Pill mills

Buprenorphine Post
jmosby1469
Posts: 104

Postby jmosby1469 » Wed Jun 12, 2013 8:51 am

Rather than enter this as a new topic, I've researched the comments already posted about "pill mills." As a Family Medicine physician, I provide total ambulatory care, including MAT with buprenorphine products. I am unsure however that our psychiatrist colleagues are recording vital signs, family histories, physical exams, and monitoring laboratory paramaters other than UDS. Based on the rationale posted by our senior member above, I concur that the rapid retail approach to offering saving therapy to opiate dependent patients is the least I can do. Many of them have no physician care at all except the encounter for their Suboxone prescriptions. I saw a 25 yo during my first day at such a clinic who had injection track marks over both major neck veins from injecting a solution of crushed pills which he couldn't specifically identify. His pleas for help, and admission of great fear nearly had me struggling back tears. I wrote his home induction prescription out of a sense of throwing a lifesaver to a desperate, drowning youth, albeit a device with so few of the features I have applied to my patients for about 30 years now, except for a caring and deep empathy. I am quite conflicted about this approach but, at least the practice owner is a former addiction counselor and Suboxone sales rep., who****ures me he vets these clients well and gives them orientation handbooks including counseling resource contact information. On my next day there I plan, belatedly, to examine those materials more closely.

drpasser
Posts: 1404

Postby drpasser » Wed Jun 12, 2013 8:51 am

I actually think that a pt on bupe, from the worst doc in the country, may actually be better off than if he or she took full agonists.

melvinipohlmd
Posts: 29

Postby melvinipohlmd » Wed Jun 12, 2013 8:51 am

In my town (yes, it is Vegas) there are clinics advertising Botox, Restalyne, liposuction and, you guessed it, Suboxone - "PAINLESS DETOX" is the name of one clinic.

bandalier
Posts: 15

Postby bandalier » Wed Jun 12, 2013 8:51 am

Well - in my area IE upstate NY the going rate is $50-150 cash per script visit in some
Like a friend says to me ...... IT'S ALL ABOUT THE MONEY
And that's a crying shame

peterorrin
Posts: 267

Postby peterorrin » Wed Jun 12, 2013 8:51 am

Wavered MDs unwavering in their greed and/ ignorance, or is this a stretch of the 'harm reduction' approach?

Cheers
Peter R

drpasser
Posts: 1404

Postby drpasser » Wed Jun 12, 2013 8:51 am

It's a problem. Money hungry pirates are inevitable. It's true that for the first year, each wavered physicians may have only 30 pts, and then, as you know, it can be increased to 100 pts/physician after that.

I imagine, they have their based covered in terms of keeping with the requirements. You could always call the DEA and suggest they look into it. I am no sure it will do much good, though.

I have posted a thread here recently about less than stellar providers:

http://bup-webboard.samhsa.gov/topic.asp?TOPIC_ID=713

Best
Kevin


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