getting suboxone/subutext in the UK? need advice please!

[mrs_mia_wallace]

Hey everyone,

I have been on suboxone since 2011, a little over 3 years now. After a lot relapsing and doing subs for a few days/week and then going back on heroin to return to the subs I've been totally off heroin and just on the subs for 8 months now. It's the longest I've been clean since I started using more than a decade ago.

I recently moved from California to London about two months ago. My doctor had prescribed me 3 months worth of medication but I've either lost the last month or not brought it with me-- I know, stupid, and I just realized it today. I only have enough medication until Friday, Saturday if I really push it and put up with some withdrawal symptoms.

I am a British citizen, I hold UK/USA passports but I've never lived here so I'm not very familiar with the NHS. I registered with a GP today since I was told that was the first step, and they told me I would be registered by Wednesday. But can any GP prescribe me suboxone? In the US I had a GP prescribing me suboxone but he was specially certified and he was the only one at his practice that could do it. I had to do quite a bit of research to find him, but I haven't been able to find any kind of list of practitioners who prescribe suboxone in London on the net. I know there are drug centers here that say they do opiate substitute prescribing, would I be better to go there than to camp out at my GP and wait for an appointment? I know in the US if I was absolutely desperate I could go to a methadone clinic and get it that day, but I really don't want to go on methadone as I know it has a 'high' and I don't want to risk exposing myself to that or becoming more inclined to do methadone over suboxone in the future because I enjoy it! I don't know how I've managed to stay sober this long but somehow I have and I'm really terrified that this situation is going to put it at risk-- and obviously I'm also very scared of going in withdrawal this weekend!

Any advice would be appreciated!

 

[MONSTA!!]

Hi,

You've got very little hope of getting any quickly, you will most likely be referred to your local drug services then will have to wait for an appointment with the doctor.

How much sub do you take a day?

Tried to PM you but your inbox is full.

 

[mrs_mia_wallace]

Hi,

I normally take 12 mg a day but I can cut it down to 8 which is what I'm doing to save for the rest of the week. I found a drug services in Camden (that's where I live) that takes self-referrals, does opiate substitute prescribing-- would they at least give me methadone? I deleted some of my msgs so feel free to PM me. Thanks for help.

 

[mrs_mia_wallace]

I finally got somebody on the phone, I was calling all yesterday and couldn't get anyone to pick up (Camden and Islington Foundation Trust - Substance Misuse Service (South Camden)) and they told me to come in tomorrow in the afternoon for an assessment. So I'm going to say a prayer they can give me something... god moments I wish I was back in America!

 

[THECATINTHEHAT]

Just explain the situation to your gp and they will refer you to the local drug and alcohol services. Either the GP or the services will take a sample (or two over a period of a week or so depending on where you are), and if you come up positive they will write you a script and devise a care plan for you. Be ready for at least two months of supervised consumption, followed by a period of daily pick up with weekend takeaway though. It will be a good four months or so before you're trusted with weekly pick up.

 

[THECATINTHEHAT]

Oh just read your last post....you're still a number of days away from a script most likely. They will want to test you at least once, probably twice before prescribing.

Don't be hoping for them giving you anything soon if I were you, you definitely wont be given anything on your day of initial assesment.

edit: Shouldn't say definitely really, but I've never heard of anyone walking away with a script on the same day as assesment. They will take your assesment to a group meeting between the workers at the clinic and make a decision as to what to do then. Could take a week or longer.

 

[mrs_mia_wallace]

I don't care if they give me a script, I just don't want to have to go into withdrawals this weekend. I mean, would they really say "sorry we know you've been clean for 3/4 of a year but we're just gonna let you go into withdrawals cause we don't want to give you even a daily dose that we supervise?" that just seems INSANE to me, I mean way to get someone into relapse!!! I'll test clean even if they hair test me as this point, I haven't used opiates since August and I cut my hair into a bob so there's nothing left from then. Even if they want me to come in daily I could give a shit... as long as I don't go into withdrawals on Saturday, cause I know me and I'll last a day and then I'll be scouring the streets of London looking for smack.. anyway I'll let you guys know how it goes!

