HELP IS ON THE WAY!!!!

[MED HELP INTERNATIONAL]

Within the next day or so, we will have a new addiction medicine specialist available to answer questions in this forum.  We know that you will appreciate his generosity, as he's volunteering his own time & expertise to help people in need.

Please help us by making sure that each new question is indeed a question and not just a "good morning" wish, or other such communication.  Because of funding & time limitations, the doctor will only be able to accept 2 new questions each day.

We'll give you more of the details as we get them....

Best wishes,
Cindy & Phil

Med Help International

[taeme]

Here's the truth of it. Most are looking here for advice on how and where to get what we want.  How to convince Dr's etc... we have what we say we have.  And then how to get the meds we want without them catching on.  Do you feel that male or female Dr.s seem to be more skeptical?  I don't know how everyone got started often I think it has to do with under medicating in the first place.  I sometimes wish darvocet had never been invented, for me I would rather take an 800mg Ibuprofen for all its worth. I am so frustrated finding a physician that doesn't try to placate me with a fancy named prescription for robitussin.  I'm quite educated in the medical field and things like this really erk me.  If I seem too educated I seem like a drug seeker, if I'm too weak I get tylenol and plenty of fluids.  I tired of spending my money with repeated visits.  If they know you just came in and then ask you to come back the next day after you've just called to say the medicine isn't working, do they not believe you? Especially if they have already done tests and cultures the first time?  Should we not be able to ask for what works? What if we happen to know a lot about medicine should we play dumb for fear of being labelled an addict, a drug seeker?  I often wonder if Darvocet is given when they don't believe you but are afraid to blatantly deny you pain meds? Maybe darvocet does something for some of you, I don't know.  Is it okay for me to let the Dr. know that even though I am hurting I can't afford(out of pocket, no insurance) to come in and try all the intermediary medication because he/she feel I may be a drug seeker.   The intermediary medications are what I call the fluff medications, you would have been better off grabbing yourself a bottle of niquil cold and fluid medicine.  I don't know if its my age(female 25),my problems(migraines, backpain, kidney stones----of course these are all over a long period of time)I guess these fall into the "watch for addicts" diagnoses.  I never had this much trouble when I was younger.  Maybe I don't know what a normal patient is supposed to do.  All I know is that when I was younger I hadn't tried as many medications, I know what doesn't work, and in general if they are in the same class they won't work either. Why should I have to pay for a medicine I know probably won't work just cause they need to see that I am not just seeking narcotics.  Now I'm just getting mad so I'll stop rambling and ask you opinion.  I know I said a lot but try and answer anything you can, I really am very frustrated.  Thanks.

[mrmichael67]

I haven't seen anything in print, but I did talk to a pharmacist who said that she saw no reason whatsoever why it couldn't be prescribed for chronic pain.  She did tell me that it isn't exactly the most suitable drug for the task because of its properties.  It can be damaging to the liver.  I know some people are on it and swear by it for pain.

[Witchywoman]

Do you know if subutex is approved for use for chronic pain, or is just for detox?

thanks!

WW

[groovygirl]

Thanks - They might have deleted it by accident...I've noticed a lot of my posts have vanished, and they didn't contain any links or email addresses.

[mrmichael67]

Something screwy happened with my computer.  Sorry for the double.

[mrmichael67]

Go here:  http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm

Hopefully, you get to see it before med help deletes it.  I couldn't imagine why posting that link is a no no.  They deleted the first one I posted.

[mrmichael67]

Here is the link:  http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm

[groovygirl]

Thanks for the info.  Did you get this info at a website?  If so, could you tell me where?  I'd like to read more.  I wonder if they will provide a list of which doctors meet that criteria?

[mrmichael67]

I am sure some people already know the information I am about to post, but I am sure this will be informative for some.  So, here goes.  In order for a physician to prescribe buprenorphine for opioid dependence, he or she must meet ONE of the following:

1.  Hold a sub-specialty board certification in addiction psychiatry from the American Board of Medical Specialties.

2.  Hold an addiction certification from the American Society of Addiction Medicine.

3.  Hold a sub-specialty board certification in addiction medicine from the American Osteopathic Association.

4.  Have completed NOT LESS than 8 hours of authorized training on the treatment of management of opioid dependent patients.

They must also meet BOTH of these requirements:

1.  Have the capacity to provide or to refer patients for necessary ancillary services, such as psychosocial therapy.

2.  Treat no more than 30 patients.


After these requirements are met, the physician will apply for a special DEA registration number.  When the physician writes a prescription for Subutex or Suboxone, he or she must have both DEA registration numbers on the prescription.

