buprenorphine and privacy issues

[Paregoric Kid]

if you go on suboxone with a doctor, do you become red flagged as an addict in all of your medical records? I know in my state they passed a privacy act and when I went to this one program to get my adhd, anxiety, and depression meds they said I had to sign papers to allow them to share and recieve information from my other doctors, which was also optional, would this prevent a doctor prescribing suboxone from telling other doctors about it? I just tried half an 8mg sublingual tablet and after a while I started to feel like I took some codeine or maybe a vicodin or two. this would make life alot easier for me if I could take buprenorphine on the days I can't find anything and easier than swallowing poppyseed tea and cheaper than buying codeine online if I could get back on insurance.

[shaunclo]

Im not really sure if I understand the question that is being asked. Are you asking if a doctor would prescribe suboxone only on days that you cant get dope? Or are you asking once you are prescribed suboxone, will this red-flag you so that if you try to go to another doctor to get some meds, he wont prescribe it to you because of previous red-flag?.......im confused

[Paregoric Kid]

I'm asking that if I get on buprenorphine will it go on my other files? if another doctor wishes to prescribe me something that's scheduled will they know that I'm "a drug addict"
like I knew someone who had drug abuse in their medical history on file and he got ritalin but once they realized that he had abused drugs in the past they called him up and told him to bring the script back.
I don't want this to bar me from getting other prescriptions in the future. if I go to a doctor for this, will it be private, between me and the doctor and the insurance company. will the doctor pass this along or what? I don't want any other doctor knowing I'm using it, is that possible?
I'm a paranoid person as it is but if getting on bup would prevent me from ever getting anything else good prescribed to me again I wouldn't take it.

[darkangel]

i used to pill shop and was quite successful at it, the doc cant give out info without your permission. if you go to a dr. and he doesnt know your an addict, he wont find out unless you give him access to the records from the sub dr., and you would have to specifically sign for those records from that particular dr, understand. theres no database with your records in it, otherwise there wouldnt be enough opiates out there for us to buy and get high. dr shopping accounts for a large portion of street drugs, and that wouldnt be possible if drs knew everyones info. unless the drs work in the same e.r.,the same clinic, e.t.c.. there shouldnt be any risk of your dr finding out your taking sub. for addiction.

[eElle]

I can't say for sure re: doctor/patient privacy but I do know for a fact some insurance companies will send up a red flag (and a "nice" note in one's mailbox) if a person is prescribed more meds than the insurance company thinks is sufficient.

Example: about two years ago, a co-worker in Texas was given a total of #90 Vicodens over three months by her dentist following a series of surgeries. She received a letter from her insurance company saying she was "overusing" scheduled meds. The letter didn't contain a threat, per se, but damn.. it scared her silly enough to resort to online purchases rather than getting flagged as a potential abuser at work. Word got around the office and others began ordering online as well.

Back then, there were a bunch of online pharmacies (now they're mostly closed down) charging $160-200+ for the same drug these people were paying a $15/copay.

A high price to pay for simple pain relief, eh?

[bi11i]

I can tell you that I've been to several different doctors within the last year (and since I've been on the bup) and not only is it nothing to worry about, but most doctors don't even know what it is (not that it's a good thing.)

Medical records really don't work like that; at least not yet they don't. I know there are some programs in development and a couple in place to create a central database for such things, but its too early for many doctors to use such a thing. I've advised more than a couple of people who are on methadone to go ahead and get their scripts for bup without stopping the methadone; who's going to know? Then at least you can go back without losting your place in line, place in time, etc.

I wouldn't worry, just don't offer information that's not necessary.... It IS a good idea, however, to include information on your person if you're ever taking drugs like bup or naltrexone, for emergency medical people. I'm asking that if I get on buprenorphine will it go on my other files? if another doctor wishes to prescribe me something that's scheduled will they know that I'm "a drug addict"
like I knew someone who had drug abuse in their medical history on file and he got ritalin but once they realized that he had abused drugs in the past they called him up and told him to bring the script back.
I don't want this to bar me from getting other prescriptions in the future. if I go to a doctor for this, will it be private, between me and the doctor and the insurance company. will the doctor pass this along or what? I don't want any other doctor knowing I'm using it, is that possible?
I'm a paranoid person as it is but if getting on bup would prevent me from ever getting anything else good prescribed to me again I wouldn't take it.

[blahblahblah]

It easy as pie to get a script under an assumed identity if one so wished, I didnt even need to show a ID @ my first bupe doctor, but it could come to bite you in the ass.

As for it red flagging you, not likely at this time as you the indivdual have the right to disclose [or not] your medical records to any other doctors. I dont believe the US's current medical record achieve is up to par, so many things fall thru the cracks. It takes alot to get red-flagged mainly stupidity.

Nice site hope it picks up pressure

[renton]

I was wandering through the old threads and came across this one that talks about the exact thing I've been thinkin about. Bupe is soon to be released in Canada and I'm thinking of trying it. I'm hoping that being on it wont get me stuck with the drug addict label like methadone seems to. My understanding is that with Bupe you can take your dose at home and not have the hassell of going to the clinic every morning and it doesent have the negative images in doctors mind like methadone seems to, it being considered a drug for "serious" drug addicts if there is such a thing. Whats been other peoples experience with the treatment you get compared to what methadone maintanance is like?

