a contract where I don't need to travel, however that ends later this year and I may well need to be able to travel at short notice in any new job I get.

See the problem? My prescribing GP basically said he's required to follow the takeaway guidelines and referred me to a drug and alcohol specialist for a second opinion. Regarding the specialist, even when I offered frequent drug testing (something I'm morally opposed to), pill counts, and a contract, he would have no part in helping me access takeaways any earlier. Just to be clear - I have no plans to abuse or sell the Suboxone. I really do have family and employment reasons for wanting them and made this crystal clear.

I could stick it out a year, but it's reasonably likely I will end up unemployed if I have to filter out all jobs with a travel component. Also, both my wife's and my parents are getting old and find it difficult to travel. I can't realistically see them for many more months. To be able to see them at short notice will take me 11 more months.

What would you do if you were me? I have a plan, but I don't want to taint anyone's response by saying what it is.

Thank you for reading & enjoy the long weekend

 

[C_Tripper]

For me, when I travel for work overseas I just let my doctor know over at Biala about a week in advance, they write me a script for however much I need for my trip (I send them my ticket to show them I’m not bullshitting) and they give me a letter to show to Customs officials that I’m properly prescribed it. Easy as, really. But I’ve been on bupe for 5 years now, so they trust me and I’ve been a Good Boy(c)(tm) for basically the entire time, so I get it a bit easier.

But basically, if your prescribing GP is making it difficult, I’d recommend seeing if you can find a doctor who is more understanding about needing to hold down a regular job and a regular life, which includes travel! If you’re in QLD, I highly recommend Biala in Roma St, they’be been fantastic to me.

 

[dangermouse7831]

Thanks for the reply C_Tripper. Once I reach 3 months on Subs, I can prearrange overseas holidays too (I think - I know I can at some point). For overseas travel that is quite achieveable. At that point I'll also be able to prearrange interestate trips (I think they arrange a dosing pharmacy interstate). I've been told I need to give 4 weeks notice, and it takes 3 weeks to get into my doctor, so it's sorta 1-2 months in advance I need to plan and book.

This works for planned international travel, but not short notice travel (which basically all my domestic travel is). Just this week we considered heading down the coast for the long weekend, but then realised we're stuck here. Also, in my experience, interstate work trips are usually only decided a few days in advance. These are the every day sort of issue I will/do come up against.

It's also taking 45 minutes out of my day EVERY DAY to go to the pharmacy. 15 minutes to get there, 15 minutes to queue and then be dosed, and 15 minutes to get home. Considering my smack habit was funded through my full time job, and my supply dropped off monthly. this has added a significant new inconvenience to my life. It's not like it has replaced a day of hustling or anything. No pharmacies open early enough for me to get to work on time either.

I have tried a second doctor (a drug and alcohol specialist). He said the rules regarding granting exceptions to the process are different in different states. He used to work in NSW and said there he could prescribe me weekly takehomes now if I met some conditions (drug tests, signed contract, staying employed etc). Apparently my state is different and there is no process for exceptions. They can be granted, but the doctor is the one who takes the risk on his/her shoulders and neither of them seemed too keen.

If it helps, I'm in the ACT. Maybe theres another MAT treatment patient from the ACT who knows the deal here.

I really appreciate your response C_Tripper. Thanks very much :D

 

[Pietra]

Hi Dangermouse! Like C-Tripper I live in Brisbane and never in a million years could I have guessed how much better Qld is when it comes to how the Health Dpt treats people on opiate replacement programs.

I've been on methadone for over 20 years and right fom the beginning i started on 5 take aways per week and for the last 10 years I've been getting 6 takeaways per week. I just pick up at the local chemist every Saturday and the scrips are provided by my GP.

Also when I've traveled it's never been an issue getting as many ta's as I need. All I have to do in order to get a script for methadone tablets if I'm trvelling for a few weeks, is give my doc 2 months notice so he can write to Qld Health to get permission to write me a script for the tablets.

I still have bad memories of how horrible being on a program in Sydney was. Having to go to this horrible clinic to pick up that had a lot of the worst sort of people. It was a lot more expensive in Sydney too.

Oh also I have never had to undergo any sort of drug test while on the program in Qld.

Anyway, good luck Dangermouse! I would also try finding another doctor because that's just ridiculously unfair the way you are being treated. All the best to you and please keep us posted.

 

[chugs]

I could stick it out a year, but it's reasonably likely I will end up unemployed if I have to filter out all jobs with a travel component. Also, both my wife's and my parents are getting old and find it difficult to travel. I can't realistically see them for many more months. To be able to see them at short notice will take me 11 more months. What would you do if you were me? I have a plan, but I don't want to taint anyone's response by saying what it is.

Thank you for reading & enjoy the long weekend

I had exactly the same problem as you dangermouse. I'm in full time employment at a major corporation. I have meetings, and for many years traveled every 2-3 weeks. I was even promised after two weeks I would be transferred to a chemist and given takeway dosing. Alas doctors and nurses lied, they royally fucked me over and utterly denied it.

I had meet and exceeded every single milestone in the OTP (Opiate Treatment Program). I loved my discussions with my case manager. "sooo um, employment, ok you've got a job......housing. Right stable housing and you own it. Relationships. All good. Criminal matters...right nothing there ok we're done".

Anyway long story short I moved myself to a clinic. Clinics have a lot flexibility. You can double and if you can hack it, triple dose. That means you only have to go to the clinic three days a week, or less. Why because at a clinic that watch you dose and watch you randomly piss in a cup. I always found it hiliarious sitting in the clinic, suited up with my suitcase, chatting with the ahem less fortunate brothers & sisters about what was happening with their court dates, what was happening on TV and who was next (holy shit never ever try to break the queue. that shit would get you bashed).

So yeah go the dingy awful public clinic coz you'll get far better flexiblity. Secondly if you show you're stable, piss clean urine and don't act like an asshole (no ego, no yelling, whinging or crying), keep your job and toe the line then the doctors who manage the patient load at the clinics will transfer you quickly out (because at the end of the day the public demand for the OTP is insane - seriously for every place in the OTP there is at least 50 people gunning for it).

And stay on the suboxone. You can easily get two weeks takeways or more and only have to see your doctor once a month.

Meanwhile on methadone in NSW you're fucked - you can only get 3 by 2 takeways (3 days worth and then 2 days).

though personally a find methadone far better

 

[C_Tripper]

Like C-Tripper I live in Brisbane and never in a million years could I have guessed how much better Qld is when it comes to how the Health Dpt treats people on opiate replacement programs.

Right? It's crazy, considering as a state we're usually behind everyone else when it comes to social issues; but for some reason, our Opiate Replacement Program is god-damned excellent. Hell, I just had a new pharmacy up the road _ask_ me to change to them, so they'll compete on price with my previous pharmacy! (And the pharmacist was super lovely about it). They're even going to stock Subutex pills just for me