I no longer provide emergency prescriptions in the state of Tennessee.
Majority of the patients who have called me for an emergency prescription have been from out of state.
Tennessee Medical Board, similar to other state Medical Boards, prohibits medical doctors from providing a prescription without a medical examination (also called physical examination).
For an emergency prescription the doctor and the patient have to be in the same state, and the patient has to be seen by the doctor in his clinic. Controlled substance prescriptions have even more stringent requirements.
What to do if your doctor is not available due to an emergency?
Most doctors can give a short term prescription in case they are unable to see a patient due to a personal emergency. They may call-in a few days prescription till the emergency is over. This can only be done by your current doctor.
If you have had to leave at a short notice … to go out of state then immediately notify your doctor. Always keep ahead by at least 7 days worth of medication. If you have less than 7 days then ask if the doctor can prescribe you an emergency supply for the days that you will be out of state.
Not all pharmacies honor prescriptions written by a physician from out of state … so check from the pharmacy first. Most national chain pharmacies like CVS, Walgreen, Walmart, etc., … will honor a prescription if it is a continuation of your existing medication prescribed by the same doctor.
If you think you will not be able to get back in time before your prescription runs out then you may have to seek a new doctor … do not wait for the last moment … you may not be able to get an appointment immediately.
If you have traveled to a neighboring state then you may be better off by traveling back to keep your appointment, instead of going through the whole process with a new provider.
If you are doing it right … that is tapering your dose at regular intervals then you should be left with at least a few days worth of medications. This should help you for a few days and hopefully in a short time your doctor should be able to continue your treatment
If you do not have enough left then immediately cut down your Suboxone to half the dose you were taking … it may not be enough to completely stop the withdrawal but you will not have severe withdrawal symptoms. A patient who is taking 8mg/day will not have severe withdrawal symptoms like diarrhea if they take just 2mg/day.
Most Suboxone providers do not have a backup system. Suboxone is not like other medications … a substitute doctor can not provide Suboxone prescription unless that doctor has obtained a certificate from DEA, and has not reached the 100 patient per provider limit. Unlike other medications this can not be prescribed by an Independent Nurse Practitioner.
These medications are controlled substances. There are no refills. The law prohibits prescribing these medications without examining the patient.
Always have a plan A and a plan B.
Plan A is never to be discharged till you complete your program. Know and follow the program/clinic policies.
If your doctor permits, then get an advance prescription, and stay ahead by a month. You are not permitted to fill the prescription before the due date, but at least you will have a prescription in hand. It provides you a cushion … you are not suddenly out of medication if you or the doctor had an emergency. You will generally be required to make a separate visit for this prescription. Not all doctors provide this facility.
If you are discharged … then there must be a reason. Doctors do not want to discharge patients … but doctors do not want to keep problem patients either. Don’t bang that door on your way out. When you approach another doctor for Suboxone … that doctor already knows you are a problem. The more doctors you have been to … more of a problem you are.
Plan B is to research and find out about other practices in your area which are accepting patients and whose enrollment criteria are acceptable to you, and you are acceptable to them. Some practices close suddenly. Some times the providers have an emergency and may not be available. The DEA has tied the prescription authority to the provider and not the program.
Always have a plan B.
You should have a backup list of at least three doctors nearby who are accepting patients.
Ask. You can get this information about other doctors from your counselor, from other people at Narcotics Anonymous meetings, Suboxone forums, from your pharmacist, from naabt.org, samhsa.gov, suboxone.com, zubsolv.com, bunavail.com, etc.