the refills on file at pharms are good. is your sister's OCS in Florida or Alabama? apparently her F2F wasn't with Dr. G.

nitemoon,
Thank you so very much for your Personal Messages. I just finished responding to your most recent one.
I'll check the computer on and off during the evening to respond to everyones messages.

Linda

it's synthetic... read at this link
http://www.medicinenet.com/nalbuphine-_injection/article.htm

No, her face to face was with Dr. G, as is the one I had scheduled for later this month. Someone else had stated somewhere on here that the refills on file at pharms would no longer be able to be filled, and I was letting them know that that is not the case, at least as of today.

As of today, there is also no record of any action taken on Dr. Garcia's ability to prescribe controlled medications. He may have decided to stop on his own, or he may have been told to stop or else, or perhaps the information takes somewhat longer to show up if someone is looking a doctor up from a pharmacy.

Unless someone has information to the contrary, at this point all speculation as to the status of his prescribing ability is just that, speculation.
That information could change at any time, of course.

At one point, it was actually Schedule II. Then it was removed from that status. Many meds that are not controlled are still prescription only.

In addition to it being used a lot currently in Labor and Delivery, I have found a lot of information on Nubain being used for chronic pain in Sickle Cell, Cancer, and several other diseases. It seems to be on the rise for use with chronic pain, where as in the past it was only recommended for acute pain. This rise seems to have happened as the public concern over "abuse" has risen.

On medical sites where you have to have a subscription to read the whole thing, I have found statements in the little bit they show you for free that say things like this blurb: "new formula of the chronic-pain med Nubain has shown positive results in its most recent round of clinical trials. The med, Nalbuphine ER, is being tested as a twice-daily tablet treatment for chronic pain. Nubain is currently only available as injectable medication"

It seems that the main reason it was not considered suitable for chronic pain was because people would have to stick themselves. The medication itself is considered very effective, they just thought people would not want/should not be injecting themselves. Why does this arguement not exist with insulin? Because it is life threatening rather than just life destroying?

Pain Management specialists seem really excited about the oral version that is in trials.





http://www.revolutionhealth.com/drugs-treatments/nubain
http://www.deadiversion.usdoj.gov/drugs_concern/nalbuphine.htm
https://www.glgroup.com/News/New-Oral-Opioid-Treatment-for-Chronic-Pain-12785.html

http://pharmalicensing.com/public/outlicensing/view/5412/nalbuphine-er
http://www.druglib.com/druginfo/nubain/

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682668.html
http://www.freshpatents.com/Use-of-nalbu...20080207667.php






http://www.vesicaremedicationforincontinence.co.cc/nubain-drug-medication-doses/

Linda or whoever,

WHERE IS DEBBIE???
I have had no contact from Consults Direct regarding my status, neither have my two friends.

I have called Dr G twice. NO CALL BACK. As I said before, I have spent hundreds of dollars on my trip down there for the F2F and I am raging mad!
I want a refund or my promised meds.

No call back from Garcia, no contact or callback from Debbie. Not for myself, for friend A, or for friend B.

WHERE IS DEBBIE?
Are they securing another doctor?? YOU work there - what is their plan??

What should I do when I've been promised 12 legal months worth of hydro and spent the money and time to get that promise only to be ripped off? Any ideas?

Please pass along that the her clients from the Northeast feel extremely abandoned! (as do the rest of this board).

Waiting for a phonecall......or an email.......AND A SOLUTION that doesn't require detox and withdrawal due to irresponsible providers.

nubain was schedule II until 1973. Endo petitioned the DEA to remove it from their list and they did. if it was a pill it probably would be schedule II because of more potential for abuse. but that is just speculation on my part.

after long term use and stopping abruptly, it causes withdrawals. so if you can become physically and physcologically dependent upon it, as far as the DEA is concerned, what is the difference between nubain and hydrocodone?

as far as i know, it is like subuxone in that it kills the pain but there is no sense of well being like with hydrocodone? please correct me if i'm wrong.

with hydrocodone, i have been more productive in the past 2 years than all the previous 10 years since the accident that ruined my back. it has been a God send! i have been able to do many activities and even sit in my lazy boy for an hour or so, which i couldn't do for 2 minutes before. now, i'm faced with the reality of sliding back into those dark, painful and unproductive days again. i don't want to go there but as i look into the crystal ball, i see no joy.

my motto is "nothing is ever as good or bad as you think it will be" which helps to keep me level. i will be repeating it a lot in the near future.

nitemoon, please keep us informed of every detail of your experience with nubain. if it is a viable option, i'm sure many ppl will be interested. thx...

