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PostPosted: Fri Feb 26, 2010 10:12 pm 
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Are the laws governing suboxone state or federal laws or both? If federal, what are the counseling requirements? For long timers, is it required that you are in counseling the entire time? If so, how often? 1x per week? 1x per month? In a case like mine where I'm not on anything and have already done the whole drug counseling thing a long time ago but have a therapist I love and work well with....do I really have to do another counseling program when I go back on it?


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PostPosted: Mon Mar 01, 2010 12:24 pm 
I don't think there is any law that states an individual must be in any type of counseling or therapy in order to be prescribed Suboxone. I think it's probably up to the doctor. There seems to be quite a bit of variation in requirements from doctor to doctor. I've heard some people talk about their doc requiring counseling or meeting attendance which must be verified in some way. But then there are docs like mine who've not required or frankly, even suggested that I get counseling or attend meetings. However, my doctor did do a fairly thorough interview and assessment at my first visit. Because of that, he knew that I had already been trying abstinence-based recovery for quite a while, had done an IOP program, aftercare and attended NA multiple times per week for months. He's never made me do a drug screen either. I don't know if he requires different things from different patients or if we're all the same. Maybe I'll ask him next time I go in.
My doctor really seems to have the attitude of putting his patient's recovery into their own hands, except for seeing him, paying him and getting your Sub Rx. He's very lax on my dosage, never has done pill counts or anything like that either. Just basically asks how I'm doing and how much Sub I'm on when I go in every month and asks if I need a script or not. The only thing he's ever 'called me out' on was that I didn't get an appointment in for the month of December (I had let about 6 weeks pass between appointments.)
Anyone else care to share what their doc requires? Or does anyone know if there really is a "law" or anything that talks about this? I'll see if I can find out anything.


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PostPosted: Mon Mar 01, 2010 1:14 pm 
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This is another good question. I have thoroughly researched this as well as requirements for urine collection. I can't find anything in data 2000 or the subsequent amendments with regards to guidelines for counseling etc. Most of the federal law focuses on the physicians and how they become licensed to treat addiction in their office.

http://buprenorphine.samhsa.gov/data.html
http://www.deadiversion.usdoj.gov/fed_r ... fr0522.htm

I think most subs dr's use the following as "guidelines" but these aren't laws and I couldn't find anything with regards to urines or counseling:

http://buprenorphine.samhsa.gov/Bup_Guidelines.pdf

I'm sure Dr J would know the answer to this and hopefully he will chime in or blog the info. BTW... His blog has a wealth of info and is important reading for all subs patients.

My Dr requires me to come in once every 28 days and I get my script at the same time. I am one of the fortunate ones who gets free meds thru the VA hosp. I say they are free but we did pay a price... it just wasn't monetary.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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