Addicts' cure has fatal flaw

Z Y G G Y

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www.methadonesupport.org/Addicts.doc

(unfortunately, I could not locate the date this article was created)


Addicts' cure has fatal flaw

By Maureen Boyle, Enterprise staff writer
BROCKTON — Heroin addicts are lining up to pay hundreds of dollars a week to Massachusetts doctors who refuse to accept medical insurance for Suboxone, the FDA-approved drug that allows physicians to treat opioid abuse in the privacy of their offices.

Some doctors are charging desperate addicts up to $3,000 for initial visits — and hundreds more for office visits lasting just a few minutes — before handing over a prescription for Suboxone, parents and experts in the field said.

“There are doctors meeting people in parking lots, telling them, 'Go to the back door of my house,' ” said Colleen LaBelle, program manager at Boston Medical Center's opioid treatment program. “It is just abominable.” It is happening across the country.

The National Alliance of Advocates for Buprenorphine Treatment found 72 percent of patients were paying cash for treatment, with some doctors complaining it was too hard to get reimbursed by insurance companies. Buprenorphine is the active ingredient in Suboxone. “The doctors say it is not worth the fight,” said Timothy Lepak, president of the alliance.

Suboxone, approved by the FDA in 2002, is the first approved medication for opioid treatment in a doctor's office, and has been heralded by some as a wonder drug for people addicted to prescription painkillers and heroin. Those treated with Suboxone take one to two tablets of the medication daily to suppress withdrawal symptoms and reduce cravings. The pills are placed under the tongue and dissolved.
Doctors can treat up to 100 Suboxone patients if they undergo an eight-hour course offered by medical societies, get a waiver from the Drug Enforcement Administration, and notify the government of their plans. That number was increased from 30 per medical practice — not physician — last December after complaints that there weren't enough slots to treat the growing need. About 150,000 people were treated with Suboxone in the country as of August 2005, according to the makers of Suboxone, and the numbers are growing.

“Parents will pay anything to get their children help,” said Joanne Peterson, founder of Learn to Cope, a support group for parents of opiate-addicted children. But with the growth — and hope the drug offers — comes the potential for greed, several said.
“There are a lot of shabby practices,” Punyamurtula Kishore, a doctor who specializes in drug treatment, said of some doctors. “They take calls and they take the ones with the cash.” He said some of the doctors are making up to a half-million dollars a year seeing patients who want Suboxone. “When you are desperate, you do anything and people are desperate for help,” said Kishore.

One Braintree mother said her 20-year-old son paid $300 for his first visit, $150 for the second and $75 each week to one doctor to get a Suboxone prescription, even though he had Blue Cross/Blue Shield medical insurance. And when the family questioned the doctor about the treatment, she said he got mad. “He said, 'If you don't want the service and you don't want the drug, you can go elsewhere,' ” she said. He wound up relapsing and his drug use escalated, she said. His parents recently found him in the bathroom, overdosing on heroin. “We spent $1,200 to do CPR on our son,” his mother said. “It was a very traumatic event.”

Lepak, who heads the The National Alliance of Advocates for Buprenorphine Treatment, said the cash-only policy by some doctors casts a good drug in a bad light. “It takes away the credibility of the treatment. It makes it seem like it is something shady,” Lepak said.

The doctors that do take insurance — and insist on counseling — often have long wait lists, parents say. There are also 15 clinics in the state, including one at Boston Medical Center, that provide Suboxone treatment. Another health center, The New Bedford Community Health Center, is expected to receive a grant to also provide Suboxone treatment. It was the only health center in this area to apply for the money.

Chantel Nouvellon, a Waltham psychiatrist who accepts three different forms of insurance for Suboxone treatment, said getting reimbursed can take a long time, depending on the insurance, and some doctors may not want to deal with the paperwork to get paid. “For some insurances, sometimes you don't get paid for a year,” Nouvellon, of Arlington, said. Christine D'Eramo, formerly of Abington, tried Suboxone and was able to stay clean for nearly a year before relapsing. “I don't think it is a miracle pill,” D'Eramo, who is now drug-free again, said. “If you already want to get clean, it can help you. If you don't want to get clean, you are going to use.”

LaBelle said at Boston Medical Center, where she works, older addicts who have been battling substance abuse for years appear to have the most success with Suboxone. “It is a great option. It doesn't work for everybody. It is a lot more effective for those who are really done. It is not a medication for someone who just wants to still get high.” She said some of the younger addicts may not be ready to get treatment yet. “It is their parents that are the ones that are dragging them in by the hair,” LaBelle said.

Maureen Boyle can be reached at [email protected].

