Seeking advice on problems with Suboxone Dr. ,

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Humilishamed

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(Summary: due to low creatanine levels I was forced to take a supervised urine test, which caused me to have a panic attack. I am worried that due to this problem I will be forced off the program and back onto opiates)
I am posting in anon because this is personal as well as an extremely embarassing situation which has me at the end of my rope.
I am not looking for ways to put one over on my doctor. I am honestly doing my best to make this work but dut to circumstances out of my control I have run up against a wall. I don't know what to do and feel so foollisht that such a seemingly unimportant thing to me in regards to my treatment could be screwing everything up.

I went in yesterday, for my third session w/ sub doc, only to find out that I was now required to do observed urine screenings rather than unobserved. The reason for this given was that my creatanine levels were too low on the previous test compared to the first one and they implied that I was either tampering with the sample, or not taking my medication as prescribed, of which I did neither. I immediately knew this would be a problem and stated so. I have never, for as long as I can remember, been able to piss with strange people watching me. Usually, in normal life, I am able to hold off until I can find some privacy and even explain to my friends that I need to be left alone in order to start pissing.

To make matters worse I am put in a little 1 person bathrooom that is maybe 3'x5' with some strange dude I had never seen there before. Rather than piss, I immediately started to have an anxiety attack, racing heart, shaking legs, sweaty palms, flushed face, and a feeling like I wanted to start crying (this has never happened before, usually if I can't piss it is merely uncomfortable until I can). I told the guy that this wasn't gonna happen, waited a bit, and tried again with the same result. I explained this to the intake lady who said, "ok, we'll see what we can do".

She proceeded to take my vitals, agreed that I was having an anxiety attack by my heart rate/BP and was very sympathetic and understanding. She attempted to explain this to the counsoler I am required to see (not the Dr., they are a husband/wife, Dr./counsoler team I think and as far as I can tell, she seems to call the shots in these matters), and the counsoler, who did not appear to be sympathetic in the least but rather implied that I was doing something against their policy, again explained to me about the creatanine levels and their policy regarding it. I received no real counseling beyond this, she didn't even ask how I was doing or how I felt.
At this point they allowed me to take the test unsupervised but I was in such a state where I still could not piss. I went in and after a minute of trying, pushing on my baldder, running my hand under water, was still unable. I was not only completely unable to focus, I was literally about to start crying, which is completely out of character for me.

I walked out, asked for my money back, and was told this was impossible since I had already seen the counsoler. They told me I could come back friday, so I made an appt for then. At this point I am so embarassed that I really don't even want to go in or have anything to do with these people, the only reason I am considering it is that they have my money, but, even though it is alot for me, I'm not sure I will.

Walking in I was feeling great. I was excited to tell them about the positive things I was starting in my life: how well my job was going, how motivated I am to get back in school, how I have finally after so many years found a direction I want to take my life, and, at their insistence, I was able to quit smoking marijuana.
Had I not had to go through these events, I'm sure I would have had no problem pissing alone but the complete reversal of emotions was too much for me and all I wanted to do was get out of there, and go get high (really the first time since I got on the prog. that I have had such strong cravings.) I saw my hopes fade away and be replaced with fear and confusion regarding my future, not to mention the absolute humiliation I felt having to look like such a loser not just in front of the people working there, but the number of other customers that were coming in and out. It was by far the most demeaning thing I have experienced in recent memory.

Now, the reason I am asking for advice: Assuming that when I go in Friday and I am able to take the test unsupervised without issue, they made it clear to me that my creatanine levels are expected to be normal (I am unsure about the units but they said I went from a 70 on my first visit down to a 10 on my second). They made it seem that the two possible reasons this could happen were me tampering with the sample or not taking my medication as prescribed, if at all. The implied accusations greatly added to my confusion and contributed to my anxiety.

At the time I had no idea what creatanine is, other than it sounded like creatine which I have heard of friends taking before working out. After a bit of reading on Wikipedia, I am now under the impression that the reason for this drop was as follows:
My first visit I had been sick for about 30hrs, which caused me to call out of work. Because of this I was very dehydrated since I really didn't even want to get out of bed to drink water. I wasn't worrying about taking a piss test going in so didn't drink water beforehand. Though I was a little nervous, I was able to piss after a few tries. My urine was dark yellow and therefore, very concentrated.
I had worked the night before my second visit. I work overnight at an extemely strenuos job where, even in the cold, I sweat alot. Because of this I bring a gallon of water and oftentimes come close to finishing the whole thing. I get out at around 6am, and took the test at 10. I make sure that I drink a few glasses of water before I go to my appt since I know that I often have trouble going in strange places. In addition I eat very little meat, especially red meat, which I think I read can play a part. If I had a breakfast before I went in it was my usual 2 pieces of toast with jelly and a cup of coffee.

