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Cost of Subutex/Methadone therapy in different countries
Cost of Subutex/Methadone therapy in different countries
I am quite surprised at how expensive and at times difficult it seems to be to get Subutex/Suboxone and Methadone therapy in USA. I've seen Sicko (looked too black and white for me) and that movie with Tupac Shakur and Tim Roth trying to find Methadone therapy. Not that movies show reality but looks like you guys do have to put in serious effort and pay a lot for medical services and meds to combat addiction.
I've been on Methadone in 3 countries (Slovenia, Thailand, Cambodia). In Slovenia I got it for free, 1 week waiting, mandatory daily visits for 2-3 months, then weekly dosages and travelling dosages (up to 6 weeks' supply).
In Thailand and Cambodia there was no waiting period, I paid about $6 for the visit and meds and in both cases immediately got 2 week's supply in a cute bottle with lines for easy daily dosage.
Btw, Xanax and such is not free here but costs very little, about $10 for 2 × 1mg boxes (60 pills), in Thailand you can buy it in a pharmacy for about the same, no prescription needed.
In the beautiful anything goes country of Cambodia the concept of prescriptions did not exist as related to private pharmacies when I was there and they had some pretty hardcore stuff over the counter, probably even some mild opiates but with high purity white H so easily available there I never bothered to ask.
Subutex is also free of charge here, you just need the most basic medical insurance which is free for citizens and which foreigners can take out for about $50 for 3 months. No waiting for Subutex for some reason, it seems doctors perceive you as more committed if you ask for Subutex rather than Methadone.
A few years ago a photographer friend from UK was staying here to cover the Balkan circus and managed to get hooked on heroin, he was accepted into Methadone program without a hitch within days.
I understand in US you have to invest much more to get into Methadone or Suboxone therapy.
Anyone from other country willing to shed some light on the subject? I'm looking for info on situation in Spain and Brazil in particular.
I found you post VERY interesting. Thank you for sharing. I am becoming nauseated over health care in this country (US). The health care companies have a monopoly, right behind the pharmacutical companies and they dictate who gets treated and how.
Case in point, just Monday I was prescribed Ambien CR for sleep- I go to sleep but wake up repeatedly during the night. Insurance denied it, only provides for regular Ambien which works about 4 hours. They told me to just take another one as I wake up during the night. Gee thanks...LOL Pretty soon we won't have drs, just appeals to our insurance companies for what they will allow. It makes me SICK.
I am with you totally greenday. It's disgusting that the large drug companies and insurance companies basically control our lives. I have worked in financial planning and insurance for decades and know exactly how it works. They are no different that a hardware store, only much larger and more powerful. They only care about a bottom line and how much product or service is produced.
The situation with drug therapies is appalling. I know in my own situation my insurance company, who I freakin work with, would pay for all of the opiates and benzos and all the trash the doctor would write prescriptions for. But when it came to recovery it would not recognize Subutex or Suboxone therapy for treatment of my addictions. So they would pay for all the drugs I wanted, but not for me to get well. That's horrible.
They say addiction is recognized as a disease in this country, but it's nothing more than a business for the drug companies and the insurance companies to earn profits from with sales. We judge addicts on a moral basis rather than working with them to try and save their lives. What a confused group of people we have making the decisions in this place.
Yep...take Suboxone for example...I hear all these different prices. Here is VA it was $400 for the initial dr visit and $400 for the initial prescription (was one of the reasons i didn't go that route). Apparently it varies depending on where you live. Why is that? It is disgusting. Probably cost like 5cents to make it. Don't get me started...LOL
Wow, that is some amazing information, further reinforcing the fact that the United States has an extremely messed up health care system and that those in charge of our government really don't give a ******************** about American citizens, wheras the almighty dollar continues to be much more important.
To shed some current light on the suboxone/subutex situation here... I am currently paying for my 18 year old son's treatment. The first doctor we went to that was licensed to prescribe suboxone, charged $400 for the first visit and I payed $155 for one weeks worth of suboxone. Needless to say, it didn't work out for my son, he relapsed and I was out the money.
A month or so later, his situation became much worse and he voluntarily went in to inpatient detox which cost $1500 a day for 7 days. My share is $2000 and insurance will cover the rest. He got out of the hospital 2 days ago on 32 mg of subutex daily with a one month script. The months supply was almost $800, my share was $225. I am currently searching for a doctor to monitor him and continue his prescription. The first doctor I called charges $750 for the first month, cash only (doesn't include the medicine). The three following months is at $350 per month for one visit and then starting the 5th month, the cost is $250 a month for one visit. For some odd reason, that I can not figure out, not a single suboxone/subutex doctor accepts anything but cash for their services!! Take these monthly charges, plus my share of the $800 a month for the script, add on the cost of out-patient therapy and the traveling out of town to see the doctor at $4 a gallon for gas and well, you got it... bankruptcy But, a mom has to do what a mom has to do.... it's called love!
Guess what? I'm moving out of country...lol
shocking, to say the least, how expensive sub therapy is. Most addicts probably can't afford it in one go and stay on the streets, how prohibitively high costs of addiction treatments benefit the society is beyond me, to the best of my knowledge no European country charges any substantial amount, if anything at all, for methadone or subutex treatment, the reasoning is that such programs reduce crime and infections, which has been proven. There is also no pressure to get off methadone or subutex in most European countries, again same logic as above, but motivated patients who do want to kick get free psychotherapy and until recently we even had free gym membership in this country (not that it was the fanciest gym in town, but I'm paying $100 a month for gym now).