In late '07, I tried a weight loss program that involved me having to give myself an injection 3X a week of a B6/B12 combo. There were times it took me 10 minutes to finally stick myself because more often than not, it hurt. I quite often drew blood and was left with a quarter-sized, deep bruise.

So, my point is, not everyone can give themselves an injection and even if they are able to, there can be pain/blood.

We are just waiting to see
Linda

Just waiting to see what??? What does that MEAN??

For a company spokesperson you sure are leaving lots to the imagination.

Are you looking for a new doctor? What is Consults Direct doing? Where are Jeff and Debbie?

I was having a conversation with my friend about having to do my own injections and how nervous I was about it. She told me that she had to give herself heparin injections when she was pregnent. I guess if it was life threatening I would do the injections, but it really does freak me out to think about giving them to myself. All of my friends think it is hillarious that the needle thing freaks me out so much considering I have about 10 tattoos.

I hope that Jeff and Debbie are out looking for a solution. I have a feeling that Linda got stuck with this job. I know we all want more info, but I don't think Linda has the answers. She is just doing the job they gave her. Everyone has to earn their paycheck.

I have been stuck with more angry clients/customers than I can count. It really sucks when everyone is mad at you and you really can't do anything to help them.

I did get to emails from Debbie today.

The first included the letter from Dr. Garcia about the Nubain.

The only problem I have with the letter is that it did contain one factual error about the medication. "There is no withdrawal from converting from Hydrocodone to Nubain because it works on the same receptors (the body does not recognize it s a different substance)"

This is very different from what even the pharmaceutical company itself says about the medication.

My other problem is not with letter, but with the way this has been handled. If we were standard patients the doctor's practice could be sued for the abrupt decision to remove us from the medications we are taking. Particularly those patients who are not on pain medications but anti-anxiety ones. Of course, he knows that it is highly unlikely any one would or could do this because of the gray area situation that exists in any pre-F2F patients.


This puts ConsultsDirect in a horrible situation. Technically it does not fall under their "Guarantee" because it is not as if scripts that were written were unable to be filled. However, people that have already done F2F are rightly angered because they either have to be willing to switch medication or receive nothing at all at reconsult times.

Nalbuphine acts at largely kappa receptors, having antagonistic action at mu receptors. They used to think that this was the reason women preferred the drug during labour. It still remains the reason why the drug may be effective for females and not for males. I wish everyone who tries this drug the very best of luck. Especially if you're male.

There may be hope, however, but it's not something to rush blindly into:

http://www.sciencedaily.com/releases/2000/06/000612084246.htm

Nitemoon, please please be careful using a partial antagonist!!!! If you've read first-hand accounts of precipitated withdrawals, I think you might think twice before injecting yourself with this medication. I am assuming that you are not opiate naive...just...ugh, the things I have read, written by people who took suboxone too soon, it knocks all the nice hydro molecules off the opiate receptors in the brain and kicks you into immediate, intense, hard-core withdrawal. This is not the slow onset w/d one gets from stopping hydro cold turkey, but instead it is like (from what I have read -- I have no personal experience with this THANK GOD) like some kind of megawithdrawal, with two week's worth of w/d symptoms hitting you all at once. It has been described as pure, brutal torture.

If you are currently taking an opiate painkiller, you should wait until you are in moderate withdrawal to begin the Nubain. Please. I don't want to hear about anyone suffering the kind of horrorshow I've read about on other boards.

