How to Talk With Your Doctor About Taking Suboxone

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If you’ve been misusing opioids, you might need professional help. But it can feel awkward or even frightening to talk to your doctor about Suboxone or another medication for opioid use disorder (OUD).

Almost 85% of Americans say they trust their doctors.[1] But even so, some patients fear starting this discussion with their health care professional.

The first thing to know is that disclosing your drug use to your physician is completely confidential. There are laws in place that prevent your doctor from disclosing your personal substance use history to law enforcement.

Even if there weren’t legal protections, doctors aren’t policemen: their job is not to punish you. Their job is to keep you as healthy and safe as possible, and most of them are happy when you disclose your concerns about your substance use as it gives them an opportunity to help you.

Know that you can always trust your doctor with information about your drug use. Starting the conversation could be lifesaving, and help you get the treatment you need.

Here's what you need to know about starting these conversations with your doctor. 

Things to Tell Your Doctor When Discussing Taking Suboxone

First, know that your doctor is not legally allowed to talk to others about your drug use, including making a report to law enforcement. Anything you say to your doctor is confidential and protected under a law called HIPAA [2]

You're not required to talk about where you obtain your drugs, and your doctor isn't likely to ask.

Your doctor may ask about the following:

1. Your Drug History

Your doctor may ask you questions like, what substances do you use habitually? What substances do you use intermittently? Have you tried a drug once and never used it again? Is there a substance that you are using regularly? This helps them to understand what drugs you might be dependent on and what medications and therapies would be the most helpful for treatment. 

2. Your Typical Dose 

How much of each substance do you take? Do you have symptoms (like nausea, shaking, or a headache) if you don't take your drug? Do you need more to get the results once delivered with a small dose? This helps your doctor understand if you have a tolerance of a physical dependence on the drug, which can help guide him or her in what types and doses of treatments can be offered to you. 

3. Your Drug Use Methods 

Your doctor may ask about this because different delivery methods of drugs pose different risks to your health. For example, individuals who use injection drugs are at risk for different infections than those who merely snort or smoke. Your doctor may ask if you swallow pills, snor/crush pills, or if you inject drugs. If so, they may ask if you share needles with others, which increases your risk of infections. 

4. Your Treatment History

Have you tried to quit using drugs before? What methods did you use? How did you feel when you tried to quit? What made you relapse? This can help your doctor understand right away what treatments have or have not worked for you in the past so that you can decide together what treatments - either pharmacological or behavioral - are the right ones for you. 

Which Types of Doctors Prescribe Treatments for Addiction?

Many primary care or family medicine doctors treat patients with Substance use disorders. Therefore, if you have a primary care doctor that you know and see regularly, talking to him/her is a good place to start. However, some primary care doctors do not treat a lot of patients with addiction, and may refer you to another specialist doctor. Oftentimes, these doctors are psychiatrists or physicians who have done additional training as addiction medicine specialists.

In some states, doctors must get a special license to prescribe Suboxone (although this is changing and becoming less common in many states in order to facilitate more easy administration of this medication. [3] In other states, Nurse Practitioners (NPs) can also prescribe Suboxone.

If you have a doctor you know and trust, ask them if they prescribe Suboxone, or if they can refer you to a provider that does.

You can also use an online tool like this one to find a buprenorphine doctor near you.[3]

Suboxone treatment programs can last for months, years, or indefinitely for some patients who need life-long treatment [4] It's important to work with someone you trust, as you'll be connected for a long time.

Don’t let fear or intimidation prevent you from talking to your doctor openly and honestly about Suboxone: they are there to help. Ask your doctor about Suboxone, or reach out to us here at Bicycle health for more information.

Sources

  1. Surveys of Trust in the U.S. Health Care System. ABIM Foundation. https://www.norc.org/PDFs/ABIM%20Foundation/20210520_NORC_ABIM_Foundation_Trust%20in%20Healthcare_Part%201.pdf. February 2021. Accessed August 2022.
  2. https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html
  3. Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. July 2022. Accessed August 2022.
  4. Buprenorphine Practitioner Locator. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/find-treatment/treatment-practitioner-locator. Accessed August 2022. 
  5. Factors to Consider Before Prescribing Buprenorphine. American Psychiatric Association. https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2018.11b12. December 2018. Accessed August 2022.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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