[groovygirl]

I live in MA, and I guess I don't have a prayer of finding a Dr. who has received the training.  I've gone thru the yellow pages, and just ran down the list.  It's an interesting story about how the "powers that be" do not want anything to take business away from Methadone clinics in MA.  It is all political.  I'm doing this "research" on Subutex not only for myself, but also for the public.  There are a lot of frustrated addicts in this state, who are losing hope because of this Subutex thing.  Apparently, many people were under the impression that their own family doc could prescribe this.  I've heard that doctors have to have special training and also can only treat 30 patients with it at a time.  Pharmacies in the area say they won't have it in stock for months and months.  It's just a bunch of b.s. - makes me sick.

[mrmichael67]

Only addiction docs with special DEA certification numbers can prescribe buprenorphine for opiate dependence.  Regular docs can only prescribe it for pain legally.

[mrmichael67]

From what I have heard, Subutex and Suboxone will be in pharmacies in a couple of months.  I would imagine they are producing it in quantity now after the approval.  They produced it in limited supplies for studies and other countries.  I am sure their production has increased one million fold.

[groovygirl]

I'd like to find out what's going on with Subutex - the new FDA approved Buprenorphine.  I have called several doctors in my area to find out if they know anything about it, and they don't.  Most of them have never even heard of it.  It's frustrating for someone like me who's waited over a year for this to happen.  Now that it has, I cannot find a doctor who's knowledgeable.

[Starraven]

Just going to throw in my two cents from my experience since finding the MEDHELP site.  When I was at my worst and didn't know where to turn I did a search on withdrawal and ended up here, but on the Question and Answers "ask a doctor" page.  I must have read a hundred posts from people asking about withdrawal.  The response from the doctor was always the same. "You will benefit by seeing an addiction doctor"  " I suggest you go see a doctor that specializes in addiction" ect ect.  Some of the people really took alot of time to explain their situation in a post only to have the doctor by pass all the questions and suggest an addiction doctor. (which is fine and good for some people, but at that point I was already on day ten, eleven ect)  THEN I found this forum.  Real people, real addiction, real stories.  Just reading all of your posts has helped me more than the Question and answers site ever could.  I know the doctor has to protect himself in offering advice, but I sure hope this forum doesn't turn into the same thing as the question and answers site. I'm only on day 22 because of this site where I can read about others in the same boat as me.
Hope I did not offend anyone with my two cents :)
Suze

[Bodymechanic]

I have to disagree with you on this one. General information may be given and questions answered without forming a doctor patient relationship.  We do it all the time here in our medical clinic.  If a doctor is really paranoid then the phrase..I am not recomending this but..can be used to make it crystal clear that there is not a doctor patient relationship.

Peace

[dru123]

I can't ever seem to post a "new" question, so I will write it here and see if anyone can help me. Here's the deal. I have several herniated cervical disc's which give me pain anywhere from 2-9 on a pain scale. My doctor originally put me on Vicodin ES7.5/750 1 x 4/6 hrs a day. After 2 month's on it he switched me to Oxycontin 20mg x 2 daily. I tried that for 3 weeks however I started needing more to control my pain, but in higher quantities 40-60mg x 2 daily it made me sick(Throwing up). My doc switched me to Duragesic Patch 50mcg x 72hrs. and occasionally 75mcg x 72 hrs for bad stretches(I've been using the patch for approx.7 weeks). I still use Vicodin ES for breakthrough on occasion(approx. 10-15 vikes a week).My wife and I would like to start having kids, however my drive is "nil", and my performance is pretty poor. I want to stop taking the patch as well as the Vike's. I don't have any mental addiction, and can't wait to get off this stuff. My doctor doesn't seem to know anything about tapering and withdrawel, and says "just stop taking the meds". I've tried a few times, and I start getting physically sick.  I've been on these meds since June 6, 2002(4.5 monthes)and I want to give Celebrex, or Viox a try. My doctor will prescribe just about anything I ask for as I have taken the meds exactly as I've been told, and never call him for early refill's or lost meds. In fact, I gave him back 50 Oxy's when they were making me sick and he wanted me to give the patch a try. What should I ask my doctor to prescribe to taper me down from this patch/vikes? I want children, and am willing to be in pain for a while if need be. I just don't want any type of withdrawel's. Please tell me what I should ask him for. Thanks!!!!!!!!!!!!

[Thomas02]

I'd be willing to tell people to see their doctor for half the amount.

[mrmichael67]

Med Help does have a disclaimer that will effectively remove them from any liability.  Their doctor can offer more advice than was given in the past.

