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Old 07-16-2011, 08:38 PM
 
719 posts, read 834,181 times
Reputation: 581

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Mary was only given one weeks dose of the Suboxone and must return Monday for some more. She is supposed to get a month's supply on Monday.


I apologize. i thought she had a month's supply. Honestly, if she only had a week's worth and the dosage is too low she may have taken them all because to not take extras threw her into withdrawal.
Suboxone has a huge street value because it blocks withdrawal. All serious opiate addicts like to keep some on hand in case they cannot find drugs.
BUT it is entirely possible with only a week's supply, that your daughter's start dose was not high enough and she was getting sick, so she doubled up. It would also explain the rage you spoke of. If she doubled up and ran out she is hurting right now, and yes, if she plans to go out tonight it is probably to seek out drugs to stop being sick.


He may be the kind of doctor who does the right thing and won't write another rx or he may just be running a drug mill.

If she only had a week's worth and doubled up because she was getting sick he may just up her dose until it keeps her from getting sick. My son's doctor is amazing. He meets with patients for a three hour initial visit in which he gets a complete drug, life, heart, and soul history. He gives them the first dose in the office and he calls them the next day to see how the prescription is working. If they are hurting he tells them to come pick up an additional script for more so they can take more each day initially. He is awesome at understanding what to do to get them on a maintenance dose. His own brother died of an opiate overdose and he is committed to helping.
My son started out with 4 wafers a day and has now weaned himself down to one half of one wafer a day.
Again, I thought your daughter had a month prescription and ran out in a week. I am sorry. Please don't rush to condemn her with her doctor. If it is her first week, she may just need more than she received, especially if she lied to the doctor about how bad her addiction is. For example, claiming to take two Vicodins a day, when she actually was taking several morphine tablets a day for months on end.



We have told Mary we will be the ones holding her rx bottle and dispensing them one at a time.
she is only prescribed one a day???? that is not even a normal starting dose. Most patients start out with 2 or 3 a day and then are weaned down to 1 a day in a few weeks or months. Because my son was injecting heroin several times a day for a couple of years they started him on 4 a day and he weaned himself down to one half of one.
Sounds like she needs to find herself a better doctor. For some it is a money game only.

Long ago, about a month after my son got on suboxone he went to work one day, and while he was gone, a friend of his girlfriend's came to his apartment and partied with his girlfriend. the friend overdosed, went into a coma and was in a vegetative state for six months. (thank god she lived, because they predicted she would not) She is fine now and back on drugs partying like a rock star (eyeroll)
Anyway, the day after it happened I called the suboxone doctor and said I was worried my son would relapse because he walked in from work and found the girl on his living room floor barely breathing and in a coma.
The doctor immediately called my son and had him come into the office and sat and talked with him for two hours about not relapsing and working through the grief of what he walked in on. etc etc. THAT is the kind of doctor your daughter needs. I hope you can find another doctor for her.


IDo you know how long the withdrawal will last?

Honestly, if she gets tossed off suboxone and does not enter rehab I highly doubt she will stay clean, but it COULD happen. The actual physical withdrawals should start to dissipate in about seven days. The anxiety and depression from the chemical brain changes due to opiate abuse can take 12 to 18 months to rectify. If she stops suboxone, encourage her to enter rehab, or see a therapist etc.



The doctor is definitely "shady" as he billed Mary's insurance company for a level 5 office call and also for "smoking cessation".

This has me concerned. I don't know what state you are in but I do know the federal mandates for doctors treating opiate addicts include special training and serious record keeping to turn in to the feds. Smoking cessation?? have you checked with your state licensing office to be sure this doctor is actually vetted to treat with suboxone?



Also, I think Mary pulled a "fast one" in order to get the insurance company to approve the Suboxone. I really do not understand exactly what happened, but the insurance company denied the rx at first and then Mary had my husband take her back to the doctor's office to change the paperwork and this change had something to do with the lying and saying the doctor prescribed Valium or something of this nature. I am really not clear about this issue and I know I am not explaining it properly. I told her the doctor needed to be turned in for overcharging the insurance company. But this is another issue.