Addicts' cure has fatal flaw

www.methadonesupport.org/Addicts.doc

A note from me: I believe this is a problem for a lot of suboxone patients. I've been having issues with this problem myself. Just recently I acquired insurance and my doctor initially accepted it and brought up no problems that could come up. Even with insurance, he wants me to pay 50% of the visit cost. I just found out through e-mail that his services were reimbursed but he still wants the 50% just in case there are future problems. I pay $100 and the insurance paid him $300 on top of the $50 I paid him.8o:X I am currently looking for a new doctor. I've developed a bond with this doctor and got used to him but enough is enough.

If anyone has any similar stories to share, please do so.
 
My former Bupe doctor was offering to script any CII-CV drug for a few hundred dollars to addicts who came in to see him for Suboxone/Subutex scripts. He was recently arrested after a 'patient' of his, who was buying truck loads of OC scripts, was caught in a hotel room with 30+ Rx bottles of OC with different names on them (all from the same dr).

Same story with him though. Several hundred dollars to get in the door, handed a script for 3 months, several hundred dollars for a visit for a refill, and so on.

Bupe Mills have been around since '02. It's an invitation to extort money from addicts. No different than Great Britain going to war with China (twice) to force continued shipments of Opium to forcibly addicted populations.
 
Are there any patients with insurance that get both their medication and doctor visits covered with just the co-pay?

The more I look into this buprenorphine business, the more I come to the decision that we need some big changes.

I have exchanged information with doctors who don't accept insurance for visits in order to understand what makes bupe treatment so different from regular medical treatment. Coming to see a doctor for 5 minutes and paying hundred of dollars for those 5-15 minutes and a script just blows my mind. I mean who wouldn't hundreds of dollars for minutes of work? I don't think it's fair that these doctors are allowed to do this. It's like stealing in broad daylight.





____________________________________________________________________________________________________________________________________________
I received this e-mail during my search of a new bupe doctor through NAABT.ORG.

(My comments are in dark red and italicized)


MY NAME HERE,

Thank you so much for your considered reply. I did expect after reading your profile that you would not be able to do this.

Several points: the main obstacle is the price of the drug which is usually covered by insurance8)(why does it matter whether you can accept insurance or not). Still some people and several of my patients have no insurance and so have to pay the full cost out of pocket so the full bill for the month for everything is about 600 dollars in this practice, again without insurance paying for the medication.

I do it the way I do it as it has been very difficult for me at times to collect from insurance and often people will drop out within a few weeks so you then have no way to get a hold of people and collect anything. In other words you are stiffed.
How does that differ from any other chronic illness, are sub patients that much less reliable that other chronic illness patients?

All that said, I have found it very much part of the therapeutic modality for people to come in and put down cash. It is an investment and logically one that should then motivate them to, as soon as possible, achieve their goal. I have had the most "trouble" with insurance patients. It makes sense. People that come in and pay are putting something of themselves into it and why would they not cooperate? Likewise when relatives pay it doesn't seem to work. Recently a mother had been paying for her daughter and that lasted, I think, two visits.
How about patients that have insurance but can't afford to pay for treatment out of pocket? Yes, it's true that people spend a lot of money on drugs in heaps of addiction, but most often they quit because they couldn't afford their habit anymore. It seems that the medical community is treating bupe patients as some sort of lepers, not to be trusted. How this is allowed to take place on regular basis blows my mind. IF it was any other condition this for sure wouldn't take place. We are being ostracized as the sector of society that does not deserve humane treatment. We use insurance for everything except bupe treatment, there really is something wrong here.

Anyway thanks again. It is rare to get such feedback. I think you should do well.

Thank you.

____________________________________________________________________________________________________________________________________________

I want to hear stories from people who are on bupe concerning their experiences with payment, time spend in office, cost of visit (if allowed according to BLUA), frequency of visits and any other info peeps want to share.
Thanks to everyone who participates.
 
Thank you Jesus!
I registered with the NAABT.ORG physician/patient matching system and specified in the comments section that physicians that do not accept insurance need not apply and finally got one that accepts all insurances providers. My insurance (BCBS of IL) covers chemical dependency and has been covering my medication ($300 savings) and I am so thrilled that I finally will only be paying the $20 co-pay. YAY!=D
 
My bupe doctor unfortunately does not accept insurance, although she is fairly cheap, especially compared to the prices some people pay around here, and she does not drug test. It costs like $140 for a script of 90 8mg pills + $25 at the pharmacy.
 
Man its fucked how much they are charging for this shit. You would think they would want to make it as cheap and available as possible, maybe then more people would get treatment. For some of the extremes some people have to pay its easy to see how they would rationalize that they would be aswell continuing to use.
 
www.methadonesupport.org/Addicts.doc

(unfortunately, I could not locate the date this article was created)


Addicts' cure has fatal flaw

By Maureen Boyle, Enterprise staff writer
BROCKTON — Heroin addicts are lining up to pay hundreds of dollars a week to Massachusetts doctors who refuse to accept medical insurance for Suboxone, the FDA-approved drug that allows physicians to treat opioid abuse in the privacy of their offices.

