Can you take Suboxone while attending drug court ordered programs?
Many drug court programs receive funding from the Federal government and SAMHSA. As a condition to that funding, drug courts are required to allow participants to seek, and receive Medication Assisted Treatment for opioid and alcohol addiction.
It will be very rare that some drug court still does not allow this treatment, and insists on complete abstinence.
Treatment is not dictated by the court. It is between you and your medical provider as to what medication is to be used, and in what doses. You will be required to provide documentation from your doctor.
Urine drug screens are performed by the court appointed officials, and if it is positive for any substance for which you do not have a medical prescription … then you will be considered to be in violation of the program, and your probation.
Does the urine drug screen test for Suboxone?
May be, … mostly not. Most courts use the SAMHSA recommended 6 panel drug test with the following cutoff levels (almost everyone tests for these).
- Marijuana (THC) 50 ng/ml
- Cocaine/Crack (COC) 300 ng/ml
- Methamphetamine (MAMP/METH) 1000 ng/ml (Crystal Meth)
- Amphetamine (AMP) 1000 ng/ml (Ritalin, Dexedrine, Adderall)
- Benzodiazepines (BZO) 300 ng/ml (Xanax, Valium).
- Morphine/Opiates (MOR) 2000 ng/ml (Heroin, Codeine)
Many programs use an expanded panel that will also test for the following:
- Oxycodone (OXY) 100 ng/ml (Vicodin, Oxycontin)
- Ecstasy (MDMA)
- Barbiturates (BAR)
- Phencyclidine (PCP)
- Propoxyphene (PPX)
- Methadone (MTD)
- Tricyclic antidepressants (TCA)
- Alcohol (ALC)
- Buprenorphine / Suboxone (BUP)
And some test cups are available with higher sensitivity, that is, lower cutoff values.
What medications are available for opioid addiction treatment?
Buprenorphine + Naloxone containing preparations: Suboxone, Bunavail, Zubsolv, and Generic Suboxone.
Buprenorphine mono preparation: Generic Buprenorphine (Popularly known as Subutex). Only prescribed to patients who are pregnant, and patients hypersensitive or allergic to Naloxone. Most providers will not prescribe these and instead will ask you to go to specialized addiction centers or addiction specialists.
Buprenorphine is an opioid agonist, that is it acts like an opioid and prevents withdrawal symptoms. It is a controlled substance and can only be prescribed by doctors who have obtained a waiver certificate from DEA. This can be tested by urine drug screen. If it is positive, and you do not have any proof of getting it from a doctor, … then you can still be penalized.
Naltrexone tablet: Generic tablet or brand name Revia.
Naltrexone injection: Vivitrol administered once a month.
Naltrexone is an opioid blocker. It blocks the effect of opioids. It will not prevent withdrawal symptoms.
It can not be abused, you can not get high on this, and so it is not a controlled substance. Any doctor can prescribe it, including your PCP, whether they will … is a different matter.
If you have opioids in your system and decide to take Suboxone or Naltrexone you may experience precipitated withdrawal as these medications displace opioids from its receptors … causing a withdrawal that comes fast and is much more intense.
Will buprenorphine (Suboxone) show up on the test, and will that cause me to fail the program?
Yes, there are urine drug screens available that will test for Buprenorphine. If you have a current prescription from your doctor then most drug court programs will not count it as a violation.
How can I find a Suboxone doctor?
Ask your fellow users, may be they are getting it from a doctor.
You can find doctors in your area from http://samhsa.gov, http://naabt.org, http://suboxone.com or doing an internet search for suboxone doctor for your city.
Most providers are primary care doctors, internists, psychiatrists, and pain management specialists. The doctor requires a waiver from DEA to prescribe Suboxone, and each doctor is allowed to treat only 100 active patients.
What is the cost of this urine drug test?
The cost is determined by the program and will depend on the number of drugs tested and the method used. It can be $25 and up. Sometimes it is included in your probation fee.
What method is used for testing urine samples?
Most drug courts use the rapid immunoassay cup with result being available in 5 minutes. This test can be performed by any court official, and requires minimal training.
In case of doubt the sample can be sent for more sophisticated testing, usually GCMS method. It takes a few days for the results to be available and is far more expensive for the patient, … anywhere from $100 to $500.
GCMS method also tests for far more substances than the rapid immunoassay method.
How accurate is rapid immunoassay cup test?
It has 93% to 97% accuracy. There may be inaccurate results if you are taking some medication, but then you should have a prescription for that. Most courts are only concerned with specific drugs of abuse.
Many tests also include a test for adulterants and have methods to check if the urine has been diluted. Tampered samples may have the same legal effect as being positive.
Drug courts may also use other methods of testing, for example, blood, saliva, sweat, hair, breath analyzer, etc.
What medications are available for alcohol addiction treatment?
The three medications approved are Naltrexone, Acamprosate (Campral), and Disulfiram (Antabuse).
How do these medications work?
Naltrexone (tablet and injection) is an opioid blocker, so it can not be given to someone who is on opioid pain medication. It works by reducing the pleasure sensation one gets by consuming alcoholic drinks. If there is less pleasure then patients are less likely to use alcohol. This medication has no abuse potential, is not habit forming, and is not a controlled substance. Any medical provider can prescribe it.
Cost is $1 to $3 per 50 mg tablet. Only one tablet per day is needed. For 30 tablets per month, the cost comes to be $30 to $90.
Also available as a once a month long acting injection (Vivitrol). The cost is $900 to $1100 per injection.
Campral (tablet) works by reducing the withdrawal symptoms in alcoholics, thus removing the need for alcohol. It has no abuse potential, is not habit forming, and is not a controlled substance. Any medical provider can prescribe it.
Prescribed as 4 to 6 tablets per day. Cost is $1 to $1.50 per 333mg tablet. Cost per month $180 to $270. (180 tablets per month)
Disulfiram / Antabuse (tablet) works by producing an unpleasant reaction when alcoholic dreams are consumed, thus working as a deterrent. It has no abuse potential, is not habit forming, and is not a controlled substance. Any medical provider can prescribe it.
Prescribed as one 500mg tablet per day. Cost is $1 to $3 per 500mg tablet. Cost per month $30 to $90. (30 tablets per month)
Are there medications to treat addiction to cocaine, methamphetamine, benzodiazepine, marijuana, etc?
There are no FDA approved medications for those addictions as yet, however there is anecdotal evidence of some medications like Baclofen, Gabapentin, etc., being useful. This would be a trial and error method.
These are not experimental medications, … these are medications that are approved by FDA for other uses, so your provider will be familiar with its side effects and safety profile. You will have to find a provider who is familiar with those medications and is willing to prescribe those.
Some patients will need additional medications to help with withdrawal symptoms in the beginning … for a very short period, 1 to 7 days. Common medications used are Benzodiazepines and Clonidine.
Addiction is not cured by a pill.
The pill will help reduce withdrawal and craving … while the patient works to change their drug seeking and drug using behavior using self-help resources, rehabilitation programs, and counseling.