vol
Stranger
Reged: 08/19/03
Posts: 4
Loc: West of California
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Just wondering if buprenorphine can be ordered (in any form) from a US OP. Will any of the doctor consults actually prescribe this for me? I'm using it to treat depression (.2mg x 3) and have just moved Hawaii and can't find a single doctor/psychiatrist who will prescibe it for me even though I've been on it for 5 months by my old mainland doc.
Really frustrating! And I've placed 2 orders for temgesic from 2 different IOP's and both shipments were sezied by customs here in Hawaii...I guess the Thailand postmark made them suspicious.
Anyway, I'm almost out of medication and really starting to get concerned since I have refactory depression that has only responeded to 12.5mg of Paxil CR augmented with the Buprenex (I have tried almost every SSRI w/ Lamictal, Depakote, Lithium ect). When I'm off the bup I sink into a dismal abyss within a few days and am really really scared.
My only other option is to go to a drug treatment program out here and pretend to be an opiate addict, but that really bothers me. Plus, they would put me on Subtex which only comes in 2mg tabs and all I need is .2mg
Any help/suggestions would be a great help to me. I love Hawaii, but cannot believe the way the doctors are handling this. Two of them even talked to my previous doctor back east who use to prescribe buprenex for me. Seems like they are ALL concerned about lawsuits or something since the drug isn't approved by the FDA for depression.
Thanks again for the help and a big mahalo!
Michelle 
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zeuzjuz
Pooh-Bah
Reged: 12/16/01
Posts: 1155
Loc: the milky way
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I also wonder about this - I have still, to this day, not seen a report of someone receiving Buprenorphine in any form from a U.S OP - They definitely would not have the 0.2mg sublingual Temgesic - because that is a foreign version of the medication, that I don't even think is made in the U.S.... (could be wrong on this) The 'standard' Buprenorphine that is usually prescribed in the U.S is Buprenex , which is actually 0.3mg's and it is injectable. It is SchIII - so there is technically no reason a U.S OP shouldn't be able to write a script for it - Because as far as I know, doctors only have to have the 'special licensing' to prescribe the stronger forms of Buph (Subutex) - I think any doctor can write a script for the 0.3 Buprenex..... However, I think injectables are sort of a no-no with OP's....... I'm not sure why - but it doesn't seem that any of them prescribe injectable medications - or at least I never see anyone reporting that they have done so. Hope this helps. You will most likely not be able to get Buph from a U.S OP - I have never seen it done once and I have used OP's for a pretty long time...... I have heard that the 0.3 Buprenex/injectable is not nearly as hard to get a prescription for, from a local physician, as regular opioid medications though. Just tell them that you have been taking opioid pain medications but they aren't working for you very well anymore, and you want to ween off of them. Or just tell them you heard it is a good painkiller - alot of people get prescribed Buprenex (including one of my relatives) for regular, take all the time pain medicine.
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//zeuzjuz
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vol
Stranger
Reged: 08/19/03
Posts: 4
Loc: West of California
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Thanks for the info, Zeuzjuz.
I have been using Buprenex only for my depression. I didn't think about trying to have a regular doctor (not a psychiatrist) write me a script. Do you think I would have to tell them it is for pain and not depression? What sort of chronic pain is bupe used to treat? Thanks again for the help and I'll post if I can find any US OP that will dispense it.
Mahalo,
Michelle
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Anonymous
Unregistered
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"Buph" has become a specialized drug in the US, used almost exclusively for treatment of opiate addiction. It is typically prescribed in 2mg or 8mg SL wafers - far above the 0.2mg level found in Temgesic. MD's in US require special certificate from FDA to Rx "Buph" for addiction treatment. It is my impression that old "OTC" Temgesic is gone in the US. It is still available from Thai and other IOP's. Don't know if 0.2mg dose would be sufficient for treating depression or pain.
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gage
Member
Reged: 11/27/02
Posts: 138
Loc: south central U.S.A.
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so this stuff is used to treat opiate dependence??? how does that work??? seems like doctors would give it if you told them you wanted to stop the opiate pain meds.gage
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stugel
Journeyman
Reged: 07/21/03
Posts: 58
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I only know IOP's that have it.
Clickdrugstore.com (thailand i think)
247-drugstore.com
destinyrx.com (email and ask for t#mgesic ordering instructions- they are phillipino)
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Trampy
Pooh-Bah
Reged: 04/02/02
Posts: 1241
Loc: Southwest U.S.
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Quote:
so this stuff is used to treat opiate dependence??? how does that work??? seems like doctors would give it if you told them you wanted to stop the opiate pain meds.gage
Under new FDA rules a doctor can't prescribe these unless they go through a special 1-day training or they're board certified in addiction treatment. These scrips are all scrutinized to ensure compliance. The high-dose sublinguals are only approved for detox, not pain.
The 0.2-mg Temgesic sublinguals were never sold in the U.S. And they became very expensive in Mexico a few years ago. Their absorption sublingually is only about 50%. Only a few brave doctors have used Buprenex for depression. The only form available in the U.S. until recently was the injectable Buprenex, which was a C-V with and FDA-labeled indication for pain ... that is, until Subutex and Suboxone were approved. Now they are all C-III.
Trampy
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Your mileage may vary ...
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kearnan
Member
Reged: 12/13/01
Posts: 194
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I located several docs in my neighborhood who are authorized to prescribe buph (only 30 patients at a time), but would rather try to get on my own because I fear that I will be red-flagged. Does anyone know about this?
I was up to 6 vics a day, but because financially I couldn't afford consult, dropped quickly to 3 a day to try and make it last until my next refill. Its already so uncomfortable. Am very interested in using the buph but would rather try and order on my own.
Does anyone know how to use it? Once a day???? Any advice would be greatly appreciated.
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omega55
Enthusiast
Reged: 12/03/02
Posts: 254
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As far as I know Buprenorphine, a Narcotic agonist/antagonist, is only prescribed for mild to moderate pain and not for depression. With so many new kinds of anti-depression medications out there, you'll find it just about impossible for any physician to prescribe a narcotic for depression. It doesn't make any sense.
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omega55
Enthusiast
Reged: 12/03/02
Posts: 254
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Oh, I should add it's also prescribed for opioid addiction treatment: http://www.buprenorphine.samhsa.gov/
To highlight my prior post above: http://www.nursespdr.com/members/database/ndrhtml/buprenorphinehydrochloride.html
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vol
Stranger
Reged: 08/19/03
Posts: 4
Loc: West of California
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It does seem to make a lot of sense with people that have refractory depression. And the whole path buprenorphine has made to its new status as a detox drug is pretty interesting...a lot of this has to do with profitablity for the drug company. I don't have the link handy.
To check out one example of buph's use as an antidepressant check out this link: http://balder.prohosting.com/~adhpage/bupe.html
For me, it has been a real lifesaver as it and Paxil CR have been the only treatment that has work short of ECT, which I don't really dig too much.
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