Compliance while taking Suboxone

Anything about buprenorphine that doesn't fit somewhere above, fit it here!
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Post by weak_and_powerless » Fri Nov 30, 2012 11:31 pm

They are getting better and better at detecting if you've been taking the exact amount you're presribed and if you are taking it consitently, daily and how your presribed.

The test I take is $700, which my insurance covers and they can also add other substances to the test nowadays like propoxyphene, tramadol, nicotine and hallucinogen properties.

I have access to mine for educational purpose, this the actual/usual test performed, though they can of course add other substances if they choose:

Cannabinoids (Cannabinoids) NEG
Cocaine (Cocaine) NEG
Benzodiazepn (Benzodiazepines) NEG
Barbiturate (Barbiturate) NEG
Amphetamines (Amphetamines) NEG
Propoxyphene (Propoxyphene) NEG
Methadone (Methadone) NEG
Opiate (Opiate) NEG
OxycodoneGrp (OxycodoneGrp) NEG
Ethanol (Ethanol) NEG
Creat-Ur (Creat-Ur) 21.0 mg/dL

It gets even more hardcore when they do the test for Suboxone, showing the actual breakdowns of the metabolite groups. This is an actualy copy:

Buprenor Grp (Buprenorphine Group) POS
Norbuprenorp (Norbuprenorphine) 959 ng/mL
Buprenorphin (Buprenorphine) 154 ng/mL

Those above are shown in actual bargraphs too see how consistent the levels stay over the appointment dates. Of course, my levels will vary each visit, depending on when I took it last prior to the test but if the line on the graph is too sporadic that could mean something to my doc.

I hear some doctors just have the usual bup, yes or no positive test.

Just some knowledge.

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bad graph

Post by boxer » Sat Dec 01, 2012 9:27 pm

I agree with you that one's bar graph should be fairly consistent.

I think each persons meatbolism is different and this could cause a difference in the rabge of the bar graph, like how much fluid intake, etc...

Most doctors may only test yes or no, unless they suspect something.

I think that a person could go a week in a month a take 0 sub for 1 week and take 8 mg a day for a week 2 and 3 andon week 4, or even 5-6 days prior to the appointment take the prescribed dose and the test could not tell whether that person skipped a week and loaded up prior to the next visit?

The reason I ask, is that some labs claim they can determine compliance over time, I just don't think they can do that. I know the sub builds up in fat cells, but not enough for them to tell if a person has loaded up or not?



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Re: No worries

Post by Genoveva69 » Fri May 01, 2020 2:53 am

Tndb wrote:
Sat Nov 03, 2012 10:20 pm
Good stuff Boxer and thanks for the research...don't worry, you are not supposed to site anything here as you are not writing a paper nor are you claiming this info to be you own. I don't really know where that came from
As has been discussed previously in this and other threads, according to research on the www, a lot of doctors are getting the heat from regulatory authorities for prescribing narcotics.

To help the doctors be more confident that patients are sticking with the prescribed medications regime, they are starting to use more and more sophisticated test(s) to determine compliance when it comes to taking too much, none or too little of their medicines.

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Re: Compliance while taking Suboxone

Post by docm2 » Wed May 06, 2020 1:12 pm

It is not the standard of care to be using expensive confirmatory (quantitative) tests. ASAM, American Society of Addiction Medicine, and SAMSHA, (the feds) both recommend simple cup tests that can be processed in an office with rare use of confirmatory tests. I am not aware of any addiction practitioners 'feeling heat' for prescribing buprenorphine products.
With 8 practitioners generating 10 UDS a year for each patient we have charges in the low 5 figures vs 2,500,000 dollars if we did quantitative testing on every sample. Huge waste of money and resources in my view.
10 per year is very ballpark, stable patients with me over a year get tested quarterly.
I can no longer speak to what is happening in the pain management world with full agonists but I haven't seen quantitative testing advocated for in an recent seminars or CME I have attended.

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