Why is it harder to get Suboxone in some states compared to others?
Buprenorphine programs for opioid dependence are implemented by the federal government. Yet, some states treat medication-assisted treatment with Suboxone, ZubSolv, and Sublocade differently. New York is one example of a state that is more strict when it comes to Suboxone film and tablets. Even though there are restrictions, traveling while taking Suboxone is still far easier than trying to travel while on methadone therapy.
Calling in a buprenorphine/naloxone Rx to New York.
If a Suboxone patient travels from Florida to New York, which is not uncommon, they must plan to have their medication for opioid addiction with them. They must also make sure that they have enough to last for the entire trip. If not, the patient may have to see a doctor in New York. Running out of medication may lead to withdrawal symptoms and dangerous opioid cravings. Staying on treatment for opioid use disorder is important.
Seeing a Suboxone doctor away from home.
While this is possible, getting established with a new doctor, especially when away from home in another state can be difficult. What happens if you are traveling and you lose your Suboxone sublingual film or sublingual tablets, or you did not bring enough with you for the trip? Well, it is possible for your Florida doctor to call in a small script of Suboxone to a New York Pharmacy. But, New York has strict rules regarding this practice.
Calling in Suboxone or Subutex to New York.
First of all, the doctor may only call in a five day supply. That is it. If you are in need of more than a five day supply of Suboxone while traveling to New York, you are going to have to make plans to see a local doctor. At least, the five days can give you time to make arrangements, including having your Florida doctor communicate with the New York doctor.
New York requires the original buprenorphine/naloxone paper rx to be mailed.
In addition to having a five day limit, your Florida doctor must also securely mail the original written prescription to the pharmacy in New York. And, it must arrive within three days. An alternative acceptable method is to transmit the buprenorphine prescription electronically.
Can a family member pick up the script in Florida and ship it up to New York?
While this seems like a straight forward solution to avoid the difficulties of getting meds such as Suboxone or ZubSolv called in from one state to another, it is not a good idea. First of all, it is unlikely that any Florida doctor will hand a Suboxone script to a family member. It is important with buprenorphine, like any opioid medication, that the patient come to the office in person for their meds to be prescribed. The doctor must examine the patient and assess their treatment program each time a new Suboxone prescription is written.
Could the Sublocade shot be a solution to the problem?
Indivior Inc. recently released a monthly injectable subcutaneous buprenorphine product named Sublocade. Rather than being sublingual, transmucosal buprenorphine, it is injected just under the skin and it forms a solid structure that releases buprenorphine gradually throughout the month. Sublocade provides excellent coverage from the beginning to the end of the month.
Sublocade in New York.
Imagine if you travel from Florida to New York just after getting your Sublocade injection. Now, you have nothing to worry about with respect to your buprenorphine treatment. You do not have to pack Suboxone. And, you will have no concerns about your meds being inspected and possibly taken away at the airport. Theft and loss are no longer concerns. You can enjoy your trip to New York without any concern about not having your Suboxone with you.
What if you are traveling while on Sublocade and you overstay?
If your doctor gives you a monthly Sublocade shot and you are caught out of town past your one-month appointment, it may be a good idea to see a Suboxone doctor near where you are staying. However, it is likely that you will be fine for at least a few days past your appointment. Sublocade is long-lasting and will likely remain at a high enough level past the one month mark so that you feel fine.
Can Sublocade work for heroin addiction as well as pain pill addiction?
Subcutaneous buprenorphine injections work in almost any case where sublingual buprenorphine works. It can be given for heroin addiction and is effective long-term in preventing relapse and overdose. Healthcare providers are encouraged to learn more about the benefits of subcutaneous buprenorphine monthly injections. Some people are calling Sublocade the New Suboxone.
Is it better to take ZubSolv over Suboxone? Are doctors more comfortable with prescribing ZubSolv?
In our hypothetical situation, where you have traveled to New York from Florida and now you have run out of buprenorphine/naloxone, does it matter what brand you are taking? Suboxone vs. ZubSolv, which is better? While there will likely be no difference if you go to a doctor or pharmacy in New York, things may actually be a bit easier with ZubSolv.
Preventing diversion of Suboxone and other buprenorphine meds.
The issue is that healthcare professionals are trying to prevent diversion. They are on high alert for the possibility that a patient is attempting to procure Suboxone to sell or distribute to other people. Interestingly, ZubSolv is diverted far less than Suboxone. While healthcare workers in New York may not be aware of this fact, if they are, they may be more comfortable writing or filling ZubSolv over Suboxone Film or tablet.
Why is it so difficult to go from an opioid to buprenorphine?
Why do doctors and pharmacists make things so complicated? Buprenorphine is supposed to be part of the solution in overcoming opioid addiction. The issue is that buprenorphine is an opioid. It is semi-synthetic and derived from thebaine, as are other opioids. If you would like to get medication-assisted treatment for opiate addiction without taking an opioid, naltrexone is an alternative.
What is naltrexone?
Naltrexone is an opioid blocker that strongly blocks the receptor, but it is not an opioid. It is a non-controlled medication that any doctor can prescribe. Once started, naltrexone reduces cravings for opioids. It happens to also reduce cravings for alcohol. The difficulty of starting naltrexone is that you have to be opioid-free for at least a week. If you are in rehab for at least a week, you may want to ask your healthcare provider about naltrexone.
Sublocade vs. Vivitrol, which is best?
Sublocade and Vivitrol are both monthly injections to treat opiate addiction. Their similarities end there. Vivitrol contains naltrexone while Sublocade contains buprenorphine. Vivitrol is injected into a muscle while Sublocade is injected just under the skin at an injection site near the umbilicus. Buprenorphine is a partial agonist of the opioid receptor while naltrexone is purely a blocker. Both monthly injections have a high rate of success. Unfortunately, both are also very expensive.
In conclusion, final thoughts on travel and MAT (medication-assisted treatment).
If you travel frequently for business or to visit with family, you may want to consider the form of MAT that you use. Methadone is the least travel friendly of them all. Because of the requirement for daily clinic visits, you will find that you have to stay close to home to continue with treatment. Buprenorphine and naltrexone treatment are more travel friendly. In fact, naltrexone may be the easiest of all because there are few restrictions in getting it prescribed and filled. Buprenorphine has some issues, being an opioid. Monthly injections are a good solution to avoid issues with carrying medications that may become lost or stolen.