CURRENT info regarding the use of Suboxone while nursing?

[LPNpaired]

Everything I've found via research is over 5 years old. Literally, all of it. Nothing based in 2017 as far as I have seen. Would love your reply if you meet any of the following:

-Work in or have been treated in, a Suboxone clinic as a nurse, and have been told or shown in practice by your MD (or boss,if you work there) that even healthcare workers who work around medications have the right to confidential addiction treatment with Suboxone

-Taken or administered a drug test for a nurse, and can tell whether buprenorphine was on the test or not

-Are familiar with the NPA's stipulations regarding 'banned substances' in practice.

-Been in IPN and know with any degree of certainty whether Sub is approved as part of your treatment

* please include your state, if you do choose to reply, because supposedly the law varies

I have two points to contribute to the discussion, for anyone who may google and stumble upon this thread as I have with so many others..

1. Been taking Suboxone under the table (from a friend, not an MD, due to fear of being in treatment being disclosed to an employer or the BON) for about 5 years. Started nursing school in 2014, was urine tested, didn't show positive. Started a job in 2015, was mouth swabbed, didn't show positive. (Researched Oral Eze mouth swab, buprenorphine not a tested substance.) Was suspected of diverting in early 2016 (can say with honesty that I was not; this was part of a facility-wide sweep that was done on ANY suspicion, including giving a PRN 30 minutes out of time frame, etc, after a nurse was caught diverting 50+ shots of Demerol), was urine tested with the HPP Comp 1 for healthcare workers, had only about 18 hours since last suboxone dose at the time of test, did not show positive. (Buprenorphine not a tested substance, according to research.) Had a cheap 5 panel on-site urine test done a month or so later in 2016 for employment, did not show positive. Have also taken my own 12 panel from Walgreens, the test included opiates but not bupe. No false positives for opiates or anything. **Not saying that it won't be on your test, if you're a nurse who is wondering. Just that I've been very blessed thus far.

2. Called a nearby Suboxone facility this morning without the intent of setting an appointment so much as just trying to grasp for SOME type of reliable information regarding nurses on sub. I asked if they treat nurses on suboxone. The reply was "Yes, we do treat [other] nurses here. Are you through IPN?" (She said it as if she had dealt with IPN clients before, so I think it could be possible that the FLORIDA IPN may allow this med-assisted treatment? But I'm unsure, because) I am not in IPN, I have not diverted, I simply am tired of running, and know that if I get drug tested, I would rather be positive for something I have a script for than just HOPING that it's not on the test and one day running into a mess. So, I told her I was not, then further elaborated on my question by asking if nurses have the right to be treated confidentially, without having to worry about a phone call to an employer. She stated 'yes, absolutely.' The final question was about whether or not she knew if it was legal for a nurse to practice while on Suboxone. She stated "As far as I know, as long as it isn't an 'issue that has been brought up' in the past, yes." I went ahead and made appointment.

Would really like to receive some input from any of the people mentioned above, before I go into this and forever leave my name in the books. I know we have all been told over the years that healthcare information is confidential, essentially no matter what, but all it takes is 1 jerk doctor to insinuate being on sub poses a risk to my patients to warrant a call to my employer and/or the BON.

Responses very much appreciated by myself and any other nurse trying to stay afloat with maintenence treatment.

[dirtyhippiegirl, BSN, RN]

Why do you have to tell your treatment providers that you are a nurse? That would solve your first problem. As you have seen, bupe is not on a standard basic drug screen so it seems unlikely that will be an issue, but at least you will have a legit rx if you come to that.

[elizabethgrad09]

Buprenorphine is on the standard urine drug screen that we use in our psych hospital. We have patients in our hospital who detox from opiates using a subutex taper, starting at a maximum of 16mg the first day (depends on how much they were taking), with a reduction of 2-4mg each day until they are done.

[LPNpaired]

Why do you have to tell your treatment providers that you are a nurse? That would solve your first problem. As you have seen, bupe is not on a standard basic drug screen so it seems unlikely that will be an issue, but at least you will have a legit rx if you come to that.

I never said I planned to do so.

I called, not intending to set an appointment, asking for information. They were helpful, so I went ahead and did so. Unless the secretary put a special note on my appt. date stating "IS A NURSE!" (hah), I don't believe it will come up,unless they ask, or do a search to find out. Board registration is public knowledge.

