Prescribed Butrans Then Test Positive for Suboxone
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melmaniam posted:
Hello everyone, I'm new to the site.

I have been dealing with pain most of my life and most recently have been diagnosed with Rhumatoid Arthritis, Osteo Arthritis, Enthesopathy, etc. My prior diagnosis were Spine disease, just "arthritis" and have had 10 knee operations, spinal taps, both rotator cuffs torn and basically gone from their normal location, torn biceps, ligaments, tendons and on and on. My Orthopaedic surgeon has been handling my pain needs with ever increasing doses of Vicodin and Percocet. Please excuse my spelling.

I recently was refered to a Pain Management Specialist by my Ortho. doctor. The PM Specialist started me on Butrans 10 mcg patches and stopped my other meds immediately. I was in severe pain almost immediately. Virtually every bone in my body hurt just to touch them. The PM Specialist changed my prescription to the 20 mcg Butrans patches. I had smoked a small amount of marijuana almost daily and informed her that I would quit immediately, which I did. The new dosage helped but still did not give me the relief I URGENTLY need since I still work a home business and am fighting off the mortgage co. to stay out of foreclosure. The next visit, one month later I informed her that I had quit the pot and she informed me that she could tell because my urine sample barely showed a trace. We discussed the effictiveness of the Butrans patch which she kept me on.

My next visit to my Orthopaedic doctor I was told that the Butrans was not strong enough for the type of pain I experience and I should be on something like Fentinal patches. I was planning on relaying this message to the Pain doctor the next visit but did not get the chance.

I called her office to get my appointment confirmed and was told by the receptionist that my appointment had been cancelled. I inquired as to why. She put me on hold and came back with the answer that I was discharged from the practice. I had to wait an hour and a half to hear back from her nurse, during this time I had the worse panic attack I had experienced in years. The nurses response was that I had tested positive for marijuana and Suboxone. I informed her that the doctor and I had discussed the trace of pot and I had never even heard of Suboxone. The doctor refused to talk to me at all, by phone or personally.

I contacted my family practice doctor and requested a complete drug screening which should be ready Monday. Today I received a letter from the Pain doctor informing me I had been discharged from her practice without explination and a list of other Pain Management facilities. She also noted she would be forwarding her treatment and notes to the one I choose. I guess my biggest concern is how in the world could I have tested positive for Suboxone when I had never even heard of it much less know what it was used for. I found out later after my family doctor's nurse looked it up and relayed the information to me. My panic attack lasted hours and finally subsided after my Orthopaedic doctor called me (return call from a message I left) and first asked me what was going on. He was very aggitated at the Pain doctors actions and let me know that he would take my pain needs back over, which he really should not have to do based on his prescription writing limitations as a surgeon and not a pain management doctor.

Does anyone have experience with Butrans patches and possibly a link to Suboxone? I feel desperate and confused!!!

Thanks, melmaniam
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annette030 responded:
Suboxone is the drug in Butrans patches, from what I know.

I do not understand why the PM doctor released you from her care. If you continued to test positive for marijuana after an appropriate cut off time, that might be the problem.

It is good that the orthopedic surgeon is willing to take over your care. As far as I know he does not have any limitations on his prescription writing due to being a surgeon rather than a PM specialist. My internist has written my opioid prescriptions for well over 10 years now. She is not a PM specialist. You only need to be an MD or a DO, even a nurse practitioner can write for pain meds in some states.

Best of luck to you.

Take care, Annette
 
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melmaniam replied to annette030's response:
I reminded him that he told me I needed to be on Fentenil (sp) and he replied that he can not even prescribe that. I am going to have plenty for him to read come Monday. I have been in contact with a Drug Testing Specialist and was informed that the main ingredient in Suboxone is also present in Butrans. Since the PM Specialist would not even speak to me and gave privacy act information to her receptionist to give me over the phone in front of the patients waiting in her office I feel there may be other avenues to explore before this is over. I was having a major panic attack and had to endure her nurse yelling at me like she was off her meds. She made every comment imaginable to belittle me as a drug addict who did not deserve their services.

The doctor asked during my last appointment if I had stopped the marijuana and I replied that I stopped the day I told her I was, which was absolutely true. Her reply was that she thought I had since it only showed up as a trace this time but she still decided to use it to add to the Suboxone as reasons for dismissing me. I did not even know that I was going to be sent to her. I guess I should have figured out how to get the THC out of my system faster than 30 days. I was reallyvery surprised it still showed at all.

Thank you for your concern.

Melmaniam
 
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annette030 replied to melmaniam's response:
You can request copies of your medical records from the doctor's office in writing. Be sure to include your full name and date of birth if you ask for them. You are allowed to put in your side of the story as an addendum, but you may not remove whatever she has written. This is a legal document, so I would write out your thoughts, and then give them 3-7 days and then edit them, wait again, edit again, then you might consider adding them to your record if you feel they would clarify the story.

