Can my insurance company disclose what meds I'm on?? Seeking treatment for drug depen

  1. 0 Long story short I realized I was having a problem with pain pills. It's so embarrassing to admit that this happened to me.....I never saw it coming. So with the support of my husband I went to a psychiatrist and have been taking suboxone for about a month and it is a miracle drug.

    I paid for the doc visit out-of-pocket as the addictionologist I went to doesn't take insurance. After a long talk with him about my confidentiality I decided to fill the script on my insurance and pay $100 co-pay as opposed to $569.00 out-of-pocket. As I discussed with him I am obviously very concerned about my employer and more importantly the BON. He was very supportive and reassuring that he takes care of nurses, doctors, teachers, cops, ect and he has never had someone's insurance company "out them" for their treatment. His response to my concern about filling this med on my health insurance was "If your insurance company reports you to your employer or the board for taking suboxone....you call me and I will give you the name of a lawyer that specializes in HIPAA and your settlement will be so big you won't ever have to work again."

    Now before you start judging there are things to know:

    1. I never diverted. I got more than enough pills from my doc so it was never worth the risk for me.
    2. I have not had any troubles at work. No disciplinary action of any kind and just had an excellent annual review.
    3. suboxone doesn't show up on standard drug tests (you have to test for it specifically)

    I just renewed my license so I have 2 more years before I have to check the yes or no box on "weather I have been treated for substance abuse." The more I think about it I wish I had just paid out of pocket for the med so there would be no paper trail. I just don't know what to do. I am fully responsible for my actions and I accept that. But at the same time I was taking legal meds that were legally prescribed to me. It just got to the point where I would get sick if I didn't take them. That's why I sought help. I took 1 week off of work (approved vacation time) to start this new medication and returned to work healthy and better than ever.

    So.....any of you out there have experience with this? Should I self report to the board or just cross my fingers?
  2. Visit  babypanda123 profile page

    About babypanda123

    Joined Nov '11; Posts: 4; Likes: 3.

    17 Comments so far...

  3. Visit  gatoraims RN profile page
    3
    I would that your ins. company reporting this would be against HIPPA. You are seeking help. I honestly do not know what or if the BON or your employer would have a leg to stand on. I am not very knowledgeable about suboxone, but are there any other treatment uses for it?

    You did not break the law, you were given a script for pain pills, you are doing the correct thing in seeing that there is becoming an issue with them and getting help for it.

    I honestly do not know if you should contact the BON over this or not. But I wanted to say good for you for getting help.

    I also wanted to add that when I was a CNA there was a nurse who had a drug issue. She was sent on "vacation" (this is what the DON told us at least) when she got back she told a few of her closer friends that she was sent by the hospital (place we worked for) from substance abuse treatment (she was addicted to pain pills). They hired her back at the hospital after going through a three month treatment plan. When I left the hospital she still had to have anther nurse with her when she pass narcs. But they gave her job back, I am not sure what happened if anything with the BON.
  4. Visit  xtxrn profile page
    7
    This might sound stupid, but give me a second

    First- no judgement from me

    Were you using the meds for a 'high', or did you have physical dependence or tolerance d/t taking the pills for a while? This is an important distinction when you get to the time of having to check the box. Ask your addictionologist how he/she is coding this. If you had physical dependence/tolerance, it is a HUGE difference between that and addiction

    I haven't heard of patients being outed by the pharmacy/drug insurance. I'm sure nothing is impossible with the variety of lousy judgment in the world, but that would be really weird.

    If you have had physical tolerance/dependence, you don't have to check "yes" for substance ABUSE treatment. There are many classifications of meds that require increased dosage over time d/t dependence or tolerance, not just benzos or opiates (or street stuff, which isn't an issue here).


    http://www.forcon.ca/learning/pharmacology.html
    nola1202, NeoNurseTX, pinkchris2000, and 4 others like this.
  5. Visit  VICEDRN profile page
    1
    No advice. Best of luck to you though!
    xtxrn likes this.
  6. Visit  79Tango profile page
    1
    Suboxone can show up as an opiate (which it is) but it can also be prescribed for Pain Management.
    xtxrn likes this.
  7. Visit  babypanda123 profile page
    1
    I never thought of it that was xtxrn....as i am just now getting a crash course in the vocabulary of this type of medical care.

