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xjunkie4jesus

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May 12 14 2:29 AM

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They started me on 8mg of Suboxone last Tuesday-6 days ago. I'm almost always crampy and nauseas and just feel like something is "not-quite-right" mentally-very amped-up but not panicky, more like overwhelmed and disorganized. They label this symptom "Malaise" defined as "the general feeling of being unwell or 'out of sorts'". It's pronounced "muh-laze". MY QUESTION IS: Do you think an increase to 12mg is unreasonable to request tomorrow at the 7-day follow-up??
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sapphire76

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#1 [url]

May 12 14 5:36 AM

If you're still having WD symptoms and are not comfortable for 24+ hours, they you could try an increase. Are the symptoms opiate related, or is it just taking a while to adjust to a medication that is very different from methadone?

This was what I was trying to explain to you about on MSO about the difference between Suboxone and Subutex, because of the Naloxone, it makes a lot of people feel 'weird' like something is wrong but they can't quite put their finger on it.

It could be that an increase will fix this, but if it doesn't, it could be worth considering that Subutex might be more suitable, particularly as you have bad anxiety problems anyway (which Suboxone can make worse).

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xjunkie4jesus

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May 12 14 11:39 AM

MaineCare/The prevailing mentality here

MaineCare has decided they will NOT cover Subutex without proof of a Naloxone allergy OR pregnancy. This is because of the perception that people ask for it so that opiates will still get them high AND it's easier to sell or misuse. Docs have made this "common knowledge" and everyone believes it. So, MaineCare listens to half (or less) of prescribers on this issue and won't cover it except in those special cases-AND IT SAVES THEM MONEY!

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mythoughts2

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May 12 14 9:26 PM

That shit burns me up! I spoke to one of the best doctors in the country who deals with Hepatitis and MMT and she said that the Naloxone is bad for people with liver disease....with is 80-90% of prior IV drug addicts and many people who need bupe. Then I asked my transplant team in SF and they said to avoid the Naloxone. So if I lived in Maine and wanted bupe, I'd just be screwed. To top if off, I have anxiety issues. So you don't want people taking benzos (though reasons may be legit) and then you also give them a med that increases their anxiety. Are you Fing STUPID??!! I' fuming.

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xjunkie4jesus

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#4 [url]

May 13 14 7:25 AM

They increased my Sub dose today

Well...They increased me from 8mg to 10mg of Suboxone this morning. I go back in 2 wks. I'm ok with this because I want to stay as low in dose as possible-BUT-I WILL NOT ALLOW MYSELF 2 BE MISERABLE EITHER!! I guess we'll see what it takes but I have SOME hope about 10mg.

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xjunkie4jesus

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#6 [url]

May 14 14 8:48 AM

The reason 4 caution

The reason they go slow is because MaineCare ONLY PAYS 4 A MAX DAILY DOSE OF 16MG! Rediculous, yes. However, it's better than nothing! Gotta take what I can get and be grateful that they didn't flat-out refuse 2 pay for it altogether! :/

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xjunkie4jesus

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May 15 14 3:52 AM

The rediculousness of this

The doc doesn't "want to max out the potential of beneficial effects because I (he) want(s) to leave room to increase ONLY when and IF it becomes necessary for stabilizing you (me)". In other words: We've got to keep your body as satisfied with as little as possible because MaineCare only pays for up to 16mg. SAD STATE OF AFFAIRS HERE IN MAINE!! :( Gee: Thanks, Governor Lepage!! Now the taxpayers are only paying for substandard treatment because you won't allow patients' individual doctors to decide what we need!! Well, you better allow for A LOT OF EXTRA FUNDING FOR CORRECTIONAL FACILITIES AND PROSECUTION!

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sapphire76

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#9 [url]

May 16 14 3:40 AM

This whole MaineCare thing is ridiculous. However, as far as Suboxone goes, when you start getting to doses above 16mg the antagonist part starts to over take the agonist part. Even so, it's plain crazy not to give patients the choice of going up in dose if they need to.

Has anyone tried challenging this ruling legally?

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wayovermyhead

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May 18 14 9:03 AM

This is so ridiculous....I do not think I know of any prescription that has a maximum coverage except on things that are considered luxury or enhancement being not "as necessary" such as Viagra etc...meaning you can have I think between 8 to 10 Viagra a month allowing a sex life of 2 to 3 times a week lol. I think that is terrible to put a limit on someone's sex life but this that we are engaged in is not enhancing us or something we can DO WITHOUT...This is a serious as any medication disease foreboding and/or can make a difference in LIFE OR DEATH.... If Suboxone or Methadone is not adequately dosed this person is IN DANGER of relapse or combining medications to potentiate. WTF!!!

NOW AS FAR AS SUBOXONE OR SUBUTEX IS CONCERNED....(unsure of what dose of methadone was adequate for you)...This medication does not work as well on patients that needed much more than 80/100 milligrams of Methadone. If you are struggling at 10 or 12 milligrams and 16 is the highest they want to pay for.......Well, just as quick as the doctor realizes you need more than your insurance is willing to cover...any reasonable doctor would say okay...this medication is very expensive and if insurance is not going to pay for what you need in keeping you stable on this i.e. a maintenance medication, we need to switch you on to a drug more cost effective but also keeping with the purpose of being maintained and stabilized...i.e. methadone. Doctors know that insurance companies have limits per say but there is more than one way to get around that.