I would also look at the THC test done most recently, and see what the trend was at that time.

I would not depend on the orthopedic surgeon to treat your pain, I would start looking for a PM doctor or a pcp who will consider managing it for you.

Take care, Annette
 
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melmaniam replied to annette030's response:
Right now I am so miserable and depressed I don't know what to do. Becoming her patient was kind of dropped in my lap at my Ortho appt very shortly before I started seeing her. I tested positive the first time and promised her I would quit immediately which is what I did. I saw her 30 days later and she asked me if I had stopped and I replied I had. She said she could tell because there was barely a trace in my sample. She appeared to be pleased at that time. I called to confirm my appt.and I was informed by her receptioniist that my appointment had been cancelled. I asked why and she put me on hold and came back saying I had been dismissed from the practice. I had to wait two hours to have her nurse call me and telll me that I had tested positive for Suboxone and marijuana therefore I was dismissed. I followed her instructions to the last detail. She refused to even talk to me and still has not. I really do not want to say how I feel right now, but it is not good.
 
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melmaniam replied to melmaniam's response:
I am not a lyer and I told her the truth from the beginning. I also can not make the pot clear out of my system any faster than nature allows it to.

I am an honest person who has been made out to be anything but that..
 
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annette030 replied to melmaniam's response:
I did not call you a liar, I just suggested what to do to get your records sent to you, and where to go from here...
 
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melmaniam replied to annette030's response:
No, I was not refering to you. I did not take offence to anything you posted at all. I was refering to the pain management doctor.

I talked to my pharmacist yesterday and he said that she has had at least 25 patients dismissed from her practice this year for the same substance (Suboxone). He thinks that she uses it to rid herself of patients she does not want to treat. Seems very interesting since she will not return calls, faxes, messages, nothing. It appears she only wants to treat robots and is a coward that does not want to explain her actions. I left her a message the other day that I had applied the last patch and within a couple hours I was nauseated and could not eat. No reply from her again. I have lost 15 pounds since I started taking this Butrans patch 45 days ago. She told me that nausea was not a common symptom and ignored me. In 45 days my weight went from 177 to 162 and I am 6' 2" tall. Nothing but skin and bones now and she will still not respond. I see my Ortho Mondayand will discuss other options with him then.

Sorry for the misunderstanding. No problems here at all with your responses. Have a nice weekend. Oh yea, notice what time it is. New patch, can't sleep, 2:30am and wide awake with screaming shoulders from the pain.
 
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annette030 replied to melmaniam's response:
I hope everything works out well for you. My husband was 6'3" and had lost weight down to 145 pounds when I met him. He was on chemo and radiation back then. Now it is 20 years later, he is fine and back to his normal weight.

Monday is MLK Day, check and make sure your appt. is for Monday. It is a holiday here and everything is closed.

Take care, Annette
 
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melmaniam replied to annette030's response:
I was typing a reply and something happened and I lost the page. Thank you for your concern. It is for tomorrow, I will respond with the results.

Thanks, Mel
 
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annette030 replied to melmaniam's response:
How did things go?

Take care, Annette
 
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melmaniam replied to annette030's response:
My orthopaedic surgeon prescribed me Percocet and recommended me to another pain center. I stopped by the "new pain management center" about a week ago on myway to take the records release document to my original pain management clinic and they told me to fill it out there and they would fax it to her. I called Friday and they had still not faxed it. It was 4:35 and they stopped taking calls at 4:30 so I will see what I can find out tomorrow. I have pretty much been in bed with little or no will to get up. I did something this morning, (well early afternoon) I have not done in a long time, or ever. I was in the shower, could barely stand and begged god to help me. I have no one else and pleaded for help. I just feel abandoned with little or nothing to get up for. I need help and god was the only one I could ask.
 
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annette030 replied to melmaniam's response:
I personally do not trust anyone to take care of anything for me. Since they said they would fax it, they should have done so.

Everyone sees prayer differently, if it helps you in any way, go for it. Did you get through the shower okay? Maybe God did help you...

Take care, Annette
 
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brownn62 responded:
soboxone is used as an opiate antagonist, how in Gods name would u get this without a prescription? your dr. sounds like an as****le. it sounds to me like this would be a good thing, if you were taking alot of opiates. i'm just a flunkie who knows what apain is, and wants to get rid of it- thru help via medical professionals- she was wrong to do that. and as for smoking pot, alot of people use it for pain control- why didn't she understand that? i'm glad your ortho dr. stepped up and helped u. hopefully u will get a better PM dr. take care nancy
 
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brownn62 replied to annette030's response:
you give excellant advise!!