Holy moly, it sounds like this doctor is a criminal. I hope your daughter finds another one. If he is allowed to prescribe suboxone there should not be a problem with the prescription unless your daughter is insured by a company that is self insured. But it sounds like the insurance company paid the suboxone prescription after it was called smoking cessation??? Suboxone has one purpose. Treatment for opiate addiction. This makes no sense.


If Tom does divorce Mary and she does not obtain a job that provides insurance or qualify for Medicaid (does Medicaid pay for Suboxone?), then Mary is going to be in a world of hurt because my husband and I cannot afford $100 a week for the Suboxone. Mary takes two tabs a day due to her size.

I don't know if Medicaid does or not. We live in Nashville and our state has something called Tenncare, and Tenncare used to pay for Suboxone, but stopped last year. It put a lot addicts in trouble, and they are back on drugs as they cannot afford the suboxone. I have always paid for my son's. I am not wealthy, in fact currently I am dirt poor, but the suboxone saved his life. He works full time, does not take drugs, no longer goes to jail, dropped all his drug connects and goes to church. I would rather pay it than have him not able to take it due to the cost. He helps me when he can and it is why he weaned down to 1/2 of one a day. The cost was killing us. I don't think size has anything to do with it. I think they start everyone on at least 2 a day but she should be able to wean down to one a day within a couple of weeks and then it is only $50 a week. Is she working? Once she is stable on a dose she can get a job and pay for it herself.

Her UE is $300 a week for 12 more weeks. She has no more extensions left (as I understand). She spends a LOT of time on the back porch smoking and doing something with her cell phone.

Texting people looking for opiates? LOL
Our seminar outlines the top behaviors of a drug addict... and in that list is constant phone use. Short calls that last less than a few minutes. TONS of texting that eventually lead to the addict remembering he or she has to go somewhere RIGHT NOW...
Do you have a computer she could use for applications? If so, I would be suspicious of her constant phone use. If not, she may well be applying for jobs.
My concern is it doesn't sound like she came to you on her own wanting help getting off drugs. It sounds like her husband dumped her at your door and drove away. If she has not decided its time to get clean, then ALL of her behaviors are suspicious to me. Just lots of experience with addicts through our seminars tells me that.



Mary told me she knows how to pass the drug tests for job interviews and told me how she does it and where she buys her supplies to do this.

Yup, You can walk into any vitamin store and buy something called a mask. It claims to be a body cleanser, but in actuality it is designed to pass drug tests. Some of them even have inserts that state if you fail a drug test after taking the product, the company will double your money back as a refund once you send them the failed test. You drink it within two hours of taking a drug test and you will pass the test. The product provides a mask for the drugs in your system. If the test is sent off for more advanced testing, the mask shows up, but for simple job, probation or sports testing the mask does its job and they pass the drug test.
She may also be using home remedies.



I am certain the jobs she is applying for are in the medical field. I know she should not work in the medical field, but I don't feel I can even try to control this.
exactly. Plus, she can get drugs on the street if she wants them. It is all within her control.

Mary blames us for running out of her meds early. Mary blames everyone else for all her mistakes.
They all do. Close your ears, go to a new movie, take yourself out to dinner and be glad you are not the addict. It is a rough road, but it is HER road and her problem. You didn't cause it and you cannot fix it.

I know Mary is not serious about getting well right now, but I want to give her a chance.
I understand more than you know. It is why I originally offered to buy my son's suboxone. I wanted to know if he decided to quit he had the tools to do so.... that if he stayed on drugs it was because he wanted to, not because he didn't have access to treatment.
Unfortunately, until Mary chooses to get well, she most likely won't. this is such a hard road for you and any parent who finds themselves dealing with an adult addict. If you haven't been here you have no idea what it is like. Just know that someone out here knows how you feel, knows what its like and wants you to know I care.
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Old 07-16-2011, 08:54 PM
 
719 posts, read 834,181 times
Reputation: 581
Thanks again, Sarah.
No problem. When I started the journey I had no one to relate to. It gives me pleasure to be able to help others. I am not a professional drug counselor etc but I am the mother of an addict and a journalist who has interviewed hundreds of addicts and their parents. If there is one thing I know... it is everywhere ..... EVERYWHERE.

She has just been able to fool so many people for so long. Her family, employers, doctors, law enforcement.

