The length of time a person stays on Suboxone, i.e. buprenorphine treatment, has become a needlessly-heated issue. Readers of my blog, SuboxoneTalkZone, likely know my opinions on the topic.
I recently met with the parents of one of my buprenorphine patients who were frustrated over their son’s ‘lack of progress.’ They complained that he has been on Suboxone for three years, and wondered when I would finally get him off the medication. They pointed out how sick he gets when he forgets to have the medication refilled, saying that he is just as ‘dependent’ as he was when he was taking heroin.
I am glad, at such times, that I don’t have to search my conscience to determine whether my treatment plan has a financial incentive. In short, it doesn’t. If anything, my financial incentive would be to get everyone off buprenorphine as quickly as possible. I have a long waiting list of people who are hoping for a spot in treatment. And since new patients usually need a higher level of care, bringing in new patients results in more ‘business.’ Because of the 100-patient cap, the portion of my practice taken up by people on Suboxone has become a small, relatively-stable group of patients.
I’ll have a longer post on the issue at some point, but I wanted to get this information out as quickly as possible. If you are having trouble finding a physician, or even if you used to struggle to find a physican, please do everyone a solid be adding your name to a petition to raise the patient cap on prescribing buprenorphine or Suboxone.
The process only takes a couple minutes, and requires nothing but your name and email. If you aren’t certain if raising the cap is a good idea, read my snarky comments at Suboxone Talk Zone, and THEN sign the petition.
The important thing, though, is to sign the petition, here: http://wh.gov/QR6K
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My personal practice receives several calls per week by people asking for help in treating their addiction to pain medications or heroin, or often both. As people seeking treatment usually discover, each physician is capped at the total number of patients who can be treated with buprenorphine at any one time. During the first year of buprenorphine certification, physicians can have up to 30 patients under treatment at one time. After a year, a physician can apply to have the number increased to 100.
I have been at 100 patients for years, and I have relatively slow turnover, since I am an advocate for long-term treatment using buprenorphine. My wait-list has about 60 names, although when a spot opens up and I start calling people on the list, many of the numbers have been disconnected. Opioid dependence tends to do that to telephone accounts, either through poverty or death.