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!

Throwaway, can I asked what happened with this? I am a new grad soon to be facing the same problem. I have already started the weaning process with my Dr but won’t be completely off for awhile. I’m scared to death about finding a job and immediately being put on BON crap list. Please lmk how your situation played out if you would! 

May I ask what state you live in? I did not disclose any information to the BON during application process. The application does ask about current or past abuse history/treatment. As far as my job, I hoped the bupe would not be included on the drug screen (on my employee health forms, I denied any problems). During my health screening before I provided my specimen, I was given a list of what would be included on the drug screen. Of course, bupe was listed and I was silently freaking out, considering walking out of appointment bc I felt like my world was gonna crash and burn. So I swallowed my pride and told the nurse that I did have a script for bupe, and I had not listed in with my other prescriptions. She said that it should not be a problem. I gave her my bottles and she wrote the info on my paperwork, and said if any issues they would call me. Never heard a word about it. I am very grateful that everything worked out. I can’t guarantee you the same, bc every state is different. Please let me know how things turn out.

I live in Alabama. Thank you so much for your quick response. I am SO glad it all worked out for you. I too share your same exact fears about employment. I’m losing my mind over here. I didn’t disclose to the BON either, simply because I am not trying to already have a negative mark on my license when I surely do not deserve it. I’ve even considered going to detox or something, but I’m a single mom of two little ones at home with zero family support. Hearing your story has given me so much encouragement, even though I know it’s different everywhere, but I was so so glad to see someone like me out there. I’m just over the moon excited for you! I don’t know if I wouldn’t have walked out with my tail between my legs LOL but I commend you for bravely seeing it through. One thing I know for sure is my prescribed dose is high and so for that reason, I’ve asked my doctor to start the taper. I don’t want to lie…obviously I’m going to be judged harshly now because I did NOT tell the BON of my history. Ugh I’m honestly an absolute nervous freaking WRECK right now. 

Please don’t let the fear overcome you. I did the exact same thing. I too can relate to being a single mom with no support. Hold your head up high. I searched the internet, Reddit, blogs high and low looking for answers and advice. I read the nurse practice act and state laws over and over trying to decide whether or not I had did all of this hard work for nothing. I only got vague answers to my questions, I was a nervous wreck for weeks after my health screening appointment at my employer. I overthink everything, which I am learning this is a trait of most nurses. Most people who comment or offer advice are not in the same situation and like to make us feel horrible for not disclosing this personal information to the BON. You are right, why incriminate ourselves before getting the opportunity to prove that we can practice nursing safely. We are actually protected under ADA as long as you are no longer engaging in any illegal use of drugs. So do not volunteer this information freely, prior to drug test, ensure you are aware of what is being tested for, if bupe is included make sure you let them know you have a prescription. That is all they need to know. I took my bottles with me, and I always keep my bupe separate depending on if it is on the test. I do not give them any of my treatment information. Be strong, you have plenty on your plate already. I hope that this will ease your fears, bc there are nurses whom have did far worse, and still practice today. My thoughts and prayers are with you. Please keep me updated. 

I have been so anxiously awaiting your response ? thank you so much for taking the time to come back on here and talk to me. Reading your reply is like reading my own words, I swear, we are so similar. All I can think about is how I’ll be judged and so I’ve stopped remembering all the good the medication has done in my life and instead feel like a horrible person. I am soon to be graduating with honors and I am SO dedicated to this career. The idea of being held back because of my prescription…it infuriates and terrifies me. I haven’t told anyone at my school for obvious reasons, but the girls in my study group like to openly share about their medications and they are on Xanax, klonapin, vyvanse, adderol, etc etc and I struggle to understand what makes my prescription ANY different. If a person with anxiety doesn’t take their Xanax, they will have panic attacks. I take my meds to soothe my disease in the same way. I’m not a danger. I chose nursing because of how thankful I am to have been given this second chance and I want to use it to help people. I’m sure I’m not telling you anything you don’t already know. So, the drug testing place gave you a list of what would be tested? I’m so scared. I am so, so scared. What if the person testing me calls and reports me to BON? OMG the anxiety is literally debilitating ?. I am so proud of you and happy for you. I am also so thankful you chose to respond to me. I’ve reviewed the nurse practice act in my state and it says a lot about NON prescription drugs but nothing specific about nurses and PRESCRIBED bupe. Someone said call the BON…absolutely not! I wish I could private message you on here but it won’t let me. I just can’t thank you enough for being so kind! You’ve given me so much hope! 