 

[THECATINTHEHAT]

Doesn't make a blind bit off difference what you tell them about how long you've been 'clean', it could all be bullshit as far as they are concerned. After your assesment a decision will be made at a group meeting as to what will be done with regards to a script. It's a perfectly sensible way of doing things, the health services here don't hand out opiates like sweets like in America, and taken as a whole it's a far more effective approach. If you choose to relapse it's not their fault, it's because you left your script at home. What you also have to understand is that they have other patients to deal with too, they're not going to skip you straight to the front of the queue just because you say you need a script quickly....what do you think most people who turn up on their doorstep want? That's right, a quick script. It's not insane at all, it's a perfectly effective system. What would be insane would be to prioritise your case over the many other people they are dealing with just because you fucked up and left your script at home.

Your case is a little different to the usual, but that's not their fault and they're not going to make special allowances for you I'm afraid. Everyone is treated equally here in the UK and will have to go through the same process as dictated by their local clinic. I'm afraid this is a case of sucking it up and taking responsibility for your own actions. I don't mean that in an aggressive manner, simply that you need to own your mistake and realise you're not deserving of special tretment.

I wouldn't hold out hope for anything before the weekend but I've got my fingers crossed for you, you might get lucky.

 

[mrs_mia_wallace]

Well all they would have to would be to test me, which takes 15 minutes to do, and they would see that I'm clean? I understand that doing a group meeting and speaking about the case would be appropriate if I am to ask for them to write me a script to take home for a couple weeks or so, because yes I could turn around and sell it on the street, but what danger would there be to give me a supervised dose? It has nothing to do with handing out sweets like candy, in America I have never heard of any such thing as someone being handed a script for methadone-- maybe if you were going to the clinic every single day for 6 months + they would give me a week of takeaway-- because methadone has too much street value in America. But it takes less than 2 minutes to pour someone a dose of it and watch them take it in their clinic, which is why you can get it immediately at a methadone clinic in America. They would rather do that than send someone out on the street to go score. With suboxone you would have to make an appointment with a doctor and then they would evaluate you and probably give you a few days worth of prescription and wait for you to come back. I'm not asking to be pushed to the front of the queue, but they told me I could come in for an appointment so obviously they have time to see me, and I don't understand why they wouldn't take that time to just give me a dose so I don't go into WD? I don't know, I guess we just do things differently in America and we are coming from a different viewpoint/experience, I don't want to argue with you. Obviously it was stupid for me not to have the extra month with me and clearly my fault that I am in this situation, but we all make mistakes. I'm sorry if I'm being a bit snippy but this experience it a bit scary for me considering I am in a country where I don't know anyone and dealing with a medical system that is night and day from the one I have dealt with my whole life.

Anyway, I will keep ya'll updated and let you know how it goes, hopefully they take pity on me!

 

[THECATINTHEHAT]

they told me I could come in for an appointment so obviously they have time to see me, and I don't understand why they wouldn't take that time to just give me a dose so I don't go into WD?

....because as I said all initial decisions on prescribing maintainance treatment through the NHS in this country are made as a group AFAIK. They couldn't care less if you go in to WD as it's not dangerous.

Thinking about it if you want to pay the money you could probably go to a private doctor and get something sorted out straight away. I didn't think of that as an option but if you've got the money it's worth considering. I was considering a private morphine script once, you can get pretty much whatever you want in this country if you're prepared to pay for it.

 

[mrs_mia_wallace]

^How would I find a private doctor? I have done searches throughout the internet for 'suboxone doctor london' and nothing comes up, I would be able to afford it.

 

[THECATINTHEHAT]

Just search for a regular private doctor on google. Maybe add 'addiction' as a keyword or something like that? I can't remember the process I went through when I was looking in to a private morphine script but I had someone agreeing to see me with a view to taking me on as a patient the same day I started looking.