It is amazing isn't it? How do you know when an active addict is lying? His lips are moving. They become expert manipulators. What my son tells seminar attendees is not to take it personally.
"When you are standing there arguing about money or whether your kid should go out, they don't see mom or dad, they see an obstacle to drugs and nothing is going to stop them from getting to the drugs. They will say or do whatever they have to if it gets you out of their way."



She does not like me (which I have accepted) and she is only here because she has no place else to go.

((((Hugs)))) She loves you. The addict that has taken over her body doesn't like anyone that cannot further her goal, which is to get high.


Thanks again, Sarah and I don't mind hearing that I am not doing the right thing if you feel you need to tell me that.
IMO There isn't a right or wrong. Each family, each situation, and each individual is different. It is easy for armchair quarterbacks to tell you exactly how they would handle it if THEY were in your shoes. Well, guess what, they DON'T know because they are not in YOUR shoes. Even if they have an addict in their family, that doesn't mean they are in YOUR shoes. As long as you do the best you can with what you have, you are not doing anything wrong sweetie... and don't you let anyone tell you otherwise. We parents of addicts are tossed into the ring without ever signing up for the fight.. we do the best we can and hope we can survive the battle. If we do that, however we did it is right.
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Old 07-17-2011, 05:00 AM
 
8 posts, read 13,081 times
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Quote:
Originally Posted by SouthernSarah View Post
Mary was only given one weeks dose of the Suboxone and must return Monday for some more. She is supposed to get a month's supply on Monday.

ETA: Sarah, I am sorry I messed up the color on this message, but I am so tired that I don't feel up to changing it. I hope it isn't too hard to read. Thank you for all your understanding.


I apologize. i thought she had a month's supply. Honestly, if she only had a week's worth and the dosage is too low she may have taken them all because to not take extras threw her into withdrawal.
[COLOR="rgb(0, 100, 0)"]I asked her if the withdrawal was too hard on the Suboxone when she first started taking them and she assured me it wasn't too hard. It wasn't perfect but it was so much better than cold turkey. But then she could have already been taking extras. If she would only tell me the truth, I could help so much more.


Suboxone has a huge street value because it blocks withdrawal. All serious opiate addicts like to keep some on hand in case they cannot find drugs.
BUT it is entirely possible with only a week's supply, that your daughter's start dose was not high enough and she was getting sick, so she doubled up. It would also explain the rage you spoke of. If she doubled up and ran out she is hurting right now, and yes, if she plans to go out tonight it is probably to seek out drugs to stop being sick. [/color]

There is no need to apologize. She may not have had enough of the meds. I don't know. She said she took 20 to 30 Vicodan a day and she has been using it for 5 years. She did not go out tonight. But we are very suspicious. She does not appear to be in withdrawal and actually was quite happy for the most part for the short time she spent in the house tonight. Most of the day and evening was spent out on the screened in porch. We think you were right about her using. We think she may have had one of her contacts bring her some Vicodan or something to the back of the house. It would have been very easy to do.

He may be the kind of doctor who does the right thing and won't write another rx or he may just be running a drug mill.

If she only had a week's worth and doubled up because she was getting sick he may just up her dose until it keeps her from getting sick. My son's doctor is amazing. He meets with patients for a three hour initial visit in which he gets a complete drug, life, heart, and soul history. He gives them the first dose in the office and he calls them the next day to see how the prescription is working. If they are hurting he tells them to come pick up an additional script for more so they can take more each day initially. He is awesome at understanding what to do to get them on a maintenance dose. His own brother died of an opiate overdose and he is committed to helping.
My son started out with 4 wafers a day and has now weaned himself down to one half of one wafer a day.
Again, I thought your daughter had a month prescription and ran out in a week. I am sorry. Please don't rush to condemn her with her doctor. If it is her first week, she may just need more than she received, especially if she lied to the doctor about how bad her addiction is. For example, claiming to take two Vicodins a day, when she actually was taking several morphine tablets a day for months on end.