I'm not sure how much these factors can effect my levels, but I honestly had nothing to hide, and was not attempting to dilute my urine, only drinking water for the reasons already stated. I really don't know what I'm supposed to do. I know there are other places that are nowhere near as strict but I have already gone through so much money at this place that it will be a while before I can afford to pay init fees at another. I had to take advances against my CC in order to get in this one, which I am still attempting to pay down.

After yesterday, I really feel like these people have no concern for me beyond the money I bring them, and am tempted to tell them so despite the fact that I know it will only hurt matters. If anyone can think of any options I have which I may not be realizing, it would really mean the world to me. For the first time in five years I felt like things were starting to go right for me, but now I am worried that I was wrong and will be forced to try and quit on my own, which has never worked for me in the past.

I apoligise for length, I really tried to only include relevant details but this is a really tough situation for me that is causing much distress.
 
Find a doctor who does not do drug testing. This is what I have told everyone I know.

Drug testing is notoriously unreliable. Doctors who insist on doing it are not worth the money they are attempting to extort out of you.
 
I agree with the Cap'n. Suboxone doctors who drug test and pill count are the worst. I'm in the middle of a troublesome situation where I am trying to find a doctor who will prescribe me Suboxone for my opiate addiction and Adderall for my ADHD. It has been problematic.

But it has given me a lot of experience with these assholes, and doctors who drug test are just looking for that extra money they receive every time they test you. Plus, they tend to have a stick up their ass. They are very mechanical and tend to type everything into their laptop so they can actually remember details of all these patients they do not care about.

I am coming to the conclusion that Suboxone doctors are the scum of the Earth. I only had one doctor who connected with me as a human being, but due to his refusal to treat my ADHD (he was a psychoanalyst, instead of being into CBT or all of those other things that work, so he thought my ADD must have its roots in psychological causes. A bit of a nutjob).
 
Like Captian H said, the easy route would be to find a new doctor that doesnt drug test so frequently. How do you go about that though? Referrals from other clients or suggestions from people you know. Its not like you can call and say, how frequent are your drug tests? You can but...

I suppose I was lucky with my doctor, I had 1 drug test in 8 years being on bupe. I did have a situation just like you described except it was with a probation officer who was convinced I was up to something and demanded I keep the door open so she could look in. I would look over my shoulder and see her eyes peeking thru the door. She would sit out there tapping her heels on the linoleum floor, drove me insane. Often it would take 3 piss tries and hours of time to give her that drop. So eventually I had my psych doctor write her a letter saying that I was having panic attacks in combination with the meds I was on [subs, adderall, klonopin, ativan] making it hard to piss and her tapping her heels making it next to impossible to piss. The doc mentioned not wanting to increase my anxiety meds just for a trip to see my probation officer. The note kinda irritated my PO but it worked no more open door but she than started adding on other test that cost more $. Metabolites from oxycodone etc. I dont know what her deal was, it could be that I was a wreck all the time.

Anyways...

Be honest with your sub doctor and explain the circumstances again. Have them search you before entering to prove you dont have adulterants or fake urine, just mentioning that should help strengthen your situation. The doc should know that opiates effect cells in your bladder and makes it hard to urinate multiple that with anxiety, new situations, new meds, somebody standing in a small room watching you and of course you cant piss. Maybe offer blood instead although that is more money. Although if they are testing for creatinine levels they are sending it out and it is not an instant test so blood might be similar price.

Do not be embarrassed this stuff happens ALL THE TIME. Your probably right they might think your trying to scam. I would go in there and apologize, smooth things over, and explain again. Drink lots of water and think urination.

Good luck.

peace.
seedless
 
im sorry u r having so many probs with your doctor i was on subs for a few months and instead of going to just a regular primary care physician i chose to go to a psychiatrist specializing in addiction he was caring and actually listened to me. u should try an addiction specialist and they r way WAY more qualified and actually want to help u instead of a regular old doc that just took an 8 hour class. i am on methadone maitence now but my doc really was awesome best wishes to u :) and congrrats for staying clean for as lonng as u have.
 
Buddy I was on parole and had monthly unsupervised tests. The tests were always unsupervised because my PO was a (great) woman. I'd pissed clean for 3 years straight when on one visit a male PO was there and "volunteered" to supervise my test. I have the exact same shy bladder problem as you. I couldn't produce, and the asshole male PO began threatening me. He was saying I was in violation of parole, etc. and I too had a panic attack. My female PO pulled the asshole out of the room and I produced quality urine. Anyhow, I agree with the other posters - you've got a bad suboxone doc. A husband & wife "team"? Give me a break! Obviously I'm using opiates, with subutex thrown in at $15.00 for an 8mg to get me between prescriptions. I get my percocet legally, 150 10/325s monthly. The dealer's doctor is out of town and she won't reveal who it is. The sub docs in my town only prescribe suboxone. If I could get the subutex myself I would. Good luck.
 
I also have a problem peeing with someone else in the BR... especially if they are waiting/observing. The only way I could do it is to drink about a half gallon of water in advance and hope I could get an observer quickly... which wasn't always possible. The problem you may have [depending on where you live] is your state may require a minimum of 8 random piss tests yearly while on ORT. I found this to be the case in two separate states I got treatment.... both midwest. I hope yours doesn't.
 