You don't know me from Adam, but I'm with Steveo; I have a BAD feeling about this. Please be careful.

What a horrible situation for all CD patients.

YEP-I got the same letter today and you are correct. This is factually wrong. Unbelievable, it really is. People are about to be thrown into full blown withdrawals with this stuff.



No gray area for me...I WILL take this further. Stopping the medication abruptly is dangerous and uncomfortable and NO doctor would do it. I have yet to speak with Garcia but hope to today.

Furthermore, here's my BIG problem: the SPIN that has been put on this. I do hate damage control and lies. This letter we got is laughable! You should see it! "We have such great news for you! You can be pain free! This is so exciting!"

I'd MUCH rather hear that the doctor has temporarily lost his prescribing license and is looking into alternatives. I'd much rather hear the truth....whatever it is. But THIS LETTER is not it.

Listen, I've kept quiet for months about my experience with Dr Garcia and CD. No need to anymore. He has been under investigation by the DEA for several months - about a year. It started when my local Rite Aid refused to fill my refill. Then Debbie switched me over to Walmart who has now also refused to fill. Straight from their mouth, the DEA has contacted them regarding A Garcia AND C Garcia (they could not fill scripts from anyone in that office) and he was under investigation. I was running out of pharmacies. This was bound to happen.

But the marketing and spin and lies is outrageous. Come clean!

i pulled a few things out of the beginning of the letter but this is the majority of it.

As you know hydrocodone is a controlled substance regulated by the DEA. What that means is that the DEA basically regulates how much and how often your physicians are allowed to prescribe this medication within a given amount of time. As you know Dr. Garcia is not allowed to let you have early refills or give you early consults when needed. If you would have your medication lost or stolen you are out of luck. You are basically made to wait it out and deal with the pain or start doctor hopping or double dipping. This is risky because you increase your chances of being black listed and then not be able to obtain any medications at all. Dr. Garcia, is a member of the American Academy of Pain Management and has been pro active in searching for new alternatives. Dr. G. has recently started a new pain management program with his patients with a medication that will give you 100% pain relief. And best of all this medication is not a controlled substance regulated by the DEA. This is great news for you!
As you know we are not the medical professionals. Below is a little information about the medication but you will need to call Dr. Garcia’s office to discuss with him if you can be converted from the hydrocodone. Some of our patients have started this new pain management program and are finding it a life changing experience. Please call Dr. Garcia at --[NUMBER TAKEN OUT]-- to discuss this program with him so that we can send your script out to you soon.
In summary, the advantages of Nubain over Hydrocodone and other addicting narcotics are as follows:
1. Nubain is essentially nonaddicting
2. There is no withdrawal from converting from Hydrocodone to Nubain because it works on the same receptors (the body does not recognize it as a different substance)
3. It is not a controlled substance even though it is a synthetic opioid therefore your physician decides how much you need and when you can get a refill (not decided by any regulatory agency).
4. The correct dosage for your weight will make you pain free; not just reduce your pain to a tolerable level
5. The patient may have the face to face meeting with the prescribing physician and continue to obtain the Nubain through telemedicine consults every 90 days
6. The Nubain can be purchased at your local pharmacy or can be shipped from one of our local pharmacies in FL that is licensed to ship to your state.
7. It is not liver toxic
8. Insurance plans through CareMark will send you 90 day supply for ONE co-pay instead of a monthly co-pay.
9. You no longer need to be made to feel like a "druggy" because you need Nubain during a rough month
10. You no longer have to doctor hop or double dip because you can't get enough medication to keep you functional
Most importantly, ask yourself: "When was the last time that I was truly PAIN FREE".

From an outsider looking in, It just looks to me like they are trying to keep the dollars rolling in???? this is 100% of what I think by reading all of CD's and Dr. Garcia's e-mails and such..........

Ditto!!

I got up in the middle of the night (2:50am) and had composed a letter to Debbie. Since they have always left all the medical details to the professionals, I am pretty sure she put in the letter the information she was provided. I pointed her in the direction to find the correct information on the misinformation in the letter.