[COLOR="rgb(0, 100, 0)"]She did not lie to the doctor about how much Vicodan she took. My husband was with her and she told the doctor she took 20 to 30 a day and the doctor asked her how she could afford that many. But actually, it may have been a lie....because possibly part of them may have been to help supply someone else...which is another part of the mystery I haven't mentioned......we know in the past she has "bought" friends. And we know there is a "friend", who didn't want her in treatment and also supposedly has $2500 of her money. We are not sure about the truth in this story. There are so many lies[/color]



We have told Mary we will be the ones holding her rx bottle and dispensing them one at a time.
she is only prescribed one a day???? that is not even a normal starting dose. Most patients start out with 2 or 3 a day and then are weaned down to 1 a day in a few weeks or months. Because my son was injecting heroin several times a day for a couple of years they started him on 4 a day and he weaned himself down to one half of one.
Sounds like she needs to find herself a better doctor. For some it is a money game only.

[COLOR="rgb(0, 100, 0)"]Your son is doing fantastic! Mary is prescribed two a day. I think Mary needs a better doctor, you are right. But at the same time I don't think she wants to get well.


Long ago, about a month after my son got on suboxone he went to work one day, and while he was gone, a friend of his girlfriend's came to his apartment and partied with his girlfriend. the friend overdosed, went into a coma and was in a vegetative state for six months. (thank god she lived, because they predicted she would not) She is fine now and back on drugs partying like a rock star (eyeroll)
Anyway, the day after it happened I called the suboxone doctor and said I was worried my son would relapse because he walked in from work and found the girl on his living room floor barely breathing and in a coma.
The doctor immediately called my son and had him come into the office and sat and talked with him for two hours about not relapsing and working through the grief of what he walked in on. etc etc. THAT is the kind of doctor your daughter needs. I hope you can find another doctor for her. [/color]

IDo you know how long the withdrawal will last?

Honestly, if she gets tossed off suboxone and does not enter rehab I highly doubt she will stay clean, but it COULD happen. The actual physical withdrawals should start to dissipate in about seven days. The anxiety and depression from the chemical brain changes due to opiate abuse can take 12 to 18 months to rectify. If she stops suboxone, encourage her to enter rehab, or see a therapist etc.

[COLOR="rgb(0, 100, 0)"]Yes, we are making arrangements for her to see a therapist this week.[/color]

The doctor is definitely "shady" as he billed Mary's insurance company for a level 5 office call and also for "smoking cessation".

This has me concerned. I don't know what state you are in but I do know the federal mandates for doctors treating opiate addicts include special training and serious record keeping to turn in to the feds. Smoking cessation?? have you checked with your state licensing office to be sure this doctor is actually vetted to treat with suboxone?

[COLOR="rgb(0, 100, 0)"]We got the name of this doctor off of the Suboxone web page.[/color]

Also, I think Mary pulled a "fast one" in order to get the insurance company to approve the Suboxone. I really do not understand exactly what happened, but the insurance company denied the rx at first and then Mary had my husband take her back to the doctor's office to change the paperwork and this change had something to do with the lying and saying the doctor prescribed Valium or something of this nature. I am really not clear about this issue and I know I am not explaining it properly. I told her the doctor needed to be turned in for overcharging the insurance company. But this is another issue.

Holy moly, it sounds like this doctor is a criminal. I hope your daughter finds another one. If he is allowed to prescribe suboxone there should not be a problem with the prescription unless your daughter is insured by a company that is self insured. But it sounds like the insurance company paid the suboxone prescription after it was called smoking cessation??? Suboxone has one purpose. Treatment for opiate addiction. This makes no sense.

[COLOR="rgb(0, 100, 0)"][/color]
If Tom does divorce Mary and she does not obtain a job that provides insurance or qualify for Medicaid (does Medicaid pay for Suboxone?), then Mary is going to be in a world of hurt because my husband and I cannot afford $100 a week for the Suboxone. Mary takes two tabs a day due to her size.

I don't know if Medicaid does or not. We live in Nashville and our state has something called Tenncare, and Tenncare used to pay for Suboxone, but stopped last year. It put a lot addicts in trouble, and they are back on drugs as they cannot afford the suboxone. I have always paid for my son's. I am not wealthy, in fact currently I am dirt poor, but the suboxone saved his life. He works full time, does not take drugs, no longer goes to jail, dropped all his drug connects and goes to church. I would rather pay it than have him not able to take it due to the cost. He helps me when he can and it is why he weaned down to 1/2 of one a day. The cost was killing us. I don't think size has anything to do with it. I think they start everyone on at least 2 a day but she should be able to wean down to one a day within a couple of weeks and then it is only $50 a week. Is she working? Once she is stable on a dose she can get a job and pay for it herself.