The doing a search to find out is what concerns me. If it is in fact not within the bounds of practice for a medical professional to practice on suboxone, it would stand to reason that they would perform a search on each potential client. This is what scares me.

[mmak]

The great thing about suboxone, as you know, is that it keeps you from feeling w/d symptoms but it doesn't make you high like using methadone for MAT would. I don't see any reason why you couldn't work as a nurse while on suboxone. I also would think you have ground to stand on in terms of taking a MAT that doesn't make you high and is effective maintenance treatment.

I would really recommend you start receiving your own bupe rx; your friend is diverting their rx and that can get them kicked out of many programs if found out.

If there was a search done and you were found to have bupe on your person, it better be your own rx so the prescribing provider can go to bat for you with your employer if they have a problem with you being on it at work. You can also call the state BON and inquire anonymously. That's probably the best way to go.

[StillRN]

My friend who is in our states board ordered program switches back and forth from suboxone to morphine/oxy/Xanax (for severe back pain..ruptured discs, sciatica) all the time. Just as long as she has a prescription, it has never been a problem. She is back on subs now because doctors don't want that responsibility of prescribing those meds, but she is back in severe pain and now just checked in for treatment for depression due to pain and this insane contract. But my point is she has been at several jobs and suboxone has never been an issue.

[Tony1790, BSN, MSN, NP]

As a provider in TN, I worked in 2 places, an Urgent care where we did drug tests for employment, and as you have found, the standard employment screenings don't test for suboxone. However, I worked at a pain management facility as well and we did routinely screen for suboxone and we would not see those patients until it had been 6 months since their last use of suboxone if they were using it for drug addiction, additionally, we would not see that patient at all if they had been on the drug for pain control, that was just a company policy due to the high tendency for abuse and the additional licensing and liability that the medication entailed.

I was looking through the Florida statutes, suboxone isn't specifically mentioned with what I could find, it's basically lumped together with all of the other controlled substances, however, the statutes and FL BON say that a license can be revoked if it can be shown that: Statutes & Constitution

:View Statutes

:

Online Sunshine

(j) Being unable to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, or chemicals or any other type of material or as a result of any mental or physical condition.

The above can be subjective, however, your post isn't entirely clear, you stated that you were investigated for diversion, but didn't say why. **And not to put a fine point on the issue, but you are diverting drugs, just not from the patients at your employer, a different patient. For which Florida statutes look pretty clear, that is both a crime and a reason to lose your license. Additionally any licensed person that knows about this diversion and that doesn't report it, can lose their license as well.

So as you are already aware, as a healthcare professional especially aware, that you need a prescription from a licensed provider in order to be taking a controlled substance, so I am glad to see you making an appointment, best not to get fired or jailed for doing something that you can easily get legally.

Good luck in the future, you didn't say if the Suboxone was for pain or addiction, either way, good luck.

[hppygr8ful, ASN, RN, EMT-I]

MODS NONE OF THIS IS MEANT TO BE MEDICAL ADVICE - BUT IF IT IS ANY WAY INAPPROPRIATE OR AGAINST TOS JUST DELETE! tHANKS.

The answer to your question is going to be state specific. In the world of Random UDS (For cause or simply for your employer's amusement) I would definitely would not risk using this method to come off opiates without a valid prescription. That little slip of paper may save you life and career should you have a positive UDS. My advice is your recovery is your business until it is not so don't tell you employer anything unless you have too. Don't tell the suboxone doctor that you are a nurse. Some medical professionals are required to report an impaired medical professional so many adopt a "Don't ask, don't tell policy."

That being said I have seen some nurses on probation and in Diversion in California who were actually required to be taking suboxone, so as I said the answer you seek is state specific.

To protect your self against the day when you may come under BON scrutiny keep very careful records. Most legitimate suboxone clinics do random UDS to make sure you are not using other drugs so ask for aND keep a copy of those results. Consider going to some type of recovery support group (AA/NA/CR) at least once a week and keep a notebook of signatures to prove attendance. Learn some Recovery language even if you don't believe it. If you are seeing a mental health professional again keep careful records. Also if you have surgery or go to ER for anything and get a prescription for any pain killer photo copy the script and keep it. If you drink stop it doesn't mix with suboxone and if you can't stop drinking for sure don't get behind the wheel of a car.

Peace

Hppy