I am really glad that I am able to help you. I was so appreciative of the 1 or 2 people that were kind enough to respond to me on here as well. Our situations sound exactly same. I also never revealed my past history with my nursing friends or study groups, and yes we all sat and had conversations about the exact same prescriptions you mentioned above LOL. I too felt debilitated going through the licensing process, and onboarding process at my current employer. Yes, they gave me a paper I had to sign that listed every substance they were testing for, my heart dropped, I felt so sick, I literally sat there fighting back tears, and trying to stall bc pure panic sat in. I came so close to running for the door. I had same fears that you have now. The nurse came out to call me back and I told her I didn’t write down my bupe script bc I feared the outcome or possibility of being reported to BON. I worked so hard to get to where I am, I have been through so much, the thought of being a brand new graduate nurse and having it all taken away due to a prescription medication is absolutely ridiculous. No one really understands what we go through, they are so quick to say “you need to get off of that, you just replacing one thing for another”. I can’t tell you how often I hear that. IF I have to take it as maintenance for the rest of my life, I am OK with it. Society will always stigmatize the things they do not individually have experience with, or understand from personal perspective. 
Do you already have an offer with an employer? Or do you know where you want to work yet?

When I started nursing school, I had a serious panic attack about my meds showing up on my drug test. After I realized it wasn’t a substance they tested for, I began to realize more and more that it was OK. I had finally accepted that I take medication just like many others in my cohort. When I had that feeling of acceptance, my life actually got better and I was truly happy. Let me tell you…if not for the medication, I wouldn’t be thriving like I am right now. I have come so far because I am finally stable. Obviously I won’t ask where, but can I ask if you are now employed with a big hospital system? I want to work at a local hospital that’s just right down the road from me. Next semester is my final one and I’ll be doing my RN preceptorship. I’m hoping to be placed where I requested because it is my first choice as far as employment, so id like to see how it is there. However…if I’m being honest, I’m afraid to apply at a big hospital system because of the likelihood/possibility  that they will test for or be against my prescription. I’m convincing myself to apply at a nursing home just because I feel like it won’t be an issue at a place like that. And that sucks because that’s not where I want to be. I don’t want to work somewhere where I’m not happy, you know? Let me tell you, I was on methadone wayyyy back in the day, and that stuff tore me up. I was on it for maintenance for the same reason I take bupe now. But it made me worse if that makes sense. I was like a demon or something. Bupe isn’t like that. I feel completely normal all the time. I still get stressed, I still cry, laugh, etc. this is a Godsend for people like us and I really don’t care what others think because they have NO idea unless they’ve experienced it themselves. Did you ever have any problems with the script during school? Did you ever have to list it at any point? I worry about that too. The nurse who wrote down your script, she wasn’t rude or anything? I went for my 2nd physical for school and told the nurse I took bupe and she was very ugly to me. I was scared to death she would report me, but I don’t think she could because of HIPAA and the fact that I wasn’t licensed yet. I cried my eyes out that day and that feeling of acceptance I was talking about? Yeah, it was completely gone. I was so upset and still am a little. I already had to report some minor criminal charges to the BON to apply for the PN licensure exam, which I take on the 30th btw, and they had to investigate me but they cleared me 4 days later and told me not to get into anymore trouble. So as if not admitting my addiction was bad enough…literally ANY complaint against me and I’m sure they will not go easy. 

Yes, I currently work for the largest hospital system in my area. The nurse was really nice and told me I would be surprised how many nurses took medication. I did not openly admit to any details. I did not have any problems during nursing school. It was not a substance they tested for, however they did test for Methadone. I would not disclose you are on bupe, UNLESS you specifically know for sure it is being tested for. HIPPA doesn’t offer as much protection as people think, however we are protected under the ADA laws. An employer cannot discriminate against you. As long as you are able to perform your job, you shouldn’t have to worry. I would not advise you to limit your opportunities to working in a nursing home if that isn’t what you want to do. I worked at one for about 3weeks and quit because they have mostly LPNs, and I felt like my license would be at risk because they were so shady. Fortunately I have not had to deal with the BON, I have never been in any trouble. I can tell you that I consider myself grateful everyday that I have came so far and become an RN and I would not jeopardize or risk it for anything. 

Yes I believe you and I feel exactly the same way. Luckily all my trouble was small misdemeanors and nothing drug or theft related. Just dumb decisions basically. I have a friend who started working in a nursing home and she said the same thing about them being shady and she also feared for her license so she quit 3 days later. It’s actually really sad that nursing homes are like that. Well, as soon as I take the NCLEX, I’ll be job hunting for LPN position until I’m licensed as an RN. I will keep you updated on what happens with me. How are you liking your job? 

Specializes in Street Knowledge.

reading about all the states I will tell you this and this is real...If you live in a red state republican run odds are your program will be super strict...Only cases I hear of any compassion are from states run by democrats...so keep voting red and live under constant policing..I am a democrat and republicans are the actual ones who want to control your every movement when it comes to speech press abortion how a woman lives her life...and flat out suppress your way of life and freedoms...Like the new don't say gay bills...what happened to freedom of speech and if your that worried about what your child hears in school...I can promise this its NOT COMING FROM TEACHERS ITS COMING FROM OTHER KIDS!! FROM kindergarten to college other peers have more influence than any teacher or parent ever will! And if you are that worried you better home school...

Throwaway, you probably won’t get on here anytime soon, but I wanted to see how you were doing with your job? I am applying for jobs now and still have debilitating fear…I am praying to God to allow me to work while on this medication. I’m terrified of being reported to BON even though I have that valid prescription. Just wanted to check in and see how you’re doing. I hope all is well with you. 

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