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PostPosted: Tue Jan 16, 2018 11:07 am 
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Hi I tried to find this subject couldn't find anything. Has anyone had problems getting their Suboxone filled? I've heard a couple of people have problems with their dose being over the 90 mme however hopeful it's just beginning of the year problems. Perhaps people confused. Thank You, Dee


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PostPosted: Thu Jan 18, 2018 11:15 am 
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Hi Dee, What does mme mean? I am so fortunate in that I have only had difficulty once and my Doctor, who is amazing, handled it for me. I hope it gets worked out and you are able to get your script!


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PostPosted: Thu Jan 18, 2018 12:36 pm 
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MME refers to mg morphine equivalence. The state drug databases show the equivalent morphine dose for people on opioids, and some states and agencies are considering having special requirements for prescriptions that exceed a certain morphine equivalence.

The data for buprenorphine, though, is wrong. I describe why on my blog at http://www.suboxonetalkzone.com, but the basic problem is that PDMPs take the potency of buprenorphine at very low doses, then extrapolates that number without taking into account the ceiling effect of buprenorphine.

I spent considerable time writing to Brandeis U and the CDC, who came up with the conversions for buprenorphine, but I never found anyone who would address the incorrect data.

I myself have not heard of any of my patients having problems getting the medication, but I can see where that might happen. If anyone is impacted, please let me know!


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PostPosted: Fri Jan 19, 2018 3:43 pm 
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The OP doesn't say how much they are prescribed. I have had pushback or refusals in the past for higher doses.
Highest right now is 24 mg a day, two 12 mg strips, the prescription management company wouldn't fill 3 strips a day (8's) but were ok with 2 of the 12's.
Everyone else is at 16 mg a day or less so I haven't had any denials of dosing. Occasionally will need to change to another brand such as Zubsolv or generic.
Companies are not approving 32 mg a day, but not based on the MME, it just isn't clinically indicated with maybe some very rare exceptions.


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PostPosted: Mon Jan 29, 2018 6:21 pm 
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Thank you Dr. J for the explanation! I really hope that with all these "controls" that they believe are going to be beneficial for all of us, in fact are really helpful and not just more red tape!


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Dr. Jeffrey Junig, M.D., Ph.D.

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