Hello. I was the one who posted this anonamously.

This was an extremely troubling situation for me. I honestly thought it would lead me to not only be back on opiates very shortly, but in a worse situation than I was before I started treatment. Thanks to the support I got here I am no longer so embarrassed about the situation, which helped greatly going in today.

I was able to talk to the doctor who, though he fits the profile of the guy with so many patients he can't remember my name or anything about me, spending more time on his laptop than focusing on me, he became much nicer to me when I opened up and explained the situation.

I resisted the urge to go in and tell them how much I resented how the "counseling" felt much more like a police interrogation. I am in the process of seeking out an outside counselor, which will mean I don't have to see the lady, who is not just indifferent but actually seems to dislike me. I will possibly switch to another clinic when I can afford it and get through a wait period.

I really just wanted to thank all who replied I honestly don't think I could've done it without the support I recieved here.

Feel free to close this thread and I will make updates on my progress to my blog here. EDIT-- Here it is:

http://www.bluelight.ru/vb/blog.php?b=3616
 
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I also have a problem peeing with someone else in the BR... especially if they are waiting/observing. The only way I could do it is to drink about a half gallon of water in advance and hope I could get an observer quickly... which wasn't always possible. The problem you may have [depending on where you live] is your state may require a minimum of 8 random piss tests yearly while on ORT. I found this to be the case in two separate states I got treatment.... both midwest. I hope yours doesn't.

Holy fuck that BLOWS. I am in NJ and my doctor requires one test per YEAR, which is a bullshit 5 panel he does with a CVS kit..so easy to pass with synthetic urine.

Seriously, so many, SO MANY doctors prescribe bupe. If you don't like any single aspect about your doc, just go to a new one. I have been to like 4 different doctors till I found the one who just hands our scripts of 8mg 4x a day on a walk-in basis that accepts most insurance. What a godsend he is! Plus he prescribes subutex if you want..so if you have insurance you get the shit fucking DIRT cheap. He made me come every 2 weeks but hell I love getting 56 subutex every 2 weeks for a 30 dollar copay and 15 at the pharmacy. Now I go once a month at most lol.
 
im sorry u r having so many probs with your doctor i was on subs for a few months and instead of going to just a regular primary care physician i chose to go to a psychiatrist specializing in addiction he was caring and actually listened to me. u should try an addiction specialist and they r way WAY more qualified and actually want to help u instead of a regular old doc that just took an 8 hour class. i am on methadone maitence now but my doc really was awesome best wishes to u :) and congrrats for staying clean for as lonng as u have.

Thanks so much for the encouragement and I really think this is the best advice I've gotten since I decided to get on suboxone.

I don't know why I was willing to put up with these obviously unprofessional people. I am giving them a bunch of money, I'm sure I can find someone else who will take my money (hopefully less even if they're really nice) and not treat me like shit.

The place I'm at is like a mill, they obviously have no time or knowledge yet they try to make up for it by being extra stringent on piss testing and acting like assholes when you fuck up (I can tell, I've talked to people who come out of there after fuckin up, they just got chewed the fuck out and ALWAYS reprecussions like coming back more often (more $ for them)).
 
yeah search for a new doc.

i guess i got lucky with mine. i love my suboxone doctor. he does drug test me, but rarely. and i can honestly say ive never pissed clean for a drug test for him, and ive been seeing this doctor for over a year now. hes never kicked me out of the program. he understands im an addict, im gonna mess up. he talks to me and actually listens, so even though i have never pissed clean, he knows i am trying hard. he knows me and my family are strapped for cash so he helps me out with paying for meds as much as he can...he gives me samples when we dont have money to pay for my seroquel. i called him yesterday because he gave me a script for suboxone pills [because i told him i like them better than the film] but then my mom said we cant afford the pills...we have a discount card for the film. so my doctor called the pharmacist and switched the pill script to a film script for me.

doctor search: http://www.suboxone.com/patients/here_to_help/find_a_doctor.aspx
 
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Listen, I know you said you're not trying to get over on your doctor -- but an interesting point to consider is taking 'loading' dosages of creatine monohydrate 72+ hours until the test, up until the point of the test.

Normal creatine ranges are from 20ng/ml to 400ng/ml. The urine must also have a specific gravity of >.003 or less as well in order to be considered dillute. Multivitamins and bcomplex for 72 hours, up until the day of the test, along with 6-8 glasses of water on the day of the test (three-four hours prior, drinking up until the test) will most likely render a negative for any drugs with appropriate creatine levels and specific gravity. If your urine is yellow, even light yellow, you're considered to not be dillute by rule of thumb if all precautions were taken. This seems extremely simple of a solution to a very real and complex problem -- it is that simple and straightforward if precautions are taken.

If you're expected to test positive for opiates/oids and these are not in the urine -- this could also jeopardize your chance of getting on suboxone.

Keep 'shopping' if there's any problems.
 
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