You can get pretty much whatever you want on Harley Street if you've got the money though really, definitely an avenue worrth pursuing. I'm not suggesting you do it but you can get injectable methadone or even heroin relatively easily privately (it's available very very rarely on the NHS [extremely rarely in the case of diamorphine]).

edit: In some ways our system is even mnore fucked up than the US8(

double edit: scratch that on the heroin actually, I think the doctor needs a special licence whether private or not. It is available to a very tiny number of people though.

 

[mrs_mia_wallace]

Really? That's a bit scary, I didn't think anyone prescribed heroin anymore! And the fact that it's easily accessible is even more disturbing...

I found the Stapleford Centre, they're the only ones that are showing up when I do a search, they were the ones prescribing to Amy Winehouse apparently so don't have the greatest reputation when it comes to following guidelines.... and they're certainly not cheap, but on their website it says they give prescriptions out on day of assessment. So it sounds like that will be the best option while I'm getting my script sorted with the drug treatment centre affiliated with NHS. Thanks for the suggestion!

 

[THECATINTHEHAT]

Like I said it's noot easily available, and I don't think it's disturbing either I think it's a goood thing and shouldbe easily available to anyone with a history of ongoing heroin addiction. It would immediately get everyone with an ongoing addiction off street gear and in to the hands of the drug and alcohol services, enabling them to stabilise their lives and get the support they need. It would mean vast increases in size to the drug and alcohol services but this would be balanced by plummeting crime rates, as lets face it most long-term addicts support their habit through theft or begging. I doubt the net cost to society would be much if anything.

 

[markrenton79]

Same problem here!

Really? That's a bit scary, I didn't think anyone prescribed heroin anymore! And the fact that it's easily accessible is even more disturbing...

I found the Stapleford Centre, they're the only ones that are showing up when I do a search, they were the ones prescribing to Amy Winehouse apparently so don't have the greatest reputation when it comes to following guidelines.... and they're certainly not cheap, but on their website it says they give prescriptions out on day of assessment. So it sounds like that will be the best option while I'm getting my script sorted with the drug treatment centre affiliated with NHS. Thanks for the suggestion![/QUOTE
HEY! I've got the same problem here. I usually get suboxone by going back to the country where I'm from in Europe. Been on it for 10 years now, never had any relapse of any kind but it's hard to get off it. I get 4-6 mg a day.
I won't be able to fly back this week end and it's too late to have them sent by post to me.
Would you please let me know if that centre works?
Thanks!

 

[mrs_mia_wallace]

^I've just given them a call but they're closed for lunch hours. If you need a script by the weekend I would call them ASAP, as you'll be pressing for an appointment tomorrow. They're pretty clear on their website that they usually prescribe medication on the day of assessment as long as you bring in what they ask-- they are not cheap though, as I said, it's around 300 pounds for either 2 weeks/4 weeks of medication depending on which one you want to go with, they offer methadone, subutext and naltrexone. After those weeks it gets more manageable at 35 pounds a week which is not bad, to be honest I may just end up sticking with this centre and not even bothering with the NHS as I don't particularly feel like dealing with supervised prescriptions, with my work schedule it's not the easiest thing for me to get to a clinic everyday. And I'm going to be off suboxone completely within the next couple months, I feel like I'm ready, just not ready to go into it totally cold-turkey.

 

[mrs_mia_wallace]

Like I said it's noot easily available, and I don't think it's disturbing either I think it's a goood thing and shouldbe easily available to anyone with a history of ongoing heroin addiction. It would immediately get everyone with an ongoing addiction off street gear and in to the hands of the drug and alcohol services, enabling them to stabilise their lives and get the support they need. It would mean vast increases in size to the drug and alcohol services but this would be balanced by plummeting crime rates, as lets face it most long-term addicts support their habit through theft or begging. I doubt the net cost to society would be much if anything.

