Why Do Doctors Want To Punish Us For Trying To Get Better?

Why is it that if we go to a Doctor to try and get a medication to help with a drinking problem that this can screw us up in trying to get insurance and even employment for the rest of our lives? The very fact that we are choosing to try and change for the better should speak in our favor and not against us. And why should Doctors suggest that we join the AA religion if we seek to get better even when we tell them that the AA religion violates our personal beliefs and has harmed us in the past? Prejudice is all–sheer prejudice.

I am posting the following exchange from the HAMS yahoo group on this topic with the author’s permission for those whom it might help.

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This probably sounds like a stupid question, but how can one get a prescription for Naltrexone without going to a doctor, and risking to have “alcoholic” be forever on your medical records? I think that any other health problem to come in the future would be secondary to the label of having an addiction problem.

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I asked the same question a few weeks ago.  I don’t think anyone had an idea for getting a prescription without going to a doctor.  There is the possibility of getting Naltrexone without a prescription, either by purchasing online (haven’t tried this yet, but if people can get Viagra online without a prescription, why not Naltrexone?), or by going to Mexico (last I checked, ten years ago, you could purchase any non-addictive pharmaceutical without a prescription in Mexico, and at low cost too), but then I believe you’re at legal risk while “smuggling” it across the border, and Mexico is dangerous these days as you’ve probably heard.

A third option I’m considering is going through a doctor here in the States, but hiding it.  This involves finding an old-fashioned GP type doctor; the kind who runs his own small practice out of a small office in a poor part of town, and hates working with insurance (They are still out there; I know one here in town, but he is getting old.  And notice I said “he”; doctors this old school are from the generation when virtually all doctors were men.)  Do not go to your usual doctor; do not involve your health plan; do not give your social security number.  Pay cash, and request confidentiality.  Since Naltrexone is fairly safe and is not addictive (it’s not like you’re looking up a new doctor for a Vicodin refill!), chances are, he’ll write you the prescription.  Hand carry the prescription to a single, family-owned pharmacy.  Not a chain, and not any pharmacy you’ve ever been to before.  For instance, I get a Prozac prescription from Rite Aid.  They have all my records and my health insurance info.  Any prescription I bring to *any* Rite Aid is automatically added to my records.  So find another old-fashioned family business.  Tell them you don’t have insurance and will just pay cash. &nb sp;With luck, your records at the GP and at the small pharmacy will never become part of your insurance records, since the insurance company won’t even know that you ever interacted with those two businesses, and won’t know to request records.  Caveat:  I haven’t tried this yet, but am thinking of it.  Anyone seeing a hole in this plan, please point it out.

It’s very sad that we have to be so sneaky to try and get better without screwing ourselves.  I for one usually have to purchase my health insurance as an individual (i.e. not part of a group or employer plan), and an “alcoholic” brand on my records (the Scarlet Letter!) would either make it impossible or unaffordable for me to purchase the minimal insurance that I need for emergencies…

Good luck!

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Just wanted to give you an update on my earlier shared doctor idea

(how to get prescriptions for alcohol treatment medications without

screwing up your health insurance records). I finally bit the bullet

yesterday and made an appointment to visit my old fashioned, cash

only, sole practitioner family doctor. I’ve been having trouble

tapering off and finally decided that I wanted to try using valium to

taper off so that I could stop alcohol cold turkey. I also wanted to

get a prescription for naltrexone. I had (mostly) success. My doctor

was very understanding, sat down and talked with me for an hour, and

wrote me a prescription for a very small dose of valium which I hope

will allow me to be abstinent for a couple of weeks at least, to

detox. He also measured my blood pressure (a little high but not too

bad), and checked the size of my liver by palpation and by oscultation

(i.e. thumping over the liver area to find the size of the liver by

the type of solid or empty sound returned). My liver is not enlarged,

thank Goddess! I did not get my naltrexone yet, though, although I

expect I will next time I go in. He asked me if I were attending any

“meetings”. I said “no, I don’t like meetings, but I am part of an

online support group”. Turns out (unsurprisingly, since the whole

point of this exercise was to find an old fashioned, conservative

doctor) that he believes naltrexone works best in the context of AA

work, and he wasn’t sure that an online group would be enough, so he

recommended that I visit some of the local groups, and check in with

him in a month if I still want to try the naltrexone. Having been

educated by PCT and others, I didn’t bother arguing about the

usefulness of AA. Instead, since I don’t want to lie to the very

kindly older gentleman, I’ll visit two AA meetings, and if I still

want the naltrexone in a month, I’ll go back and say that I’m now

going to meetings *and* my online group, that I’ve stopped or greatly

reduced my alcohol intake, but I still want the back-up help of the

naltrexone.

I then took the valium script to a small family pharmacy, and paid

cash (no insurance records that way). I’m looking forward to detoxing

for a bit, and do expect that I’ll be able to get the naltrexone, if I

want it, in a month.

Based on this experience, I would add one thing to my earlier advice:

participate regularly in HAMS chat, which, after all, is a *meeting*,

IMHO. Then if you’re asked about going to meetings or etc, you can be

prepared to say that you are regularly attending meetings of your

alcohol use support group. I could easily have said this myself if I

hadn’t been surprised (caught off guard) by the question. Now I’ll

have to suffer through two AA meetings. Well, perhaps it’ll be

educational; I’ve never attended an AA meeting, though I tried OA a

couple of times in the past (and did not find it helpful). Now at

least when you AA veterans complain, I’ll know what you’re talking

about! 😉

Cost for the hour exam was $85, and the valium cost $15. I expect my

next office visit, in a month, will be shorter and cheaper. If it all

works, it’ll be money well spent, even just on reduced alcohol

purchases…

Wish me luck!

Copyright © 2009, The HAMS Harm Reduction Network

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About Kenneth Anderson

Kenneth Anderson is the author of the book How to Change Your Drinking: a Harm Reduction Guide to Alcohol. He is also the founder and CEO of The HAMS Harm Reduction Network.
This entry was posted in 12 steps, Alcohol, alcohol harm reduction, alcoholics anonymous, doctor, naltrexone and tagged , , , , , , , . Bookmark the permalink.

4 Responses to Why Do Doctors Want To Punish Us For Trying To Get Better?

  1. Jaded John says:

    Naltrexone only works if you drink. It’s a mutually exclusive approach to AA, which works only if you don’t drink. Naltrexone works only when you train your brain to unravel its craving for alcohol, which only happens when you drink with Naltrexone in your system. You may know that already, but I was pointing it out since your doctor suggested otherwise. It’s counter-intuitive on one level, but it’s logical when you study how the drug works.

  2. fairieswild says:

    I have to say I had an eating disorder and Overeaters Anonymous made it worse. So I can only see how AA can make drinking worse. I’m working on tapering off. I think I substituted disorders.

    • fairieswild says:

      The only thing that stopped my eating disorder which started with a diet my Mother forced in me in High School was allowing myself to eat when I was hungry. And allowing myself to eat what I wanted when I wanted it. I think a lot of things happened in my childhood that forced me to ‘stuff’ my emotions – but I never had a worse relapse only bulimia than after I tried Overeaters Anonymois.

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