Some doctors are charging desperate addicts up to $3,000 for initial visits — and hundreds more for office visits lasting just a few minutes — before handing over a prescription for Suboxone, parents and experts in the field said.

“There are doctors meeting people in parking lots, telling them, 'Go to the back door of my house,' ” said Colleen LaBelle, program manager at Boston Medical Center's opioid treatment program. “It is just abominable.” It is happening across the country.

The National Alliance of Advocates for Buprenorphine Treatment found 72 percent of patients were paying cash for treatment, with some doctors complaining it was too hard to get reimbursed by insurance companies. Buprenorphine is the active ingredient in Suboxone. “The doctors say it is not worth the fight,” said Timothy Lepak, president of the alliance.

Suboxone, approved by the FDA in 2002, is the first approved medication for opioid treatment in a doctor's office, and has been heralded by some as a wonder drug for people addicted to prescription painkillers and heroin. Those treated with Suboxone take one to two tablets of the medication daily to suppress withdrawal symptoms and reduce cravings. The pills are placed under the tongue and dissolved.
Doctors can treat up to 100 Suboxone patients if they undergo an eight-hour course offered by medical societies, get a waiver from the Drug Enforcement Administration, and notify the government of their plans. That number was increased from 30 per medical practice — not physician — last December after complaints that there weren't enough slots to treat the growing need. About 150,000 people were treated with Suboxone in the country as of August 2005, according to the makers of Suboxone, and the numbers are growing.

“Parents will pay anything to get their children help,” said Joanne Peterson, founder of Learn to Cope, a support group for parents of opiate-addicted children. But with the growth — and hope the drug offers — comes the potential for greed, several said.
“There are a lot of shabby practices,” Punyamurtula Kishore, a doctor who specializes in drug treatment, said of some doctors. “They take calls and they take the ones with the cash.” He said some of the doctors are making up to a half-million dollars a year seeing patients who want Suboxone. “When you are desperate, you do anything and people are desperate for help,” said Kishore.

One Braintree mother said her 20-year-old son paid $300 for his first visit, $150 for the second and $75 each week to one doctor to get a Suboxone prescription, even though he had Blue Cross/Blue Shield medical insurance. And when the family questioned the doctor about the treatment, she said he got mad. “He said, 'If you don't want the service and you don't want the drug, you can go elsewhere,' ” she said. He wound up relapsing and his drug use escalated, she said. His parents recently found him in the bathroom, overdosing on heroin. “We spent $1,200 to do CPR on our son,” his mother said. “It was a very traumatic event.”

Lepak, who heads the The National Alliance of Advocates for Buprenorphine Treatment, said the cash-only policy by some doctors casts a good drug in a bad light. “It takes away the credibility of the treatment. It makes it seem like it is something shady,” Lepak said.

The doctors that do take insurance — and insist on counseling — often have long wait lists, parents say. There are also 15 clinics in the state, including one at Boston Medical Center, that provide Suboxone treatment. Another health center, The New Bedford Community Health Center, is expected to receive a grant to also provide Suboxone treatment. It was the only health center in this area to apply for the money.

Chantel Nouvellon, a Waltham psychiatrist who accepts three different forms of insurance for Suboxone treatment, said getting reimbursed can take a long time, depending on the insurance, and some doctors may not want to deal with the paperwork to get paid. “For some insurances, sometimes you don't get paid for a year,” Nouvellon, of Arlington, said. Christine D'Eramo, formerly of Abington, tried Suboxone and was able to stay clean for nearly a year before relapsing. “I don't think it is a miracle pill,” D'Eramo, who is now drug-free again, said. “If you already want to get clean, it can help you. If you don't want to get clean, you are going to use.”

LaBelle said at Boston Medical Center, where she works, older addicts who have been battling substance abuse for years appear to have the most success with Suboxone. “It is a great option. It doesn't work for everybody. It is a lot more effective for those who are really done. It is not a medication for someone who just wants to still get high.” She said some of the younger addicts may not be ready to get treatment yet. “It is their parents that are the ones that are dragging them in by the hair,” LaBelle said.

Maureen Boyle can be reached at [email protected].

Addicts' cure has fatal flaw

www.methadonesupport.org/Addicts.doc

A note from me: I believe this is a problem for a lot of suboxone patients. I've been having issues with this problem myself. Just recently I acquired insurance and my doctor initially accepted it and brought up no problems that could come up. Even with insurance, he wants me to pay 50% of the visit cost. I just found out through e-mail that his services were reimbursed but he still wants the 50% just in case there are future problems. I pay $100 and the insurance paid him $300 on top of the $50 I paid him.8o:X I am currently looking for a new doctor. I've developed a bond with this doctor and got used to him but enough is enough.

