Suboxone use and the Boards of Nursing

Nurses Recovery

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Does anyone here know, with any degree of certainty, how the various State Boards of Nursing view the use of Buprenorphine (Suboxone/Subutex) for opiate dependence and/or addiction? Do they allow nurses who are in diversion/alternative to discipline programs for addicted nurses to use buprenorphine as part of their treatment plan? My first reaction would be that they would not approve of it and would actually state that if a nurse is using Suboxone/Subutex they would be practicing in violation of their Nurse Practice Act. But I don't know that for a fact. I believe that buprenorphine is saving many lives right now of opiate addicted individuals...giving them a much better chance at sustained recovery over the long term. It does not affect the mood, produces no euphoria and in fact, in my opinion, provides a good safety net against relapse. While on bupe, the opiate receptors are loaded and taking a full agonist opiate will provide no high to the user, thereby taking away the obsession to use. There are just so many good things about this treatment modality that I cannot believe it is not more widely accepted amongst the Boards of Nursing. I have heard that most if not all, BONs prohibit its use, but I'd like to know if anyone knows that to be a fact, either by their own experience or by reading about it somewhere. I'd appreciate any responses. Thanks a lot!

Specializes in ICU.
The ISNAP (Indiana State Nurse's Assistance Program) does NOT allow use of suboxone, or any other controlled substance. When you first go into the program, they warn you that ISNAP follows an abstinence-based program, and that if you are currently taking any controlled substances, they will give you 8-12 weeks to be weaned off of them or you cannot participate. I'm not sure how that works out for people who have legitimate medical conditions, but that's what the ISNAP agreement says anyway.

In Texas if someone has a legitimate medical condition and needs narcotics, then they say that the program would not work for them so they refer them back to the bon.

Specializes in Med-Surg, Intermed, Neuro, LTC, Psych.
In Texas if someone has a legitimate medical condition and needs narcotics, then they say that the program would not work for them so they refer them back to the bon.

Yes, the Indiana program says basically the same thing... that if you require long-term narcotics use you will be discharges as non-compliant from the program, because taking narcotics is not compatible with safe nursing practice.

Specializes in geriatric.

I know of a nurse who is in the proffesional assiatance program who lives in NY she is on suboxone for almost 4 years and has been doing wonderful she is working a slow taper and has gone grom 32 mg to 14mg .without it i do not think she would have made it thay far. she is now after 3 plus years working as a lpn in NY with no restrictions on her license except that she acn not do more overtime then 10 hours every other week.so it may be a case to cars basis.

Yes, the Indiana program says basically the same thing... that if you require long-term narcotics use you will be discharges as non-compliant from the program, because taking narcotics is not compatible with safe nursing practice.

wow, I'm glad Missouri doesn't have that rule. I have a herniated disc and literally cannot function without pain medication. The whole time I was in the program I attended a pain clinic and was prescribed Vicoden. As long as I had my prescription, it was acceptable.

florida ipn allows suboxone while practicing.....i have it in my ipn contract. I eventually got off of the stuff though because I wanted to be free of the addiction to the stuff. I have been off the subs for a few weeks now and my brain is now truly off opiates. That is something that is truly a remarkable improvement. I have a little bit of paws but it gets better every day.

Specializes in PICU, ICU, Hospice, Mgmt, DON.
florida ipn allows suboxone while practicing.....i have it in my ipn contract. I eventually got off of the stuff though because I wanted to be free of the addiction to the stuff. I have been off the subs for a few weeks now and my brain is now truly off opiates. That is something that is truly a remarkable improvement. I have a little bit of paws but it gets better every day.

Congrats for getting off of everything...and it does and will get better every day--according to the research on addiction it takes approximately 18 months for the brain to return to preaddiction status :)

As far as the Fl IPN goes, it's done on a case by case basis..the IPN is an Abstinence only program. This includes the use of all controlled substances and alcohol while you are in the program. The use of suboxone is not allowed unless your addictionologist wrote it specifically into your contract.

I personally have very strong negative feelings about the use of suboxone, as I don't believe in substituting one opioid for another...and believe me, I know what I am talking about. The withdrawal from suboxone is far worse and much longer than any of the plain old narcotics on the market as it stays in your system for 11 days (it took me 9 days of hell to get off of suboxone)..but now it's been 2 and 1/2 years since I have had anything...and it's GLORIOUS.

Good luck to all of you out there trying to beat this disease. You can do it.

in Virginia, i was allowed to practice as a floor nurse in ltc. allowed to give/count narcotics, but was required for eight months to take suboxone. i didn't feel i needed it, as i was "over" the wanting to use. i had to take the pill every day witnessed by my work site monitor, who had to sign a log sheet. i lost some weight, had less appetite, but didn't notice any other effects. i really felt like vahmp didn't really know what else to do with me and my case. i still had to call five mornings a week and pee test as they randomly chose. i was appreciative of the fact that i was allowed to practice, and that i was fortunate enough to find an administrator/corporate office that would work with me. even though i felt like i knew i was over my active addiction and crazy behavior, i was aware of the fact that the board had to attempt to protect the people i was caring for. i don't know if vahmp determines suboxone use on case by case basis, or what--but in my case i greatly benefited from it.

Specializes in Impaired Nurse Advocate, CRNA, ER,.

Each board of nursing determines their stance on the use of opioid replacement therapy. Check their web site or contact the BON to see if they'll share their position. You can find links to the boards of nursing and many alternative programs here:

State Boards of Nursing Including Information About Alternative to Discipline Programs

wow..glad I found this site. I am a RN who surrendered my license abt. 10 years ago because of a terrible addiction to pain pills that has almost cost me my life on more than one occasion, I am talking abt. coding in the ER. I have been on suboxin for a second time for a little over a year now, down to 1 mg a day plus a butrans 10mcg/hr patch. I am wanting to go back to nursing really bad and I feel like it is time. But suboxin has saved my life and I don't want to give it up. I live in Wisconsin, anyone know abt. the Wisconsin BON? I am scared to even call them, should I be honest or be quiet and take a chance on a positive screen ruining me?

Specializes in Psych ICU, addictions.
should I...be quiet and take a chance on a positive screen ruining me?

No no no no NO.

Sure, there's a chance you could get away with it. But if you tested positive, first you may not get the opportunity to explain your innocence. Second, if they do let you explain it...if you don't disclose the suboxone use and then try to address a positive test after the fact, you have to convince them that you have not relapsed...and unfortunately, as a nurse in recovery your credibility is often shaky to begin with. It's not always fair but that's how it is :(

I would call them and ask. If you are too scared to call, send them an e-mail...and if you're really scared, send then an anonymous e-mail. After all, the worst they can tell you is "No"...which is a lot better than gambling on a UDS.

You've worked this hard in your recovery...you've done a lot harder things in recovery than making a phone call. You can do it :)

Best of luck!

thanks so much for the info and advice! I am gonna do this! not sure how yet! will keep you posted.

Specializes in Psych ICU, addictions.
thanks so much for the info and advice! I am gonna do this! not sure how yet! will keep you posted.

http://www.drl.state.wi.us/

Specially, the BON site is here: http://drl.wi.gov/board_detail.asp?boardid=42&locid=0

I vote for the anonymous e-mail route. If you need to, get a free gmail or yahoo account to do it with.

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