[Starraven]

I can't even remember what I posted to you earlier..they removed my post due to me posting my email address unfortunately.  You have gotten some really good advice from others that know more about detox programs than I do.  I am clueless about detox done through a clinic. Luckily I have been able to go cold turkey.  Although I would have appreciated that kind of help at the time.
Going cold turkey for me this past time was worse than the time before.  My symtoms of withdrawal are always the same.  Endless trips to the bathroom, vomiting ALOT, the shakes, NO sleep for about two weeks, night sweats.  You name it.  Although I have never had a headache.  That indeed might be another issue all together as said in an earlier post.  It DOES get better,  the one time I did taper I had NO withdrawal symptoms.  Which really amazed me. I braced myself for the worse but it never came.  I just found this forum on day 18 and at that point I was feeling better and didn't try the recipe.  Others swear by it.  At the point in which I would have needed the recipe, I honestly don't think I could have left the house to get the needed supplements. Ugh. I do think this forum is good for me.  Now that the physical withdrawals are almost gone I still come here to be reminded just how terrible I felt that first week.  Hoping this will keep me from calling in my refill of Lortab.
If I can get through this I know anyone can.  I have NO willpower what so ever.
I don't ever want to feel like I did a few weeks ago.  I have thought to myself many times while sitting in the bathroom crying and wretching, that if I could pull all my hair out to make it stop..I probably would..:(  
Stay here with us..You'll get through it..With help or on  your own..Its different for everyone, but we all know how it feels.
Hugs and GOOD luck :)
Suze

[bmac]

No I am sorry,it is slow release morphine.It is kinda like MScontin.Kadian is a capsule with tiny pellets in it.It is time released.Sorry.
I do appreciate your thought and I do remember seeing your posts last week or so.I am 100% better.
                        Bill

[Sugarbeens]

Hi there.  What exactly is Kadian?  Is it a narcotic or is it a painreliever without codeine?  I wish I could find something that works for my pain other than a narcotic!  And other than surgery!! Yuck! Just don't think at my age, 48, that I will go that route.  I don't post often, but, I am Butterbean(now sugarbeens) because I couldn't get back in to post for some reason with the Butterbean name, but that is me! I have had this back problem since 1978 when I fell.  They are just now given me a real diagnosis after all the test,etc I went through over the years.  I still don't think it is accurate as I know something is busted along and near my tailbone and lower back.  The MRI says I have arthritis and some herniated disks and a small tumor on spine(doc says that has nothing to do withthe pain).  Anyway, I know you have been clean a good while, but, is this new drug non-narcotic.  If it is and if it seems to work for you, I may request my doc let me try it.  I have never let him give me oxycontin because I am afraid of it after reading all the stories.  However, I see that many people love it and say it really keeps them pain free.  I am tired of narcotics and the tylenol in them.  Is tylenol going to kill me at an early age?  I never took a drug in my life until age 40 when they finally found these narcotics to help me deal with the debilitating pain.  I only drank wine sometimes.   However, I did abuse these pain meds and still take more than I am supposed to sometimes.  I hope you respond and I hope you tell me it isn't narcotic.  I guess I am looking for a miracle.  By the way, Iread everyday, although I don't post much anymore and yours are some of the most rewarding posts because I see how far you have come after abusing drugs for so long.  I think you are a great person of character and yes, bravery.  I am sure your wife is very proud of you.  You are making it!!!!  Love to all!

[Thomas02]

I think any doctor talking to anonymous online patients is inherently limited in the advice he can hand out. We are not doctors and don't claim to be (I'm not, that's for sure). We can give our opinions, suggest stuff, tell war stories and it doesn't constitute professional medical advice. If you put yourself in the shoes of a doctor who can be sued for malpractice, I think it's easy to understand why so many of us on the forum have been advised to see our doctor.

I'm hoping that this addiction doc can at least offer some updtaes on what's available for pain, detox, maintenance, recovery, etc. plus some insider's info on how and why the national medical apparatus operates the way it does.

Thomas

[Thomas02]

Laura, sorry to hear about your back injury. I had back surgery in 93 and know some of what you're going through.

The way a chronic pain patient approaches narcotic use, tolerance, detox, etc. is different than how an addict like myself would. I think it's a great idea to see your pain doc to possibly switch to another pain killer you might be able to use without abusing. But please get those headaches checked out. Your pain doc will insist, anyway.

Thomas

[bmac]

My day was fine.The Kadian is a big help.I can actually do things again.Well besides being the best bassist in town,I have
been walking a lot and getting back to livin' after the hell
I put myself thru this summer.God,I am so glad the summer is over.Well I'll let you get back to making up ****,the one thing I know you are good at,so peace to ya!
        See ya on the other side,
                 resident bassist
                 ohhhhhh noooo!!!