The reason I mention gym is because your son should start working out, it is amazing how quickly and to what extent exercise (proper aerobic exercise + some weights) restores natural endorphine production and improves general well-being mentally and physically. It prevents depression, which often accompanies even partial detox and also helps boost the immune system. I don't know why, but for some reason many addicts get clean and soon afterward experience some medical problems, perhaps symptoms were blocked by opiates, at any rate exercise helps and you should push your son to start working out and if you can afford it, take him to a dentist, chances are his teeth are in bad shape.
Most importantly, your son should not stay on subutex/suboxone for too long as he will get addicted to subs and the longer he's on meds and the higher the dosage the longer and more painful withdrawal will be, assuming he does not plan to be on subs forever (which in some cases seems to be necessary, relapse risk is high as you know).
32mgs sounds like a lot, probably too much, sub has a "ceiling" effect on 30mgs, i.e. anything more than 30mgs doesn't do anything. For most people 16mgs is more than enough while stabilizing and some people actually feel better on lower dosages. I suspect your son is still in addict's mental state and asked the doctor for max dosage fearing wd symptoms. Read as much as you can on sub so you know what you're doing.
You have to know that sub is a relatively new drug, many unknowns there, some people swear by it, others want to sue the manufacturer as they are unable to get off it. It is very subjective (like any drug), but what it certain is that it reduces if not eliminates wd symptoms and cravings, blocks full agonists like Heroin or Methadone and what is almost certain is that it should be used as detox treatment, not substitution therapy, otherwise methadone will do just fine.
What they often do in this part of the world is a rapid detox, either overnight (under anaesthesia) or over 1 week's time (somewhat uncomfortable but bearable) and once this is done they insert a capsule with opiate antagonist like Naltrexon with super slow release time in addict's lower abdominal area (small scar). What it does is it blocks heroin or methadone for 6 months or so, in fact if addict were to use it IV style he would experience severe wd symptoms and thereby his brains learns a new trick, he doesn't associate drug use with pleasure anymore. Cost of such therapy (detox + blocker) is about $1.500 for overnight, $500 for 1 week's method. If interested let me know and I will refer you to an excellent private clinic (no, I'm not getting a cut).
I would recommend this: you be in charge of your son's med intake. Taper down suboxone to the lowest level possible by means of increasing the time between dosages (sub has 37.5 hrs half time, i.e. after 37.5 hrs he still has 1/2 of what he took 37.5hrs ago in his system + whatever's left from previous dosages) so once he's on sub for a month he cannot be sick even 48 hrs after taking it. If you can taper quickly do so, if you (or he rather) cannot, keep reducing till you get to like 1mg or so, then you'll have to be crushing tablets (should probably do this from the start anyway) begin mixing it with something like aspirin and gradually keep reducing the active substance (sub) and increase the aspirin until he's getting nothing but aspirin for a couple of weeks. The placebo effect works, you can keep him on aspirin for a few years.
By the way, there are some non-opiate meds that are surprisingly effective at reducing wd symptoms. Clonidin is the best known such drug, otherwise it is used for hypertension and your doctor probably knows about it. A mild antidepressant might be needed, herbal is best, St John Wort or something, but a few Valiums won't kill him either as long as he doesnt start abusing benzos, then you will have an evern more wicked substance to detox from.
Important note: if risk of relapse is high, ask for an agonist blocker like Naloxon, Naltrexon etc. which he should take daily so if he messes up he suffers enough for his brain to do a U turn. As painful as withdrawal looks it is not life threatening.
If I were American I would definitely consider detoxing in another country, meds like Sub though are probably illegal to import so don't bother.
Finally, loving your son is OK, but bear in mind addicts are manipulative, keep a close eye on him and ask something in return for paying his medical bills. Have him build his life back, get a job, socialize with straight people, find a hobby, a girlfriend would probably help if he can get one.
Hello and thank you for info. Can i get subutex in thailand and can you please tell me where. I'm living in norway and here i use subutex, for 6 years now. I'm married to a lady from thailand and we planning to move from norway to thailand but i need my subutex. I see you wrote something about cambodia and since we live near the border to cambodia maybe i can go over there to get it. Very thankful if you will answear me.
You dont pay for therapy they give for you free if you go see your doctor and he makes a presciption of methadone or subutex
Now i stay in thailand for hollyday and i need to find subutex 8mg tommarow
i am in the uk and therapy is free over here if you can prove you are on heroin with a urine sample you are in. we have lots of clinics here giving methadone out you can get it from any doctor . but some doctors will not deal with suboxone but there is plenty of clinics who will and if you are not working you get it free for how long as you need it . but if you work it will cost you £7 a script aroung $4 every 4 days if you can get a takeout from the clinic ..but if you go everyday to the clinic to take your suboxone you dont have to pay working or not
try posting on here mate
Originally Posted by bangkoker
Last edited by ddcmod; 10-25-2010 at 02:56 PM.
I m actually in pattaya Thailand,
I went in a lot of pharmacy central memorial hospital and bangkok hospital,
subutex/subuxone are not allowed in thailand,
i go see a doctor in bangkok hospital he gave me methadone in sirop
1250 bath for the visit about 25/30usdollars
and after is about 120 bath for a bottle ( about 4usdollars) for a day 1 bottle
Dear Leito, I am actually in Vietnam but I am going soon to Cambodia where I need to be treated. Can you please indicate me the adress of where I can go to have Subo or Methadone???
Originally Posted by leiito
Your answer is very important to me. Thanks
Dear Leito... Or someone! I am going to bkk, and due to my addiction, i will need some kind of tatment, which means meth or sub.
Can you or nayone give me a contact?
Could you share your doctors contact? Inam going to BKK and i will be desperately needing some kind of meds due to my addiction.