I find you very confusing, you're pro prescribing heroin to addicts but you'll defend the NHS policy of putting addicts on wait lists and putting them off getting opiate substitution medications ASAP, criticizing the American medical system for prescribing methadone on same day assessment because it's "handing out drugs like candy?" I feel like you're just arguing with me for the sake of argument, or perhaps I just don't understand your position, I don't know? Personally I think we should be focusing on getting addicts off opiates and putting them on medications like suboxone/subutext, methadone if necessary-- and gradually tapering them off of these substances as they become stronger in their recovery. The NHS used to freely prescribe heroin before the 1970s and it was disastrous, no one stabilized and there was just rampant drug addiction in the country and that's why they discontinued it. From the studies I've read there have never been any good repercussions from openly prescribing drugs like opiates/cocaine/etc.

 

[mrs_mia_wallace]

MarkRenton-- I've just given them a call but I don't know how quick you'll get an appointment. They said they would send me an application form, then they need to look it over and then call back and you get an appointment in a week usually. I explained my situation to the receptionist and she said she would send the form to me ASAP and do what she could to make an appointment as soon as possible. I would call and stress your situation.
Also it's a bank holiday monday so most likely everything is closed!

 

[THECATINTHEHAT]

I find you very confusing, you're pro prescribing heroin to addicts but you'll defend the NHS policy of putting addicts on wait lists and putting them off getting opiate substitution medications ASAP, criticizing the American medical system for prescribing methadone on same day assessment because it's "handing out drugs like candy?" I feel like you're just arguing with me for the sake of argument, or perhaps I just don't understand your position, I don't know? Personally I think we should be focusing on getting addicts off opiates and putting them on medications like suboxone/subutext, methadone if necessary-- and gradually tapering them off of these substances as they become stronger in their recovery. The NHS used to freely prescribe heroin before the 1970s and it was disastrous, no one stabilized and there was just rampant drug addiction in the country and that's why they discontinued it. From the studies I've read there have never been any good repercussions from openly prescribing drugs like opiates/cocaine/etc.

They're not putting you on a waiting list for the fun of it, they're doing it because that is how the system operates and there are other people waiting too. It's highly unlikely you will be assesed by a doctor with the power to prescribe, you will be assesed by a drug worker of some kind.

You'll notice I advocated giving heroin to addicts with longstanding issues i.e. where traditional prescribing hasn't worked. The handing out opiates easily comment was one generalised to the medical system as a whole, I didn't say anything about methadone clinics. Like I said you can quite easily go private in this country and get the same treatment, which I think is also wrong. The whole concept of privatised medicine creates a fundamental conflict of interests in many cases. If the doctor wants to keep your business they need to keep you happy and do what you say, which may not be in your best interests.

Regarding the prescribing of diamorphine as maintainance treatment, I think you'll find the trials in this country over recent years have been highly successful it's just that no government will push it through as a policy for fear of losing votes.

Hope you manage to get yourself sorted though.

 

[RaspberryJam]

Here's what happened to me:

Called up. Same-day appointment with a drug-worker who took a urine sample and scheduled an appointment that evening with a doctor. They asked me how much methadone I needed. Buprenorphine was offered, so I assume this would've worked equally fine. The day after that I was picking up a dose at a local pharmacy. I remained on maintenance for a couple of years and then decided to start tapering off.

I really feel your pain, mrs_mia_wallace: a couple of times I've had some really close shaves. Once I was at university after picking up the thrice-weekly script and it fell out of my backpack and smashed all over the floor. They couldn't replace it without a new script, so I had to get on the train and get there, which led to them getting the doctor to write a new one on the same day - the doctor wasn't at the clinic, so I had to wait until 6PM, but it was alright 'cause I'd already had my dose that day.

Fixing it for new jobs and stuff has really been annoying, but they really are angels about it. My experiences have been with a place in the North-East of England, so I don't know if it will help. How are you doing so far? Have you been to see them and talk to them about it? I'd take the pills along and just try to be as honest as you can. They certainly don't want anyone to go into withdrawal or screw up after eight months clean! Their hands may be tied, however, by the fact that they don't know you and the doctors they tend to use for this sort of thing only come by on certain days each week.

Good luck! I hope it all works out for you. If you fancy a chat any time about it, drop me a line.