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 Post subject: Suboxone film count ?
PostPosted: Sun Aug 18, 2013 4:45 am 
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Hi I have been on suboxone for about 1 year and 3 months . I have never had any dirty drug screens never messed up in anyway with my doc.

I got a call on Friday from my nurse saying that per my suboxone contract that they can call me up at random requiring me to go into the office for the nurse to count my suboxone films ? This came to me by surprise because in this whole year I have been on them I was never called once to ever go in and have my subs counted . :shock:

Does this sound right has anyone's sub doc done this before ?

No where in my contract does is even say will you be required to come in at random to do a film count. I am very confused :? that all of a sudden after a year of never having to do this that i get a call .

Thanks :D


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PostPosted: Sun Aug 18, 2013 7:26 am 
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Hello Valerie and thanks for your great question! Actually that very thing happened to me at least twice that I can think of right now. It WAS in my Suboxone contract with my sub doctor.

I was called one time by his nurse and asked to bring my Suboxone (I was on the pills at that time) pill bottle, and what pills I had left for them to count. I was told right on the phone that if if didn't "add up" to what I should be taking, and what I should have remaining I would have to explain. I was also told that if there less than I should have I could be discharged from their sub program.

Luckily I had been tapering my dose down without the doctor's knowledge and had plenty of sub to make the difference and have exactly what I should have left and all was well.

Does the doctor have any reason for making this request such as you running out of sub "early" or asking for more at any time during your sub therapy? If not maybe they are implementing that plan of action because someone else was caught being dishonest with their pill count? Only guessing there, but that could be the reason.

If you have taken what you should have, and not given any away or sold any, then you should have nothing to worry about. I'm NOT judging you in any way, only explaining what I know through experience. You should have had to sign a contract when you first went to this doctor, and somewhere in it there should be a paragraph saying they are allowed to follow this protocol.

I'm not positive if they can do this or not even if you have no signed contract? Maybe someone else knows that answer and will jump in here.

How are you doing on the sub Valerie? May I ask how much sub you have been on at your highest dose and what you are taking daily at this time? And do you plan on remaining on the sub or getting off anytime soon? I'm sorry for the questions and you certainly don't have to answer. I was only curious because there is so much good information on this site from very knowledgeable members all willing and wanting to help anyway they can, me included. If you have any other questions please let us know.

Hope this helps and I wish you the best. Again welcome here and hope it works out for you! Take care Valerie.

Karen xoxo


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PostPosted: Sun Aug 18, 2013 8:25 am 
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The FDA has a push on for voluntary training for all prescribers of ER/LA opioids, (Suboxone would be included). They are calling for 'better' monitoring and tighter controls. I suspect some states will make this mandatory soon. Random UA's, pill counts, pt. agreements are all part of this 'call to action'. It is not just sub patients but anyone on long term opioid use. I prefer the term agreement because it is not a legal document nor is it binding.

ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care CME/CE from MEDSCAPE


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PostPosted: Sun Aug 18, 2013 4:02 pm 
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Here is a table from one of the trainings. This is an FDA initiative with collaboration from State Boards of Medicine; not driven by the DEA. It is in response to the escalating overdoses and deaths that have been occurring due to opiate prescribing.

Table 8. Examples of Provisions That May Be Included in a Management Plan

◾The patient should obtain opioids from only 1 prescriber
◾Opioid prescriptions must be filled at a designated pharmacy
◾Certain steps should be taken to safeguard prescription opioids: ◾Do not store prescription opioids in a medicine cabinet—theft from medicine cabinets is a major source of diverted opioids
◾Keep the medication locked (eg, patients should be encouraged to lock their medications in a medication safe)
◾Do not share or sell medication

◾Instructions for disposal of the medication when it's no longer needed
◾The patient makes a commitment to return for follow-up visits at a specified minimum interval
◾Compliance with appropriate monitoring: ◾For example, providing a urine specimen for random urine drug testing when requested, and bringing in prescription medications for pill counts

◾Frequency of prescriptions, which may involve limited prescriptions (in weekly or biweekly instead of monthly amounts)
◾Specific behaviors that may lead to opioid discontinuation
◾An exit strategy if opioids need to be discontinued


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PostPosted: Sun Aug 18, 2013 4:33 pm 
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Thanks Karen for the information , I have nothing to worry about I have all of them since I don't sell or give any away . I was just very surprised since I have never gotten a call to do a pill count.

In my 28 years of life i have needed multiple surgery's for many things like gallstones,kidney stones,and i had 3 kids and all my births didnt go well and needed emergency surgery for all three kids birth. Due to all my surgery's and hospital stays I was always put on Morphine ,percocet, & Vicodin .

So because of all this being prescribed for long periods of time due to my pain for each surgery , I got hooked on these opiates .

My drug of choice then were percocet 10/425 mg I would take on average 8-10 per day and was pregnant with my 3rd child . I took these for the whole pregnancy of my 3rd child I felt bad but couldn't stop I was so hooked on them. The docs starting prescribing them to me for the remainder of my pregnancy as a precaution. They were telling me that they didn't want me getting them off the street while i was pregnant due to the dangers of street pills. And also because if I stopped taking percocet and went into withdrawal while pregnant i could loose the baby due to the stress of the withdrawals.

So I stood on the till I had my baby girl she came out fine with no withdrawal symptoms which was great. Me on the other hand I needed to do something cause I was in bad withdrawals after being cut off the day i had the baby. They referred me to my current sub doc and in just a week I was prescribed 3 1/2 suboxones a day , this was such a life saver for me and it made me feel normal again .

It had been 1yr and 3 months the same age as my daughter , that I have been on the subs I am on 3 suboxone films per day currently and they are the 8mgs films. I am going to try and taper to 2 films a day next month i hope all goes well. I plan on staying on suboxone for a few years until im strong enough to get off them mentally and know that I wont go back to pills which I am really afraid of .

And thanks for all the questions I don't mind replying or answering any question you might have nice to meet you and hope to talk to you soon.


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