Lacing up my hoop-jumping shoes.

I got a letter from the state today, informing me that they will cease paying for my Suboxone treatment as of June 19, 2008.

Well, at least they gave me a sufficent amount of time to taper off. (Yes  that’s sarcasm.)

The letter said that they’d received my doctor’s request to extend my treatment for another six months. According to they who make the rules, this is not a medically appropriate usage of Suboxone, so I am SOL.

There is an appeal process I can go through, but if I want to continue my treatment while they consider my appeal then I MUST appeal within ten days of the date on the letter. The letter I got was dated May 27, 2008 – which means I would have to have appealed by yesterday. But wait! The postage-meter stamp on the envelope the letter came in was dated June 4, 2008 (that’s right, a week after the letter was dated) and I didn’t even get the thing until today (June 7).

I knew going into this treatment program that my insurance, which is medicaid and so is paid by the state, would only cover my treatment for six months. My doctor, who deals with a lot of peeps like me told me that they always grant an extent ion for a second six months and so we’ve been working from that assumption. We agreed together that I would use the second six months of my treatment to taper off of Suboxone because he thinks that a slow taper with plenty of time to stabilize between reductions leads to a better chance of success.

Right now, I’m just hoping that this is a formality, and that they categorically deny all first requests for an extention. My doc seemed so sure that I would get the extention, we didn’t even discuss what would happen if I didn’t. The one doubt that’s eating at me is that last month my prescription was held up for about a week. I heard this was because the state had become aware that the majority of people who were getting Suboxone on Medicaid’s dime weren’t in therapy or treatment, which is not ok, and they’d decided to finally enforce that rule. Now I’m left to hope that they haven’t decided to be more strict about the six months rule.

It would make sense if they are cracking down; Suboxone is an expensive drug and these are hard times.

I’m not freaking out though. In fact, I feel strangely calm.  If they do cut me off on the 19th, it will suck because my next refill is due on the 20th, but I’ll be ok. If things turn out badly with the appeal, I’ll just borrow money to pay for my scripts until I can get safely tapered off. I’ve got a backup plan and an understanding doctor, so I’ll be allright. I just hope I don’t have to pencil “go through withdrawals” into my datebook anytime soon.

I do find it ironic though, that the state would want to cut me off of the one treatment that has stabilized me so much. I no longer take anxiety meds or the hideously expensive migraine medication that I used to take, and I’m at the doctor’s office far less than I was when I was using. And despite what they say about “evidence based” practices, I’ve read that the best outcomes for Suboxone treatment are people who use it long-term. But I long ago stopped expecting things to make sense, so I’m not suprised.

This is yet another opportunity to see how I’ve grown. If this had happened just a few months ago, I’d be freaking out right now. I’m learning to not make a big deal out of things until they become a big deal, and I’m starting to trust that I will be able to handle my life – even when it gets hard, and without turing to a chemical escape. I like this feeling of competence. I do believe it’s one of the rewards of the hard work I’ve been doing, and I intend to enjoy it.

Other than being put on notice by the medical beaurecrats, I had a lovely day today. Little C and I went to a birthday party in the park, and the rain even held off until the end of the day. A&J and I got a chance to catch up and the fresh air did me right. Now I need to buckle down and work on some Logic proofs – quiz Monday and Final Exam on Wednesday. Then I’m free for the summer, oh joy!

 

Almost There

The study coordinator just called and said my blood work came back fine and I can come in for my induction tomorrow morning. Woo! That’s one obstacle overcome. Now I just have to hope the suboxone works, and then that I don’t get the placebo in the next part of the study. But still, progress, right?

On other battlefields, DSHS is trying to take away my benefits. It’s like they get a golden egg every time they kick someone off her bennies or something, the lengths they will go to to trip you up. This last round they’re trying to say I don’t work enough hours, which is convenient for them becasue if I did work enough hours I would make too much money and I’d lose my benefits. ARGGGH. Anyway, now I’m on hold again for the millionth time, while they try to figure out why they’re trying to make me participate in a program that I’m exempt from for not one, or two, but three separate reasons.

It gives me a place to channel my anger into though, which is good. And something to think about other than starting this study. Thankfully, and I can’t believe I’m saying this, I have to work for the rest of the week, and hopefully that will keep me from too much navel gazing. Oy.

I am a little worried that I won’t be in “moderate w/d” by the time 8 am tomorrow rolls around. I think I’ll be ok, I’m giving myself 24 hours to get there, so. And now, I have to make like a functional person and get ready for work.