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  • Methadone vs. Suboxone and an angry doctor

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    Old 12-13-2006, 07:50 AM   #1
    csk2098
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    Methadone vs. Suboxone and an angry doctor

    Hey evryone, I need some guidance. I recently lost part of my left foot due to an infection and complications from my diabetes. The doctor I was seeing at my pain clinic had me taking oxycontin and lyrica. Unfortunatly I was on the narcotics for so long that I have an addiction issue now, I talked to my dr. about this and he put me on suboxone. I am not able to tolerate the suboxone or subutex, I become violently ill on both meds. I went online and did some research on methadone, I then spoke with my pain mgt doc. He refuses to put me on methadone, and became irate when I told him about my fact finding expidition on MMT. He then "kicked me out" of his clinic, because he said that "HE" was the doctor and knows what is best for my treatment and will not deal with anyone that is willing to go "behind his back" in ref to rx info. I live each day with chronic pain from my neuropathy and a back injury from a 4-wheeler accident from 2 years ago. I am at my wits end, the closest methadone clinic is almost 2 hours from where I live, but I recently found out that there is 1 doctor in my town that prescribes methadone. Here is my dilemma, I don't know how to approach this doctor. I am afraid that if I go to him and ask to be put on methadone on my first visit, he will think that I am just trying to get a fix. Can anyone give me some advice on how to handle this.

    Thanks in advance
    Chris

     
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    Old 12-13-2006, 11:35 PM   #2
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    Re: Methadone vs. Suboxone and an angry doctor

    Hi chris, The way the meth laws were written, anyone dependnet on opiates is eligabl;e for MMT, However a doc can prescribe meth for pain, no doc is allowed to dispense meth in the US to treat adddiction in private practice. PM docs can use it to treat chronic pain but if his prescribing looks like a meth taper or you request meth for addiction or an alternative to suboxone or subutex, He can't prescribe meth as he isn't licenceds to run an independent meth maint proram for addiction.

    Suboxone would certainly make anyone ill that's physically dependent due to the naloxone in it. Even subutex is iffy the first few day because it's a mixed agonist/antagonist but doesn't contain the naloxone .Adjusting to subutex would have ocured in a few days and you may have been able to use it sucesffuly as a pain med. It's a shame it isn't used as a first line pain med before turning to meds that will inevatably cause physical dependence.

    There is a huge difference between simple physical dependence and addiction though. If you believe your are addicted and not simply dependent, that belief will prevent any doc from prescribing meth in privavte practice. You have to aproach it as an alternative med for pain control, and learn and beleieve the difference between dependence and addiction.

    The doc that released you obviously didn't believe there was a difference and simply equated dependence to addiction or some other actions to adiction. That meant he couldn't prescribe meth as an alternative if he has it charted your addicted, not just physically dependnet which is a given with any CP patient on long term opiates. It's against the law to prescribe meth in private practice to an addict. So everyone using meth for PM is certainly dependnet, but not addicted or labeled this way by their prescribing doc.

    You would have to aproach the doc that uses meth as a pure pain management alternative Everoyine that takes opiates is dependent, that doesn't mean they are addicted, what destructive behavior did you exibit, show or do while on oxy? Did it hinder you more than help. Did the negative aspects outweight the good. At what point did a physical reaction "dependnece" become a psychological problem or addiction?

    You have to realize every doc has their own opinion. Switching meds and calling you an addict simply because you are physically dependnet doesn't make sense without the behavioral aspects of addiction. Mis-use, non compliance, etc etc etc.

    If you feel you do need help with addiction, subutex, without the naloxone would be better than going cold turkey. Suboxone is used once the transition from pure opiate has been made to subutex and your stable. If he started with suboxone, he really doesn't know addiction management.

    You have two choices. Find a doc willing to give subutex another try once you are completely off the oxy a couple days. There may be other docs like shrinks that can do this locally.Or simply say BS, dependence doesn't equate to addiction without all the other factors that equate to addiction and pusue PM. If that's the case, I would just explain your doc wanted to switch you to suboxone, it made you sick, you asked about trying meth and he released you. You have to pursue one or the other, but you can't intermingle addiction treatment with pain management.

    Good luck,and that's why doc #1 knew he couldn't use meth if he has you documented as addicted. If you go to another doc and say you want meth for addiction, any doc will have the same problem .Meth can't be used for addiction except at certified MMT clinics. Wanting to try meth for chronic pain rather than oxyC is a completely different scenario and would be percieved as an alternative for PM. A doc prescribing meth for adiction in private practice is illegal and the clinic is your only choice for MMT for addiction.
    Good luck, Dave

     
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