Her UE is $300 a week for 12 more weeks. She has no more extensions left (as I understand). She spends a LOT of time on the back porch smoking and doing something with her cell phone.

Texting people looking for opiates? LOL

[COLOR="rgb(0, 100, 0)"]She very well may be texting people looking for opiates.

Our seminar outlines the top behaviors of a drug addict... and in that list is constant phone use. Short calls that last less than a few minutes. TONS of texting that eventually lead to the addict remembering he or she has to go somewhere RIGHT NOW...
Do you have a computer she could use for applications? If so, I would be suspicious of her constant phone use. If not, she may well be applying for jobs.
[COLOR="rgb(0, 100, 0)"]Yes, I have offered her the computer many times. She has started chain smoking and we do not allow smoking in the house and as a nonsmoker I really wish she wasn't doing in on my screened in porch as the porch is completely walled in on three sides and only one side is screened in and the smoke does not dissipate.[/color]

My concern is it doesn't sound like she came to you on her own wanting help getting off drugs. It sounds like her husband dumped her at your door and drove away. If she has not decided its time to get clean, then ALL of her behaviors are suspicious to me. Just lots of experience with addicts through our seminars tells me that. [/color]
[COLOR="rgb(0, 100, 0)"]She does not want to get clean. Not once has she said that she wants to get clean. I realize this now, looking back. We just talked her into it and I think she agreed to the program because she knows she can't stay here if she isn't trying to get clean.[/color]

Mary told me she knows how to pass the drug tests for job interviews and told me how she does it and where she buys her supplies to do this.

Yup, You can walk into any vitamin store and buy something called a mask. It claims to be a body cleanser, but in actuality it is designed to pass drug tests. Some of them even have inserts that state if you fail a drug test after taking the product, the company will double your money back as a refund once you send them the failed test. You drink it within two hours of taking a drug test and you will pass the test. The product provides a mask for the drugs in your system. If the test is sent off for more advanced testing, the mask shows up, but for simple job, probation or sports testing the mask does its job and they pass the drug test.
She may also be using home remedies.


[COLOR="rgb(0, 100, 0)"]Mary told me she passes the drug tests by using something else and I don't know if I should say it on a public forum as it may give other addicts the idea, but then again, maybe all the addicts already know of her method. If you are interested in knowing how she does it, I can PM you.[/color]


I am certain the jobs she is applying for are in the medical field. I know she should not work in the medical field, but I don't feel I can even try to control this.
exactly. Plus, she can get drugs on the street if she wants them. It is all within her control.

Mary blames us for running out of her meds early. Mary blames everyone else for all her mistakes.
They all do. Close your ears, go to a new movie, take yourself out to dinner and be glad you are not the addict. It is a rough road, but it is HER road and her problem. You didn't cause it and you cannot fix it.

[COLOR="rgb(0, 100, 0)"]We do not dare both leave the house and leave her here by herself. About a year ago on one of her infrequent visits we had several hundred dollars turn up missing. It vanished out of thin air. Also, she has totally cleaned out her family's bank account. Her husband has made over $80,000 so far this year. She has even gone so far as to hock her daughter's Apple computer and her son's gaming system.

Also, approximately a year ago, her mother-in-law told us Mary stole a few thousand dollars from her.

Mary's 10 year old son told me the other day that they are very poor and do not have food a lot of the time because Mary spends all the money. [/color]
[COLOR="rgb(0, 100, 0)"]Thank you. I know I did not cause this and I am not taking it personally.[/color]
I know Mary is not serious about getting well right now, but I want to give her a chance.
I understand more than you know. It is why I originally offered to buy my son's suboxone. I wanted to know if he decided to quit he had the tools to do so.... that if he stayed on drugs it was because he wanted to, not because he didn't have access to treatment.
Unfortunately, until Mary chooses to get well, she most likely won't. this is such a hard road for you and any parent who finds themselves dealing with an adult addict. If you haven't been here you have no idea what it is like. Just know that someone out here knows how you feel, knows what its like and wants you to know I care.
[COLOR="rgb(0, 100, 0)"]We are realizing more every day just how sick she is, both addiction-wise and also emotionally. I am going to tell her Monday that she needs to give me her Unemployment card to hold along with the meds. She is not going anyplace without us right now and if she does need to use the card then she can have it back. My husband and I stayed up most of the night discussing this and as I already said she is most likely using drugs again and if she is, she will want access to her money for this purpose. If she is not using, then she really doesn't need to have the card with her all the time. There are not any ATM's in this house. Mary knows I am honest and would not steal from her, so if she is not planning on giving the card to someone to take to an ATM in order to take out money for drugs, then she should not have a problem with me holding her card. I would not have even thought this would be necessary, but Mary has already lied to us and continues to lie to us about so many things and she already messed up once and took extra Suboxone and then lied to me when I asked her about it. We have zero trust and are not going to allow her to stay her and use drugs illegally. She can only stay with us if she is serious about getting clean. [/color]