If anyone has any similar stories to share, please do so.

God bless the NHS, where you get all the drug treatment, and methadone/bupe, you need absolutely free

*Wipes tear from eye and salutes the Union Jack*
 
To be fair I rather like the idea of a five minute visit to get a script and out the door no fuss no muss, its very close to legalized drugs.

See I'm a stable addict who has been self maintaining for years and have no intention to quit, opiates stabilized my mental state and life and I intend to stay on until I physically can't. The idea of just strolling in and paying my cash for suboxone with no questions asked appeals to me.

Now force me to pee in a cup or attend counseling sessions and hear people yammer at me about how god wants me off the drugs or try to pry into my life and you know what sub is no longer looking attractive I think I'll just buy some poppy pods online, that drug dealer doesn't waste my time and try to watch me pee.
 
^Nobody wants the extra crap like drug testing, I was just saying that on top of paying for insurance m0ntly I have to pay for the doctor visit up front even thou he did get reimbursed $300 for a $100 visit.

A lot of the suboxone doctors are crooks that are in it just for the money. Insurance covered visits are a no questions asked type of a thing anyways. I don't see how your post relates to what I'm trying to convey.

I do agree with you tho that sub doctors are basically drug dealers that u need to pay to get the drugs on top of paying for the drugs. They are in it only for the money, at leaset my doctor is. He has a voicemail that u can call and leave a message and he'll call back. When I stopped paying cash he told me to not call that voicemail anymore. I had a rash and problems from the meds he gave me but he didn't care, told me to come in if I have a problem. Money hungry bastard. I', never going to him again.
 
Z Y G G Y;7496074 A lot of the suboxone doctors are crooks that are in it just for the money. Insurance covered visits are a no questions asked type of a thing anyways. I don't see how your post relates to what I'm trying to convey. .[/QUOTE said:
I wasn't speaking to you but the article, the article had a subtle slant that counseling and all that bullshit should be foisted on patients to increase the legitimacy of suboxone treatment.
Beyond the outrageous prices sub doctors are charging I really see nothing wrong with it, but there is still a stigma to the idea of giving addicts drugs to maintain. It makes people nervous somehow, we're supposed to get clean after all8)

You have to remember before 2002 it had been sixty years since a doctor in the US could legally script a opioid to maintain an addict. It was just a few short years before sub that people would have scoffed at the idea.
 
considering the majority of heroin addicts don't work in order to pay taxes=D

god bless the nhs

*Wipes tear from eye and salutes the Union Jack*

Even heroin addicts pay taxes my naive friend, while the vast majority of heroin addicts do have jobs and do pay income tax lets just assume for a moment you're correct and heroin addicts don't pay any income tax okay.

Do they eat food? Well there is VAT or sales tax, and all the taxes the grocery or restaurant is paying.

Do they live somewhere? Well there is property taxes, even if they rent they are paying property tax indirectly.

Do they buy anything at all like clothes, computers, DVD players ETC? VAT or sales tax, and customs and import duties.

Do they buy heroin(duh)? The dealer or those higher up will need to launder the profits through a legit business if they want to make major purchases, taxes taxes taxes.

The only way you can avoid any taxes even indirectly is to not do anything basically.
 
Do they buy heroin(duh)? The dealer or those higher up will need to launder the profits through a legit business if they want to make major purchases, taxes taxes taxes.

now you're just being pedantic

Do they buy anything at all like clothes, computers, DVD players ETC? VAT or sales tax, and customs and import duties

Again, what heroin addicts have you been talking to?
 
the docs in this article are exactly the same as the other cash only docs. it's not new but it's fk'd up to abuse ppl who are trying to get clean.

a few months back several cash only docs in my area were shut down for selling scripts for $100-$300 each. they're not "practicing medicine"; the money is their only motivation and that greed causes a lot of suffering and death.
 
now you're just being pedantic



Again, what heroin addicts have you been talking to?

The point I was trying to make was everyone pays or contributes to paying taxes, of course some pay more than others but no contributes none its impossible.

The heroin addicts I am talking to are the invisible ones, the ones with jobs.
Just because homeless street addicts are more visible doesn't make them the majority.
 
Are there any patients with insurance that get both their medication and doctor visits covered with just the co-pay?

No problem in NY. There was a $100 deposit in case you missed your appointment, or stopped going. But I used to pay $50 a month for my script and $20 for my appointment. That was all, until I pissed dirty on multiple occasions and they wanted me to do outpatient rehab.

The ridiculous part is if they want you to go to outpatient rehab. Which would have cost me $20 a visit 4x a week for a few months ($320 a month for outpatient....fuck that shit), then I'd get lowered to 3x per week @ $20 a visit and so on for the next year or two.

I don't know, I've had 2 suboxone doctors in NY and never had any trouble...my insurance covered almost everything....besides outpatient.
 
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