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!

faithnow, may i ask the vincinity in VA where you were able to find employment. I am having a horrible time trying to find employment now that I am involved with the VRP program in PA. I am also not sure how to approach the subjuct with perspective employers? Any ideas or help would be greatly appreciated......thank you

I have been and addict since 1999. I was given a dx of fibromyalgia (this is not a fake disease, it is however an over used dx by many lazy physicians) after extensive testing in 1995 and initially treated with pain meds, which I did not abuse. Over the course of 4 years I was lucky enough to get hooked up with a doc who did not believe in narcs for fibromyalgia but physiotherapy instead. He weaned me to Tramadol (later also found to be addictive :

epocrates: best of luck to you!!! i have absolutely no idea what your BON will say or do- but i hope it works out for you!!

FYI-the Naloxone in Suboxone is not absorbed into the system. It is simply in the combination drug to keep people for shooting it up. Otherwise you actually absorb little to none. It's the Buprenorphine itself that has such an affinity for the mu receptor it can't be bumped off by 99.9% of opiates. So, the naloxone doesn't keep you from feeling the effects of opiates, or make you sick, it's the affinity of the buprenorphine to hold tight. If you were to take buprenorphine without naloxone whilst having opiates on board it would kick whatever opiate you've taken off the receptor and take it's place. that's why you cannot start someone on Subutex, or Suboxone until they are in full withdrawal.

What if you have been reinstated just a week ago, already signed your agreed order from your BON? The only instructions is no mood or mind altering substances, if u are on meds your doctor must fill out a paper stating the reasons why you are on them. I have been an addict for 10 yrs. I thought suboxone would help me from a relapse. I'm in the state of KY, does anyone know??

Specializes in Impaired Nurse Advocate, CRNA, ER,.

I don't think Kentucky allows a nurse to practice while on Suboxone. You might want to consider consulting with a nursing license defense attorney. I've put out some feelers from folks who might have the answer to this question. If I receive anything definitive I'll post it.

Jack

Specializes in geriatric.

Well said. I have been on it since 2006 .Some may say I am weak and still using but since I only answer to myself I say I am almost eight years in recovery. I can honestly say I have not used any iligal narcotics.i have no cravings and have gone from 32 mg a day to 4 mgs a day. I am now a practicing lpn for four years without a single incident.Although I have seen many other nurses using and diverting drugs with no proof I have to mind my business and worry about myself. I was out of nursing for almost three years and thought I would not be able to work in nursing a gain. I did start as a can until my compny felt they built enogh trust to let me work as a lpn which I am now doing. My life is normal and some day I may not need it but for no I will continue to slowly wean myself off and live in alife wear I can do what I love nursing. when I got my license back the nys nursing board new I was on suboxone and aloowed me to work while on the medication. So for any of you who think its as bad as using other narcotics yea I will call you ignorant because as they say addiction is a disease which can be controed with medication same as any other illnesses and also like other illnesses is no cure.Best wishes for any one going thru the struggle..

I'm not sure either, thanks for the help. You are the only one who has answered me. :-)

Specializes in critical care, ER,ICU, CVSURG, CCU.

double edge sword, i am glad i was not afforded it

most BON say no....

i see it help in myclinical environment of practice, but only few have weaned off.....

the 12 step way worked for me, and i personaly advocate the steps

Specializes in ICU, psych, corrections.

It was one of my options and I quickly turned it down because for me and me only, I would have been replacing my dependence on pain pills to dependence on suboxone. From what I have seen working in the psychiatric field for the past 5 years and many, many addicts, when they have been offered suboxone, it doesn't encourage them to find other ways to manage their sobriety. They aren't much interested in meetings, a sponsor, etc. This is just from my experience. I think it has its place, short term but long term use just wasn't for me and I didn't want to even start down that path. I was taking close to 40 Norco's a day and endured a nasty 7-10 days of withdrawal but then it was over and I was clear of any pills, medications or the need to take anything. And that was when I buckled down and started a 12 step program in order to ride myself of the obsession/craving.

I know our BON does NOT allow it at all. They are very much opposed to the use of just about anything while on contract.

Imodium??? Loperamide, the "opiate" in Imodium only acts on the intestines, it can't pass the blood/ brain barrier, so Cant actually effect the users brain or mood. Even not allowing Benadryl is ridiculous. Only in Texas.

Specializes in LTC, Psych, Med/Surg.
.. Even not allowing Benadryl is ridiculous. Only in Texas.

No, not only in Texas. Several states are as bad or worse. My state has no alternative to discipline program of any kind for ANYONE with any addiction, so one's career is destroyed regardless of how many years, even decades of recovery are in place.

Catmom :paw:

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