Thanks again, Sarah. You don't know how much help you have been.

Last edited by Lookingforanswers2; 07-17-2011 at 05:03 AM.. Reason: The color is messed up....
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Old 07-17-2011, 10:17 AM
 
719 posts, read 834,181 times
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She has gone through enough money in the past year, from your description, that I wonder if she is on something in addition to Vicodin. It's possible I guess, but typically, when they are going through that much money they are on something stronger and more expensive. (diluadids for example) Oxycontins are also very expensive on the street, however, the manufacturer recently tweaked their composition, making getting high from them much more difficult, so lots of addicts are jumping off the oxis and jumping onto dilaudids, morphine or heroin. Time will tell and it really doesn't matter WHAT drug she is on, the result is the same. I commend you for all you are doing in the effort to protect yourself as well as help Mary. Someday, she will realize what her addiction does to the entire family. Until then, as you know, it is the battle of a lifetime.
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Old 08-11-2011, 10:25 AM
 
Location: Texas
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Just a quick response in defense of the doctor- if she feared the insurance wouldn't cover the suboxone, then setting the appointment under the guise of "smoking cessation" was likely the best way to get the visit covered and not cost her $300. In most states, doctors are required to attend special training before they can prescribe Suboxone, so he is a specialist and likely knows that he is bending the rules to best treat his patients. As a healthcare provider myself, I can say I have very high ethical standards but lose sleep over the hurdles that the government and insurance companies require me to jump in order to provide the best patient care- when it cones down to it, I choose my patients every time! An intermediate or high level visit isn't always about the time spent; we can use that code for the initial visit- there's often more that goes into a first visit than just the face to face time. I've never met another provider who spends 5 hours in an office visit, unless they're doing psychological testing or something, but that's an entirely different code. As long as he's not using that code for every visit I would give him the benefit of the doubt. Giving her weekly meds, trying to help her get the visits covered, etc makes him sound like he has her interests at heart and not insurance and regulations which puts him on the good side in my book. Always be cautious, of course, but like I said, there nay be good reasons. Thanks!
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Old 08-11-2011, 03:45 PM
 
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Originally Posted by Rumplesolsken View Post
Just a quick response in defense of the doctor- if she feared the insurance wouldn't cover the suboxone, then setting the appointment under the guise of "smoking cessation" was likely the best way to get the visit covered and not cost her $300. In most states, doctors are required to attend special training before they can prescribe Suboxone, so he is a specialist and likely knows that he is bending the rules to best treat his patients. As a healthcare provider myself, I can say I have very high ethical standards but lose sleep over the hurdles that the government and insurance companies require me to jump in order to provide the best patient care- when it cones down to it, I choose my patients every time! An intermediate or high level visit isn't always about the time spent; we can use that code for the initial visit- there's often more that goes into a first visit than just the face to face time. I've never met another provider who spends 5 hours in an office visit, unless they're doing psychological testing or something, but that's an entirely different code. As long as he's not using that code for every visit I would give him the benefit of the doubt. Giving her weekly meds, trying to help her get the visits covered, etc makes him sound like he has her interests at heart and not insurance and regulations which puts him on the good side in my book. Always be cautious, of course, but like I said, there nay be good reasons. Thanks!
Thank you Rumple! This makes a lot of sense and I appreciate your knowledge and input!

My daughter is not living with me any longer and is not in contact. She is now living with her brother's wife. The brother is out of town a lot for work so really she is not with her brother.