    I was taking them for pain....then I was taking them because they made me feel less depressed (for which I am also being treated for now), and when I realized that if I didn't take them I would get sick I got scared and got help. I have no idea how he coded my appointment. My billing receipt says "initial assessment" and subsequent visits say "med management" He told me that he "doesn't answer to the nursing board" and that the ONLY time he would release my medical records would be for a "criminal suponea" and that he would not respond to the nursing board as he is not required to do so by law. Then of course the standard harm to self/harm to others. He said if I were to ever be questioned about it by my employer to say "pain management" and nothing more....then call him
    xtxrn likes this.
  8. Visit  Simply Complicated profile page
    2
    AS xtxrn said, there is a big distinction between a physical dependence and an addiction. I would talk to your doc about it. But what you are describing sounds more like physical dependence. Also, my understanding is, when they ask about being treated... they are usually referring to actual treatment for addiction, not just a doctor using suboxone to wean you off of narcotics you came dependent on.

    Good luck to you. I would discuss all this with your doctor. Considering you said that you never diverted, have not had any repercussion with your job I would hazard to say you are safe. Also, the pharmacy nor insurance should report you to anyone for filling a legal script. As someone else said, suboxone can be prescribed for pain as well. So they really can't report it and say you are addicted.
    NeoNurseTX and xtxrn like this.
  9. Visit  doegirl profile page
    2
    I would not advertise, but not lie either should the issue arise. Such issue could be a drug screen, for instance.
    It is of no concern to BON or coworkers what you have been legally prescribed by a doctor for a very real problem. As long as your judgement isn't impaired and you're a safe nurse, who cares.
  10. Visit  jesskidding profile page
    5
    I don't have much advice regarding the specific questions you asked, but I do think it's great that you recognized you had a problem and are doing something to help yourself.

    That's hard for anyone to admit, let alone seek help. I applaud you!

    I wish you the best!!

    catmom1, xtxrn, flyingchange, and 2 others like this.
  11. Visit  DizzyLizzyNurse profile page
    2
    Just wanted to say I wish you luck with everything and good for you tackling this head on!

    My mother died of a drug overdose after being addicted to pain killers for years. She used to be a nurse.
    nola1202 and xtxrn like this.
  12. Visit  Ashley, PICU RN profile page
    4
    OP, look up the DSM-IV criteria for substance dependance vs substance abuse. It very clearly defines the differences. According to the information you provided here, you are no where close to a diagnosis of substance abuse and barely meet the criteria for dependance.

    I whole-heartedly agree with what xtxrn said. Just because you developed a physiologic dependance to a legally prescribed drug dose not make you an abuser and you should not have to be punished or worry about others finding out.
  13. Visit  xtxrn profile page
    2
    Quote from babypanda123
    I never thought of it that was xtxrn....as i am just now getting a crash course in the vocabulary of this type of medical care.

    I was taking them for pain....then I was taking them because they made me feel less depressed (for which I am also being treated for now), and when I realized that if I didn't take them I would get sick I got scared and got help. I have no idea how he coded my appointment. My billing receipt says "initial assessment" and subsequent visits say "med management" He told me that he "doesn't answer to the nursing board" and that the ONLY time he would release my medical records would be for a "criminal suponea" and that he would not respond to the nursing board as he is not required to do so by law. Then of course the standard harm to self/harm to others. He said if I were to ever be questioned about it by my employer to say "pain management" and nothing more....then call him
    This is not the behavior of addiction When an addict feels better, they will do just about anything to get more of THAT drug (or class of meds=opiates). They don't think "Hm, this isn't good. I need some help".

    I don't see where this is substance abuse. If you would have been admitted to the drug/alcohol rehab I worked at, you would have been, more than likely, medically detoxed and sent home. I think the addictionologist's referring of this as med management is correct, and shouldn't raise any red flags w/insurance or the pharmacy.

    Relax, and just get through this heartbeat:heartbeat
    TXRN2 and DizzyLizzyNurse like this.
  14. Visit  babypanda123 profile page
    2
    Thanks for the support guys. I really appreciate it. Trust me I am not discussing this with anyone. No one knows but my spouse. I don't know what I would do if my license was threatened. I'm thankful I have health insuranse to cover this Med but I'm sure
    as nurses you can understand my worry
    DizzyLizzyNurse and xtxrn like this.


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