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sapphire76

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#11 [url]

May 19 14 3:32 AM

I just can't believe that Maine has got away with doing this. Ultimately it is going to cost people their lives. I wonder if there would be a way of challenging the 2 year limit and the dose limit of Suboxone legally?

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xjunkie4jesus

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#12 [url]

May 19 14 5:17 AM

CAN get time extended, NOT dose

Because I had surpassed my LIFETIME limit of 2 yrs, the doc had to submit a request for more treatment with Suboxone. They will NOT pay for additional time on Methadone. As far as Suboxone DOSE, they will NOT budge on that. There is NO dose limit on Methadone but the 2 yr limit kind of limits you because you have to account for a longer taper out of your 2 yr limit (LIFETIME)!

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sapphire76

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#13 [url]

May 20 14 4:14 AM

So even if a Dr would sign something to say that your life was at risk if you were to come off MMT, the state would still boot you off?

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xjunkie4jesus

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#14 [url]

May 21 14 12:51 AM

Gov. Lepage doesn't care-more dead, less 2 pay 4

Yes they would STILL "boot you off" of Methadone and switch you to Suboxone which CAN be extended beyond your 2 YR LIFETIME limit. The reasoning is: You knew when you started Methadone Treatment that you only had 2 yrs so if you don't taper off within 2 years, that's YOUR problem!-REDICULOUS!!!!

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shelly6906

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#15 [url]

May 21 14 4:38 AM

QUESTION ???

I'm just wondering? What if you did the suboxone treatment frist instead of methadone would the same rules apply ? Or you had to start the methadone treatment frist, and you don't have a say so in it? It's just to bad that you can't travel to another city or state to stay on MMT .

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sapphire76

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#16 [url]

May 21 14 6:46 AM

Good question Shelly! Wonder why they are allowing people to extend on Sub and not methadone? Methadone is actually cheaper than Sub, so the cost argument doesn't stack up. Maybe they've been lobbied and paid for by the Sub companies?! Backhanders all round probably!

In Maine in 2012, there were something like 4 child ingestions of methadone, and 86 of Subs, so it doesn't really hold water that Subs is 'safer' than methadone either.

So if it's not safer, and it's not cheaper, what exactly is their reasoning behind not allowing it?

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wayovermyhead

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#17 [url]

May 21 14 10:05 AM

WHAT THE REAL ISSUE HERE IS.........

xjunkie4jesus wrote:
Yes they would STILL "boot you off" of Methadone and switch you to Suboxone which CAN be extended beyond your 2 YR LIFETIME limit. The reasoning is: You knew when you started Methadone Treatment that you only had 2 yrs so if you don't taper off within 2 years, that's YOUR problem!-REDICULOUS!!!!

THE ISSUE IS PHARMACY.........BIG INDUSTRY.....MONEY........GOVERNMENT.......POLITICS....It would not surprise me if Rickett Benckiser owns the State of Maine or vice versa...but there is something behind it all...they probably pay her campaign etc....

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xjunkie4jesus

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#18 [url]

May 21 14 1:14 PM

Do u mean Reckitt has some kickback payments to Maine??

I know we really can't know 4 SURE, but are you saying it's possible that maybe Maine agreed to strong arm it's patients onto Suboxone in exchange for some benefit to The State of Maine?? It's just odd to me that instead of the $60/wk the clinics accept from the state Medicaid (MaineCare) as payment, the state is using policies to push us onto Suboxone which they pay $9.50 per 8mg strip ($19) and we have to pay $3 per Rx whether it's a 7-day supply or 30 days worth-STUPID, USELESS COPAY!

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sapphire76

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#19 [url]

May 23 14 3:32 AM

Yes, there is definitely some kind of financial incentive involved for Maine to only be allowing people to extend treatment on Subs. As I said in another post, it's not cheaper, it's not safer, so there has got to be a reason that the state is pushing it over MMT, and that reason is likely to be financial kick backs.

I really would like someone, or a group of pts challenge this in court, as no other area of medical care would allow it's pts to be treated like this.

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wayovermyhead

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#20 [url]

May 25 14 9:46 PM

In a nutshell that is exactly what I mean....

xjunkie4jesus wrote:
I know we really can't know 4 SURE, but are you saying it's possible that maybe Maine agreed to strong arm it's patients onto Suboxone in exchange for some benefit to The State of Maine?? It's just odd to me that instead of the $60/wk the clinics accept from the state Medicaid (MaineCare) as payment, the state is using policies to push us onto Suboxone which they pay $9.50 per 8mg strip ($19) and we have to pay $3 per Rx whether it's a 7-day supply or 30 days worth-STUPID, USELESS COPAY!

Physicians get pay off's from pharmaceutical companies to exchange patients scripts from one kind to their kind etc....I worked for an Ortho doc who the pharmaceutical reps would bring in massive doses of trial packets of their product to hand patients out and every patient a doc could transfer over to their meds he would get points and a check cut quarterly determined on the point amount.....

It would not surprise me if this govenor is not getting her wallet padded by Rickett Benckiser and/or campaign helped in some way etc....just sounds too fishy..thier is some kind of reason why maine wants to force sub on patients...when Methadone has 50 years of evidence and bupe doesn't....

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