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Office Based Opioid Therapy
Office Based Opioid Therapy
It seems that OBOT only uses suboxone for treatment. I do know that in NYC and in Baltimore, there are a few doctors that allow you to be treated with methadone. This way you go to the doctor's office once a month and they dispense methadone in diskette form. I know that in Baltimore I would get the 40mg diskettes and I was on 40mg/day. Plus he charges only $80/month (plus or minus a few dollars depending on your dose...methadone is a very inexpensive medicine especially compared to suboxone).
Unfortunately I was relocated to Florida and while I could continue getting monthly take homes, the price went from $80/month to $400/month. I still get the 40mg diskettes.
It's ridiculous that more doctors don't realize that they can apply to treat patients with methadone in addition to suboxone. It seems they don't want to go to the trouble of doing so, and many tell me it's illegal and you must go to a clinic. When I told them about Dr. Hayes in Baltimore and the doctors in NYC, they just shake their heads and say it's against the law. Well, obviously it's not, they just don't want to deal with it.
I'm a successful methadone patient and have been since 1985. I'm stable now on 30mg/day, and look at the medicine the same way I do with my Zestril (lisinopril) which I take for high blood pressure. I know I'll be taking it for the rest of my life (I'm 55), just as a diabetic takes insulin. I have a good job, a supportive family, and haven't taken a street drug or benzo in over 20 years.
But I'm forced to a clinic that charges exorbitant fees rather than get my prescription from a doctor where it would only cost a few dollars a month for the methadone.
If my wife didn't get relocated to south Florida, I'd be back in the Philly area in a second. The 100 mile drive to Baltimore once a month was well worth it, a caring doctor who thought it was a crime to charge so much for such a cheap medicine. I know the clinic here in FL tells me that the charge is not as much for the methadone as it is for the counselors, etc., but I don't need that anymore. OBOT you just go once a month, give a U/A to verify that you're still clean, and leave with your medicine. No counseling sessions, no group sessions. It's not for everyone, I realize a lot of people need the counseling and/or group sessions. But not everyone.
But the stigma attached to methadone seems too strong to break, even among medical professionals who could make things a lot easier for those of us that don't abuse their meds. How can Baltimore and NYC be the only 2 cities that allow this? It's ridiculous.
Thanks for the opportunity to vent! Happy Memorial Day to all and thanks to our men and women who are in our armed forces.
I decided to register after reading your story because I would like to hear more about your experience and opinions regarding this topic. I tried to PM you but was unable. If you could please PM on here or at the email address, email@example.com, it would be greatly appreciated.Thanks.
Doctors are allowed to Rx methadone and suboxone only for pain mgmt, not addiction, while SubO is used in Europe for pain mgmt it's still contraindicated for pain here in the US, there may be exceptions, but I think docs would have a major battle with insurance co's with billing as I believe they have specific riders in their policies re pain mgmt. Most doctors don't know a lot about methadone so they are leery about prescribing it, plus as you said there's also the stigma involved. PM docs are the exception.