Suboxone and Nursing

Thanks for the topic--for those of us in CA, at least, the discussion couldn't be more timely..

First, to the OP: I'm sorry I don't know anything about Texas licensing issues but I suspect, like most boards, issues regarding past medical/criminal/etc. issues tend to be handled on individualized bases i.e., no 'hard and fast rules'. Best of luck to you!!

HOWEVER, is anyone else following the attempts to revise prorocols for all licensed boards that fall under the Dept. of Consumer of Affairs? Some of it is as a result of the recent 'headlines' regarding BRN discipline and diversion program enforcement shortcomings and some is just a timely overhaul of all the various boards in order to form a more coherent system of guidelines for any such future substance abuse program to be run, regardless of whether each separate board decides to initiate and maintain a program of their own.

That said, and while nothing is set into law as of yet, there are a number of proposed changes to CA's current system and, while perhaps some are needed, I personally feel they are displaying enormous difficulty in managing the protection of patients/consumers of the state on balance with the individual rights of RN(and to now include LVN) licensees.
I don't want to muddy the topic with many concerns(this is actually a relatively lighter one) but, as of now, the legislative staff has endorsed not utilizing a MRO in conjunction with any drug testing process to be put in place. This is relevant as the specific need NOT to install such a professional in place was because an MRO can deem whether or not a positive test is as a result of legal and prescribed means and that, following these new proposed protocols, NO licensee in any diversion program will be allowed to ingest any scheduled medication, legally prescribed or not--for any reason. A specific example of an injured nurse testing positive for a prescribed opoid was given as a reason for a program 'failure'.

I guess I'm just wondering if this is the norm for other states? Is it reasonable to suggest a nurse would not follow medical advice regarding presribed medications for the duration(3 years as proposed standard)?
How do you balance acute injury, for example, with the desire for program compliance?
How does, if you know, your state handle licensee's w/ADHD, chronic pain issues, etc.? I know we all have our own opinions on whether nurses should or should not work on various meds outside of these programs and that generally seems to boil down to a big, fat, 'it depends'. It also tends to be a divisive point of contention...
But, how does your board deal with scheduled meds AFTER you've become involved in the diversion process?

To the OP, my personal advice to you is that you can enter the HC field and be successful, as a recovering addict, I know people who have done so. I also know people that have relapsed after yrs of recovery, when they became nurses. I would not encourage nursing to any recovering addict, just based on the reality that nursing is stressful and is emotionally and physically hard, the hours are irregular, and the availability of meds is always there.

As far as disclosing this info to the BON, I personally would not do so. This is not their busienss and if a person is able to recover without incurring any criminal records and on their own initiative, this is private medical info that is protected by HIPPA laws. It would only be used in a negative way by any BON and is discriminatory.

As far as suboxone use... too many "recovering" people object to it, and think that people using it are not in recovery....I personally disagree with this, and base recovery on how a person lives and acts, and the people I know using maintainace drugs are NOT the same as addicts trapped in the hells of active addiction. They don't lie, steal, or behave in ways that addicts do, instead they are working, responsible, and looking for ways to grow and change for the better.

I cannot see how people can make a determination about someone elses recovery based on what they read online, and the idea that people automatically label a suboxone user as a red flag, and are concerned about them soley due to the use of a medication is unjustified to me.

There are some states that do allow sub use, IN is one for sure... and there are some states like FL that is definitely against it. All states differ, most don't address this in their NPA.

FYI, NY BON allows this

http://www.nysna.org/practice/positions/position15.htm

Whoa: The above is simply a position statement endorsing the idea of methadone maintenance programs. It it NOT and endorsement of methadone use among practicing nurses. NYSNA has not taken an official position on the issue of nurses who use opiates chronically for pain management. This is such a complex issue and we don't have enough data to support either a pro or anti status. Having said that, a small amount of study does support the use of suboxone over methadone because there are suble differences in judgement skills. We don't have ANY studies supporting the safety of nurses who use either drug. Until these come in, the employer has to decide whether to hire someone on maintenance drugs.

I live in Missouri. I have chronic back pain which is what got me into trouble in the first place. Almost the entire time of my probation I was enrolled in a pain clinic and took vicoden on a daily basis. I needed it to function!

The BON was fully aware of this and was perfectly fine with it.