We decided that she had found a source of drugs and think she had someone bring them to her at our house (back porch). There are several reasons why we thought this and it has become even more apparent since she left.

I asked her if she was using drugs and she didn't say no, but said I was kicking her out. This was not true, I was not kicking her out. She said she couldn't get well at our house, which I am sure is true, because of the mistrust all the way around. Also, we do not really think she wants to get well at this time.

I know that the situation will not work out with her brother/brother's wife for the long term and I doubt her ability to find and keep a job at this point in time, so I am worried about her future.

I am afraid we are going to get a call one day, either her saying she is living on the streets or a call saying she is dead.

I feel bad for her and her children/husband, but don't know what I can do at this point.

Thanks again for your input and for clearing things up.
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Old 08-13-2011, 05:47 PM
 
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Originally Posted by Rumplesolsken View Post
Just a quick response in defense of the doctor- if she feared the insurance wouldn't cover the suboxone, then setting the appointment under the guise of "smoking cessation" was likely the best way to get the visit covered and not cost her $300. In most states, doctors are required to attend special training before they can prescribe Suboxone, so he is a specialist and likely knows that he is bending the rules to best treat his patients. As a healthcare provider myself, I can say I have very high ethical standards but lose sleep over the hurdles that the government and insurance companies require me to jump in order to provide the best patient care- when it cones down to it, I choose my patients every time! An intermediate or high level visit isn't always about the time spent; we can use that code for the initial visit- there's often more that goes into a first visit than just the face to face time. I've never met another provider who spends 5 hours in an office visit, unless they're doing psychological testing or something, but that's an entirely different code. As long as he's not using that code for every visit I would give him the benefit of the doubt. Giving her weekly meds, trying to help her get the visits covered, etc makes him sound like he has her interests at heart and not insurance and regulations which puts him on the good side in my book. Always be cautious, of course, but like I said, there nay be good reasons. Thanks!
I believe ALL states require suboxone doctors to go through the certification process. I still question a doctor who lies to an insurance company, especially in light of the fact that all the big ones, BCBS etc cover it.
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Old 08-18-2011, 03:26 AM
 
Location: Minnesota, USA
7,548 posts, read 8,356,212 times
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My brother has a severe opiate dependency, and he and his like friends have impoverished our family. Some recommendations:

1) Replacing one opiate or narcotic with another is standard protocol for treatment centers. Stopping an opiate immediately is extremely unpleasant and probably unlikely to be successful in the long-run. As far as I know, she will be administered lesser doses of suboxone over time until she is completely weaned off of opiates.

Voluntarily choosing to go to treatment is a very good sign. We have tried to get my brother into treatment several times to no avail.

2) If Tom divorces her, she may qualify for state-run low or no-cost medical insurance programs, especially considering that she has no assets and will soon have no income. In Minnesota, these cover the costs of drug rehabilitation; I would expect them to in other states as well. She may also qualify for food stamps, but she would probably have to live on her own to get those.

3) Whether to take her in or not is a decision that only you and your wife can make. As with other compulsions, opiate-dependent people will do anything and everything to feed their habit, regardless of the effects on others or themselves. She is in treatment, which is a positive: however, if she decides to discontinue treatment, or relapses during treatment, you will have a very difficult situation on your hands that could very well ruin your life.

4) What a mess!
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Old 08-18-2011, 03:32 AM
 
Location: Minnesota, USA
7,548 posts, read 8,356,212 times
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Quote:
Originally Posted by Rumplesolsken View Post
Be honest about everything, don't let this become anyone else's problem but hers (easier said than done, I know) talk to the insurance about other treatment options, and let them know about her psychosis and paranoia- she sounds like she could meet criteria for inpatient based on what you're telling me- so perhaps you should try again to get her admitted based on her psychiatric needs as well. She doesn't sound very committed, and until she is there's not much you can do except tell her you aren't going to help her kill herself, but that you will fully support her efforts to get clean. Go to al-anon, it will help a lot! There's so much you are dealing with and I think you will find a lot of support and answers there. Take care!
My brother, an opiate addict, is an excellent manipulator and pathological liar. He certainly does not have a psychosis or paranoia - but manipulates my mother into thinking she is in the wrong when her actions are perfectly reasonable. This may be a possibility.
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