I also pointed out that the new oral form that is still in trials is the only one currently on label for chronic pain.

this whole thing with Nubain being in trials for chronic pain patients reminds me of the period around 1996 to 1998 when Ultram and a few other strong non addictive , supposedly , alternatives came out as a way to not precsribe hydocodone to people. people were having dr's tell them all kinds of wrong facts about how those drugs would help them without any bad side effects. that turned out bad as patients and dr;s eventually found many troublesome problems associated with those drugs , some of them are no longer even available at all. non of them worked for pain as well as hydrocodone and eventually dr's went back to prescribing it .

i would hope anyone desperate enough to try this would be very careful as injecting ones self with anything is serious . diabetics are at least trained by medical staff to do it before being sent home with syringes.

i can see a real possibility of trips to the e.r. and possibly people being damaged beyond repair from this proposed " treatment " . i have no dog in this fight as i don't depend on cd or dr. garcia for my treatment , i just hope those that do and are considering this step will be very careful .

This whole Nubain Option is Literally Insane. Please People Don't Do It!
Nightmoon .....You really need to think about this before your EMT friend sticks that Needle in You!
I would rather Have the WD's and Pain anyday then Have this Quack of a Doc tell Me to Inject Myself with this Stuff!!

Please Think About it!!

Don't Do It!!!
Stevo

My thoughts exactly 53Chevy. I have no dog in this fight either. Sounds like there still doing clinical trials on Nubain for chronic pain. Do we want to be the guinea pigs? There is not enough data available for this med in chronic pain use.

My first thought is that if he could prescibe scheduled meds, he would. He's just not able & this is his way to still make money off of chronic pain patients. He's a dog!
And he calls him self a Pain Management Doc. I bet he wont be practicing any kind of medicine for too long.

Me & Stevo were posting at the same time. My thoughts exactly, DONT DO IT.

There were high hopes also for pentazocine and meptazinol a few years ago. They have both outlasted nalbuphine in the UK, even though they are rarely used, and also have agonist/antagonist properties.

Again, while I am not sure I want to try it, it is not a new thing nor a very unusual one apparently.

One of the three pharmacies here in my very small town carries it, he said they order it for a number of pain management patients who seem to be very happy with it.
He even told me what doctors locally prescribe it.

It is not like this is some unheard of experimental therapy, I found a lot of info on it yesterday.

My problem lies with the quick change to this medication and the misrepresentation of facts about it.

HoneyBunny,

Thank you for your concern. I am out of hydro (thank god I have some xanax left). I am back on Ibuprofen 800 and flexeril. So I assume it would not throw me into withdrawls since I haven't taken any in several days. Plus, I don't even know if they are going to send the me script for the Nubain since I told them I couldn't pay $200 for a seven day script.

It is hard to believe what I am reading here.
First of all, five minutes of research on Dr. Angel Garcia will give you an education on what kind of people you are dealing with here. In addition to his "Dr. Notes" flim-flam, Intracare and problems with bankruptcy court, he was also cited by the Florida Medical Board for "abandoning his patients" for which he was fined and given community service.
Regarding Nubain, the primary reason it was removed from the CSA schedules is because the maker managed to convince the authorities that its abuse potential was very limited since even hardcore substance abusers were not desperate enough to use it by injection.
I'm firmly convinced that if and when it is approved for oral prescription, it will be scheduled.
I hope all of you are wise enough about your own healthcare to stay away from this quack and his shady family.

Can he be reported now for scripting the way he did and letting his patients go into withdrawls with no warning?
K

It probably should be scheduled. I called one guy to ask if he had ever heard of Nubain. I had assumed since he has done every drug known to man, he may of heard of it before. His reaction was: That is some good sh*t. And where can I find it?

It also seems like it is going to be pretty expensive, especially if you don't have insurance. I could get a script of hydro filled locally for $35, I think this Nubain is about $4 a shot.

I am still in college right now. I can't be shooting up pain meds in between classes at night. Maybe I could ask on of the nursing students to do it for me.......