Is this true accord. to FL or Other Law? No appt, No Refill

Will buprenorphine show up in drug tests? Can nurses take Suboxone? Can I do drug court on methadone or buprenorphine? My PO says NO medication-assisted treatments.
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shalalagirl_2000
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Is this true accord. to FL or Other Law? No appt, No Refill

Post by shalalagirl_2000 » Thu Sep 30, 2021 12:01 pm

Can someone help me find the answer to this, (hopefully the exact law, IF it exists) I have read what little I found online about Florida & Federal laws about refills, but it's vague, maybe I'm missing something, can't find a hard/fast law that might state this?

Question: If I can't afford to see my psychiatrist who prescribes my Suboxone at exactly 3 months since my last apptointment (I'm a well established Suboxone patient who has never used illegal drugs, have been with my doctor for over 4 years), will he not refill my suboxone according to Florida law? (HE did NOT say this, his wife did). His receptionist (who is also his wife and is not a nurse or doctor) told me that if I cannot afford to come to my 3 month appointment, that he will not refill my Suboxone script, and that I will have to go cold turkey, I will be cut off. (I think that it's not an exact law, that doctors have a bit of leeway with it, because many of my appointments were not exactly, to the day 3 months, some where a few days early, some a few days late, and even a couple of them were weeks late. But she is saying it HAS to be EXACTLY 3 months.

Here's the thing: When this happened before, he went ahead and refilled my script (he gives me 3 refills at a time, every 3 months on the day of my appointment), then I had my appointment soon thereafter when I had the money. (His wife said the same thing then, but he did not cut me off, and I had my appt soon after). Also, there was once when I did the appointment and paid the next week when I had the money.

I asked if I could still have my appointment, then pay 3 weeks later, but she said NO, and stated that the law also says that he cannot do an appointment without payment when it comes to prescribing buprenorphine, either.

I need to call her back, to let her know that I will definitely not be able to make a new appointment before my medication runs out, and will be without medication for 3 to 4 weeks - but WHAT IF she does not tell him so that HE can make the decision? (I'm afraid that she thinks that saying NO will force me to come up with the money somehow, she's his wife, so someone paying late affects her financially, too, and that I will end up being okay, but that will not be the case, I will NOT be able to come up with the money, and have already had her cancel my original appointment (I did not want to cancel at last minute, because that would prevent my doctor from filling the time slot with another patient). My husband & I have exhausted ALL sources of money, we have NO credit cards, no savings, no 401k, no ways to get money - IF we did have, we would be eating better. My husband already had to borrow money for gas to get to work, as he drives over 90 miles one way.

So when I call her, I would like to know IF any laws actually do state that my doctor can legally stop my medicaiton abruptly because I can't afford my appointment for an extra 3 weeks. Also, if anyone has any advice about what I could do to make sure that my actual doctor knows about this situation, how can I make sure that she will relay the info - the reason why I'm afraid she won't, is because I know she has not yet, because he would've made a decision and either called me or had her call me to tell me HIS decision - she mentioned to me that they are not "wealthy" like other doctors are, that they have money issues too, so if that's true, maybe she's thinks that saying I will be cut off will cause me to find the money somehow, as if I am not being truthful about coming up with the money. I thought about sending a letter or a fax, but even if it was addressed to my doctor, being that she takes care of the mail, she would probably open it, and maybe he would never see it. I notified her over 2 weeks ago when I cancelled my appt, knowingn I couldn't pay, and I have not heard from my doctor, and I know for sure that if she would've told him about my situation, that he would definitely get in touch with me, even if he had her make the call, to tell me that YES, she was right, or whatever the case may be, he would never leave it hanging like this, he knows that my stress level is very high lately, and that I'm struggling with many other problems, so I just know for a fact that he would give me some type of definitive answer that obviously comes from him, not her.

When she told me this, and kept going on about how and what I should do with coming up with money, being that I was already at a high stress level, it caused a lot of anxiety and panic, and I just finally gave in and told her that there's nothing more I can do to come up with it - and she said, "What will you do? If you go to the hospital, they won't give you Suboxone just because you're out" I told her that I understand that (I've worked in hospitals in several different states due to being in the miltiary and working in civilian hospitals while I was a Reservist, so I know that Florida hospitals, in my area, anyways, will not treat any ER patients with suboxone or methadone for ANY reason, not like other states do).

