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PostPosted: Fri Mar 29, 2013 5:40 pm 
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Hello, everyone! I am happy to find this forum and am hoping you guys can help me. I have been in recovery for six years and haven't relapsed for the last three years during which time I have been on Suboxone, 4 mg a day, taken as prescribed. I am in the process of getting a professional license, and they want me to do their drug testing program before they will give me my license. The tests they give are urinary 12 panel tests, which I don't think even pick up on buprenorphine typically.

They know that I am on suboxone. The man in charge told me that was okay but that they would just check to make sure the levels of buprenorphine were correct. Can you even get reliable levels from urine? I assume they are testing for some metabolite rather than buprenorphine itself....what if I metabolize it idiosyncratically? I also take another drug that will, through its CYP34A action, slow the transformation of buprenorphine into norbuprenorphine. I don't know if this means that I will have elevated levels.

I am nervous about this. As I said, I am taking the medicine as prescribed, but I know that if the tests come back that my level is too high, they are going to believe the test rather than me. Does anyone know how reliable and accurate these levels tests are? Given that I have been on suboxone for years, I assume that my blood and urine has about the same amount of it in me all the time, right? Would it make sense to not take my suboxone in the morning if I find out that I am being tested on that day to keep the levels down, or would that not make much difference? I know in naive patients that buprenorphine levels peak .7 hours after administration and norbuprenorphine levels peak after 1.45 hours or something like that. If I make sure that it has been as many hours as possible between when I took the last one and when I do the test, will that make a difference in my levels?

One other thing is that I always take my suboxone right after washing my mouth out with mouthwash. I read on here that alcohol can increase the bioavailability of suboxone. My mouthwash has some alcohol in it. Will that elevate my levels? Does higher bioavailability = higher levels in urine? Should I stop using mouthwash?

Sorry for all the questions! As I said, I am very worried about this. I have put a lot of money and effort into obtaining a professional degree, and I have a great job lined up, and now I may not get to do it because of dumb things I did a long time ago. I appreciate your help a lot!


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PostPosted: Fri Mar 29, 2013 8:50 pm 
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Hi WSN,

First of all congratulations on your degree and the great job offer! It seems to me that you have put alot of effort into this career and that you really want to make it work. I think that is fabulous, but I also think you are causing yourself undue stress here because it is so important to you. I can't quote you any kind of statistics or medical information here...all I have is my own experience with my doctor. He tests me every month to see if my levels are what they are supposed to be. I have not been real great with taking my subs as directed. I would almost always have either too much or too little in my system on test day. The only time I have run into problems is when my test showed NO sub in my system at all. I just don't think the tests can pinpoint exactly what you should have in your system at any given time precisely because of the reasons you listed. What is in your system will depend on how each persons body metabolizes the drug, what time you took it that day, and any other number of variables. It sounds to me like they are being very accomodating to you and understanding of your situation with the suboxone. I think it would be a good idea to just keep doing what you are supposed to do with it and trust in the test to come out in your favor. I read nothing in your post that would make me believe that you should have any problems whatsoever.

Relax and enjoy the rewards of your hard work!


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PostPosted: Fri Mar 29, 2013 10:01 pm 
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Hi there and welcome,

I think your best bet is to discuss this with your perscribing doctor. Explain to him what's going on and all of your worries. He will know better than anyone and should be able to address your concerns.

Congrats on getting your license. Don't sweat. If you're taking it as prescribe and taking it around the same time daily, you should have nothing to worry about. :)

Let us know what he says, could potentially help others, too!


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PostPosted: Wed Dec 18, 2013 2:08 am 
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Gotta plug my blog again: http://www.suboxonetalkzone.com/a-new-suboxdoc-in-town/
and http://www.suboxonetalkzone.com/urine-d ... -suboxone/

Urine comes from gallons of filtrate that has been concentrated down by 100-fold. The quantitative advocates try to use levels of BUN and creatinine to estimate the degree of concentration, and to then derive the blood levels... but blood levels of buprenorphine are affected by many medications, including antidepressants that block metabolixm... and there are large variances between the percent of a dose absorbed from one person to the next. 'Quantitative' testing of urine is an oxymoron. The problem is that many of the docs using it are just PLAIN morons.


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