re-examing diversion

Buprenorphine Post
Posts: 571

Postby kcairns » Fri Jul 17, 2015 7:26 am

Another addition (but one to me like from bros Grimm) to our common (as some of above) experience ---i inducted man week ago today (thru my OTP work where no pt limit so was only source of helpintime) ... long history of imprisonments, and just got out again , history ...believe it or not ...2 people come to him at once, one a dealer saying "i have just what you need"...the other an acquaintance offering 3 bup, saying "dont let yourself go back to prison , try these..." ... he chose the bup, one daily x3 helped so much he immediately found out where to come for help...imo the above grand jury issue vividly tells of : the extent and crucialness of the unmet need for treatment and the viciousness of the disease , the incorrectness of legal system, and stunning chronic malinformedness of citizenry, like discrimination against addicts 25 years to the day post passage of the Americans w Disabilities Act bob Dole still calling on country to improve how it views disabled people and noting only 3 country's in world have refused to sign the UN Treaty on the Rights of Persons w Disabilities,- the Congo, Guyana and the United States of America ...imo we can rejoin the war on drugs or we can stand up w data showing that -- all else considered regardless of source of bup or heroin or rx pain pills, bup is safer and saves lives..I agree w hdavid in the aspect that i RX bupmono only to the pregnant and happy we have it for so many moms who otherwise could not b offered preferred RX.I have no ivbup users in my practice and if did would refer for dot, and the number of people number out there w bup as iv drug of choice miniscule compared w those w heroin oxy ms dilaudid methamphetamine re what i can do do help ivdu out there who would like to get help to stop but who are not my pts I guess I could work for super US public health program when it startshaha.or as in guys and dolls go out and beat the drums to bring in the sinners who would just plain rather be left alone to nonviolently exercise their right to get their own selves high, but w all the docs easy rxing RX drugs and bup easy to get on the internet, to achieve such mission, i would need help like signing on a sidekick such as sancho panza

Posts: 9

Postby tdbailey » Fri Jul 17, 2015 7:26 am

A counselor at one of the clinics in which I work recently served on grand jury duty. Of the 47 people they indicted, 42 were related to Suboxone-either selling or illegal possesion. This was startling to me. It's no wonder law enforcement-and the public at large-seems so often to have a prejudice against MAT. Not that I intend to stop treating pts with Suboxone but it is imperative that we do all that we can to try to mitigate diversion. We can never eliminate it 100 percent, but we need to try to keep it to an absolute minimum if we ever hope to get broader acceptance. This likely factors into the 'cap' issue as well. I can see how those evaluating the TREAT act might ask if we can't keep track of 100 pts how can we keep track of more? (And frankly, I'm not sure I have a good answer to that question.)

Posts: 118

Postby sslonim » Fri Jul 17, 2015 7:26 am

One of my male patients has a girl friend who also has opioid dependence (I don't treat her). She is now pregnant so he was giving his Suboxone to her as he didn't want the baby exposed to multiple opioids ... she has been unable to find a Suboxone doctor where they live (he comes about 30-40 miles to see me). He went back to heroin and his urine was positive. I guess I'm supposed to discharge him? (according to some but not me)

Posts: 198

Postby NoDrugs4u » Fri Jul 17, 2015 7:26 am

MChaplin, all good points. I have gotten several new patients who were "inducted" with street bup.

What really gets my knickers in a twist is that the DEA doesn't care about people diverting their prescription for 300 Vicodin from Dr. Feelgood, but God forbid someone share one Suboxone strip with a friend in withdrawal.....

(I know, we are all preaching to the choir here)

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