From what I read about FL refill laws, yes, it states that the patient should see their doctor every 3 months, but are those "standards" or guidelines? or a hard/fast rule? , but I also found something that said that cutting a patient off would not be the best course of action (for many obvious reasons), it's vague. Also, he has given me a refill before when my appointment was not exactly 3 months, so, how did he do that without losing his license to practice? And, they could do my appointment and allow me to pay late, they know I'm good for the money, they know where we work, where we live, they know my husband well, etc.

I know that she did not tell her husband (my doctor) about this issue, because she would've said that "he said _____". But I'm afraid to ask her to call me, because, since he is a psychiatrist, that would be like requesting an appointment, and I don't have the money to pay, not even for a 15 minute appt. If he was a any other type of doctor, I would DEFINITELY request that either he call me, or that his wife ask him for me, but I can't do that, as he's a psychiatrist and charges for any time with him at all, but in the past, like when the pharmacy messed up my script, he called me to tell me he fixed it, etc.

She also suggested that he might be able to put me on some type of other mediciation that "would help stretch out the films you have left for the next month" - But wouldn't that require an appointment, too? In other words, she's suggesting that he give me a new script for a new med without an appointment, but won't give me a refill on a med I'm already on without an appt - This proves to me that she is BIASED, and this is not the first time she's said things to show how biased she is about Suboxone patients. The point is that SHE IS MAKING MEDICAL DECISIONS FOR ME, when she is not the doctor, she's not even a nurse or tech, she's just his receptionist, and is the only one who works in his office - they don't process insurance.

She questioned me on the phone for almost 2 hours, asked me why I haven't went to food banks, why I don't have coverage yet (but his office does not accept any insurance at all anyways) and she told me that I could take something over the counter to stretch out the few films I have left to make them last a month, etc, etc. (If there was a way to do that, believe me, I and everyone else would know about it, and no one would be on Suboxone for very long at all, and we'd all be done with it for good!) She talks to me as if she forgets that I was a nurse & emt my whole life who also was a medic with an Aeromedical Staging Squadron and Combat Rescue Unit - she also talks to me like I have zero expericence as a patient who's been on Suboxone for years.

We are having financial problems, but it's temporary, and so bad that we can't even afford to buy enough food to eat, but will catch up soon, it's not like we are irresponsible, I'm in my 50s, my husband in his 60s, we are both prior military (I am not covered by the military yet, but I am fighting to get my coverage from the neck injury I got while in the Air Force that is what caused me to become addicted to percocet after my surgery), so I can't afford to see him for another few weeks, but my refill is due.

I think that his wife is just saying that, wrongly thinking that I can come up with the money somehow, because she asked me on the phone if I had thought of other ways to pay for the visit! Of course I did, I've tried every way possible to come up with the money, and if I could use grocery money in the place of it, I WOULD, but we don't even have grocery money, and won't for the next couple of months, so that is another thing we have to work out, and we have not eaten well for a few months already, which makes everything harder - my husband has a very physical job, in the heat, and drives 3 hours a day round trip just to get back & forth to work, and being that he's in his 60s, it's hard for him to keep up, but he's doing it. I get so hungry that when I DO get something to eat, I can't swallow it, I have to force it down, it's awful, but we are alive, and will get through this somehow.

But, if I am cut off of my Suboxone, at best I will be sick enough to be hospitalized, I know that for a fact, I was a nurse my entire life until I broke my neck, so I know the effects & dangers of stopping my medication abruptly, and with my other health issues, at worst it could cost me my life. (When I had gallbladder surgery a couple years ago, I DID almost die, I coded a couple days after surgery because the surgeon and other doctors would not give me any pain meds because I was on suboxone, and my blood pressure, which is usually on the low side, stayed at 210/120 for hours, and instead of relieving my pain which was what was causing it, they gave me blood thinners, which cause me to nearly bleed to death because the surgeon had nicked me with an instrument they used in my surgery, and when they seen my bloodwork, they had to give me emergency treatment AGAIN, and they STILL REFUSED to contact my psychiatrist who prescribes my subuxone - My doctor said afterwards, that if they would've called him, he would've told them how to treat my pain properly, even thoughh it was not a planned surgery, but they would not have listened anyways, since they refused to call him to begin with, they did not want any other doctor advising them of how to treat their patient because of their egos. I STILL have nightmares and flashbacks about the pain I felt for days after that surgery - plus, it caused me to not be able to get up and move around after surgery, I kept telling the nurses & doctors that I could get pnuemonia, etc, I could not even shift my weight in bed for 2 days afte surgery, I was in so much pain, and I should've been getting up, going to the bathroom, and walking the next day, but they REFUSED to treat my pain.

