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!

You shouldn't have to disclose anything. If your drug screen is positive, the MRO will call you and ask if you have a prescription. If you do, the drug screen will be reported to the company as negative. If you do not, it will be reported to the company as positive. 

I really appreciate your response. I have been terrified over past weekend. The forms I have to fill out prior to the screening, ask about past addictions or drug counseling. I have already decided I am gonna say No. However, on the form it requires me to give consent to medical records so I am still worried, hopefully I’m just being paranoid. In the event the test shows that specific substance, I do have legal prescription. I have never been in any trouble, no disciplinary issues.  I am a new graduate just starting career, and I have worked so hard to get to where I am today. I pray everything goes smoothly. Thanks for your time.

I'm sorry you're going through this! That seems really invasive for the hospital to ask. I did have one job that asked similar questions and asked what medication I was on. I just put "N/A" for everything and then the MRO called when it was positive and I gave him my prescription info. It was then reported to the hospital as a negative drug screen, since I had a valid prescription. 

I agree it is very invasive. May I ask does your state allow nurses to practice while taking Subutex?

Well health/drug screen included Bup on the UA. I had no choice but to tell the collector that I did not write that medication down. She allowed me to add it to my medication list, however I still answered other questions about past history with a “No”.  She told me as long as I had legal script, it should be considered a negative result. But the BON in my state does states that nurses aren’t allowed to practice if using subutex. Can they report me to the BON, or require me to enter some type of program?

That I don't know...if she's saying it will be considered a negative, I don't know who would report it to the board? Your hospital won't be able to see anything other than "negative" once your script as been reviewed by the MRO. I once had an MRO ask what I did for work so I don't think they automatically know you're in healthcare. 

They said I may not hear anything back, but if so it should be by the end of the week. They did send my specimen off to lab as well, she claimed it was just to confirm the substances. On my paperwork it specifically asked if I have ever had treatment or counseling for drug or alcohol abuse and I answered “No”. The nurse made a statement that the MRO may contact me if he has any questions in regards to my answers on the form. I have been on subutex for many years, so I am not sure how I would explain or respond to his questions.  Maybe simply explaining I haven’t been in active addiction for many years and did not see the relevance of disclosing that information, since it will never be an issue to my performance.  I sincerely appreciate all of your reply’s and comments. You have gave me the courage to push through this issue. I felt like running out of my appointment yesterday or telling them I wanted to decline the position.  However, it is a big hospital system and they own nearly every facility in my area minus 1 or 2, other than LTC facilities. And the pay rate they offered is nothing to complain about. If you would like, I will continue to keep you updated?

Suboxone can be used for pain management! Easier said than done, but try not to worry too much. The MRO might have concerns about you being a nurse on suboxone and that is OK. You're not doing anything wrong. I think they report it as "negative with safety concerns" (look up DOT drug test). So if they did that, I still think you would have an opportunity to discuss it with the hospital. And yes, I would love if you would update, I'll be thinking about you! Hang in there 

Specializes in Neuro.

I know this post is old but I’m curious if your an active nurse and chose to go to a doctor and get help about 2 years ago then it’s time to renew your license it’s asking about addiction. I’m concerned about answering this? I didn’t even know there was a possibility I couldn’t take it and my doctor has never said nothing to me and they know I’m a nurse….

Hi, this is actually current post. I am a new graduate and trying to complete onboarding with Hospital system. I have been extremely worried that I could possibly lose everything that I have worked so hard for.  I am not sure what state you live in or the guidelines that are specific to your state Nurse Practice Act. The advice I have received, is don’t disclose unless it is revealed. I am still waiting on my results from my health/drug screening, which tested for Bup. I told the nurse prior to submitting my UA sample and was allowed to add the medication to my list. On the form I put “No” for past addiction treatment or counseling, not sure how this all will play out. 
If you are already employed, as long as you are not impaired or at a risk of harming patients, and no longer engaging in illegal substances….I would not disclose. This is my personal opinion!! I strongly believe we should have the right to keep this information private if no wrongdoing. Addiction has such a negative stigma, not many understand. If you were taking Methadone, I would say otherwise, but Buprenorphine does not impair one’s ability to perform safely. 

I know a nurse in OH that was called and questioned about her Suboxone tx. She has seen an addiction doctor since before nursing school, has never had practice errors and was reported to the board because there was a Suboxone discrepancy and everyone on her unit was tested- and bam she was positive- but she is prescribed. 

The Ohio BON took no action against her license, perhaps because she is in recover and functioning. Or perhaps it happened during covid and this https://www.NCSBN.org/Policy-Brief-US-Nursing-Discipline_COVID19.pdf

Appreciate everyone who has responded. Well it has been over a week and I have not received any phone calls or emails from MRO/Employee Health, so I am assuming everything is okay. Like I said I did provide my prescriptions and the nurse wrote all info down on my drug screen report. I know she sent my sample to lab to confirm, but assuming no news is good news.

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