[HistoryofMadness]

Your doctors are supposed to get express consent for each doctor specifically that they are going to talk to. You should never sign away your HIPPA privacy rights, that is, your rights to keep your records from whomever you deem necessary.

You should be fine, and if your doctor insists that he be given blanket permission to speak with anyone regarding your addiction, you should find another doctor.

And bi11i's right: there isn't a central medical database in place yet. But it has become the next big thing with all the medical policy wonks, for reasons you'd be disappointed in if you knew why.

Insurance companies are also bound by HIPPA, so even there you SHOULD be ok. I say SHOULD because its really an ethical issue on the part of insurance companies, and they aren't the most ethical bunch.

Having said that, they can't spill the beans, and they can't drop you for doctor's care, but your only means of protection in such a case would be law suits. The problems are (1) insurance companies have lots and lots of money for lawyers and the ability to drag your name through the mud publicly if you decide to sue, but you may not even have that option because (2) often times insurance companies screw customers by binding them to arbitration, which is both run by the insurance industry and slanted towards the same companies.

So the best option is to make decisions carefully about insurance claims, and read before you sign (and don't sign blanket privacy waivers).

[Opiyum]

Yeah 3 years ago and a few months after getting off subs i was able to acquire a few different scripts. Including Diazapam, Lorazepam, Temazepam, Hydrocodone and T3's.
One of the first things they tell you is that noone else will know unless you want them to.

[Zoop]

Yeah, it's totally nuthing to worry bout. My bupe doc told me that he and other docs will sometimes use subutex or suboxone to treat bad back pain. Which is funny to me, because I've had some mufukin back pain while on that shit. Anyways, I don't submit the office visits for the bupe doc to my insurance, because the doc has to put a diagnosis code on there and there is a diagnosis code for opioid dependence. That's what he'd put on my thing if I were to submit the claims for his office visit to my ins. So, I only submit the prescription to insurance, and without that "opioid dependence" diagnosis code, they can't prove shit - I can say I've been takin subutex for back pain!

Oh, and about getting prescriptions under assumed identity. I have been going to a local "quack" doctor in my area (well, he's not exactly a quack, just nice and will pretty much let you tell him what to prescribe. Put it that way). So, I been getting stuff from him for a while, under this fake name (it's not "Zoop"). I go the same pharmacy every time with his scrips because they recognize me by my fake name there! I always worry about them sayin' "could we see some ID" but they never have. The doctor hasn't the pharmacy hasn't neither. so, if you're gonna do that, ALWAYS PAY CASH (it' looks pretty fucking dumb if you whip out a credit card with your REAL name on it) and ALWAYS KNOW YOUR DETAILS, like your "fake" address and "fake" phone number. Also, I recommend putting your cell phone number down as your "fake" phone number. JUST MAKE SURE YOU DON'T HAVE "HEY THIS IS (your real name) LEAVE A MESSAGE!" ON YOUR CELL PHONE! 'Cos what if the doctor calls it and it says it's someone different than who he thinks it's supposed to be? Just say your telephone number on your cell phone message.

[renton]

I was wondering too whats the deal if you need to go on a vacation, will they give you a two weeks dose to take? do they ever do that with methadone either?

[Opiyum]

I regularly get a two week dose...even more this time due to Labor Day. They will give you vacation doses but if your new then its xtremely hard to do. You have to do a lot of paper work to prove the vacation and what not.

[Zoop]

Yeah, depends on how long you been on bupe. I have been on maintenance since last November (2005) and now, I'm up to a 30-day supply in one whack. Started out just 3 days, then 7 days, then 2 weeks, then 3 weeks and then 4 weeks for a couple months. The last one, Dr. Buprenorphine wrote out a 30-day supply. 75 tablets of pure buprenorphine satisfaction.

Man, I can't fuckin wait until methadone goes on prescription status like buprenorphine! I really sincerely believe it will in the next few years, because there's so much demand for it, and in the United States of America (God bless America, wipes tear from eye), the word "demand" means $$$$$$ !!!!!! Yay money!

To wit:

The Drug Addiction Treatment Act of 2000 (DATA 2000), Title XXXV, Section 3502 of the Children's Health Act of 2000, permits physicians who meet certain qualifications to treat opioid addiction with Schedule III, IV, and V narcotic medications that have been specifically approved by the Food and Drug Administration for that indication. Such medications may be prescribed and dispensed by waived physicians in treatment settings other than the traditional Opioid Treatment Program (methadone clinic) setting.

Granted, mind you that methadone is a Schedule II narcotic, although it is FDA approved to treat opioid addiction, and would not be covered by the provisions of DATA 2000. A new formuation of methadone for oral use, methadone/naloxone tablet somewhat akin to buprenorphine/naloxone would most likely be classified in Schedule III of the controlled substances act. Viola! You got doctor's office methadone scripts.

At the very least, there will be some more drugs out in the near future, because as you can see, DATA provides for Schedule III, IV and V drugs to be used to treat opioid addiction. Bupe is in schedule III.

You heard here on opiophile.org first.