I've had so many problems due to beiing on this drug, I've been constantly abused by people who should know better, and when my doctor's wife questioned and questioned me, about how I could come up with payment, the anxiety & panic is has caused has hurt me a lot, if that was the case, she should've just stated that NO, I cannot get a refill, that would've been better than what she did, going round and round with me about it, I was explaining myself about why we were in our financial situation, why this, why that, why I didn't do this or that, and I am just really tired.

So, if anyone has any advice for me, I'd appreciate it, I want to change doctors even though he is a really good doctor, but I have fears about changing doctors because I know that it's difficult to find a decent one who is not biased, the only problems I have with him as a doctor is all due to the way his wife is, I get a panic attack when I know I have to even just call to make an appointment - I put it off as long as I can, because just calling to make an appointment (on a normal basis, not referring to this particular time) is very stressful because of how she talks & talks and judges and tells me stories, she goes way too far. I felt suicidial when I got off the phone with her the other day, I was so panicked, I should not have allowed her to grill me like that, but it just happened.

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rule62
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Re: Is this true accord. to FL or Other Law? No appt, No Refill

Post by rule62 » Sun Oct 03, 2021 11:07 am

Not a very nice story. You are between a rock and hard spot. My only suggestion is to shop around for another Buprenorphine doctor. Not sure how they are in Florida but here in Nevada and California they are pretty easy to deal with. My doctor charges $100 for a visit and prescribes generic Suboxone which is not very expensive. He will not do refills although doctors are allowed to.

I had to change doctors when I moved here and it wasn't hard at all. Use the NAABT site or your own internet search to find one. What may be hard is to find one who accepts insurance. (although you don't have it yet) Some are in for the money and others to help addicts. The two I found were the helpers.

Time to get busy finding another source. Sorry for your predicament.
Don't take yourself so damn seriously

shalalagirl_2000
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Re: Is this true accord. to FL or Other Law? No appt, No Refill

Post by shalalagirl_2000 » Wed Oct 20, 2021 11:58 am

Thank You for reading my long post! I appreciate all of the info you gave me. Yes, I decided to get a new doctor,(I do have new insurance through my husband's work, but am still trying to get covered by the military, since I broke my neck when I was full time - that was in 2007. I just couldn't use it for my doctor because he does not accept any insurance at all) My husband & I made the decision today, as I had another unfortunate discussion with my doctor's receptionist - the worse one ever - and I prepared myself well for it, but that did not matter. My husband ended up taking over the call because my stress level was at about an 8 after talking to her for just a minute - I NEVER get that stressed, and the only times I do get that stressed is when I talk to her or when I have constant issues at the pharmacy). I found out what the issue at the pharmacy was (they keep telling me I have zero refills left, even though the scripts are not expired) and fixed it, but it keeps happending still, but at least I'm able to tell the next person what the issue is so they can look and see for themselves, they just need to know to look, and need to be told to add numbers together then subtract that number from 30, which is something they have great difficulty doing.

I have one more appointment with him, and I'm going to tell him what I've wanted to tell him for a very long time about his wife, that she needs to be properly trained, so that she does not hurt people who are trying to heal, not just the Suboxone patients, but the people like me with CPTSD, too. She has said things to me that no one should ever say to any patient, much less a psychiatry patient, she should at least be a tiny bit aware from working with her husband in that environment. I think she must love conflict, because she sounds like she enjoys it, it's like she comes alive when she upsets me, it really creeped me out. I have good insurance, and don't have to pick doctors from a network, but I'm very leary about changing docs, so I'm going to request a phone consult first, so I can ask some questions.

My first Sub doc started me on one 8mg/2mg tablet daily, and it worked fine, I had no symtoms at all, it was like magic. 2 weeks later, he reduced the dosage and I had severe cravings, then he reduced the dose again in one week, and I was a mess, but I never took anything to replace it except an er doc had to give me ativan to calm my withdrawl it got so bad, I couldn't even stand, it was full blown, awful. By the time I got a new doctor, several months later, I was on THREE 8mg tablets daily. It took me over a year to get down to 2, and much longer than that to get down to 1, I was stuck at 1 for a long time, now I take half an 8mg film daily. I've been on Suboxone for 12 years, and I believe that if my first doc would not have tried to wean me off so quickly, I would've been done with it in about a year after starting. I am just so tired of being treated terribly because I take suboxone.

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