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9 Reasons Why Doctors Won't Offer Suboxone - Alcoholism, Liver Disease, Mental Illness, Pregnancy...
Suboxone has many advantages to other forms of opiate addiction treatment. The medication can be prescribed in take-home doses (saving patients from daily trips to a methadone clinic) the eventual detox off of Suboxone is less difficult than for methadone, and the success rates of the two drugs are similar. But Suboxone won’t work as well as methadone for some people, and doctors may be reluctant to prescribe the medication to some "at risk" types of people.
Here is a list of some of the reasons why Suboxone might not be right for you.
1. You have a very high level of opiate dependence.
People who have been using opiates heavily may find that Suboxone does not give them enough symptoms relief. People with heavy habits are often recommended to start on methadone instead.
Buprenorphine has a ceiling effect, and it can only work up to a certain level – after this ceiling, taking larger doses has little effect.
2. You are unable or unwilling to follow safety instructions
Because Suboxone is prescribed in take home doses, doctors must feel confident that you will understand the risks and benefits of the medication, and are able and willing to follow safety instructions on its use.
Some people, with lowered cognitive abilities, may not be appropriate candidates for the self administered treatment.
3. There is a concurrent mental health problem
Patients with psychiatric illness may not be suitable candidates for office based Suboxone therapy. Suicidal or homicidal ideations preclude a patient from take home opiate therapy. Additionally, since the interaction effects between buprenorphine and many psychiatric medication remains unknown (lithium, anti psychotics) doctors may be reluctant to recommend this form of treatment to patient also prescribed certain psychiatric medications
4. You are pregnant or thinking of becoming pregnant
At present, methadone is the recommended treatment for opiate addiction during pregnancy. Suboxone remains largely unstudied for use during pregnancy.
5. You are an alcoholic
Buprenorphine is a relatively safe opiate type medication, and the risks of a fatal overdose are lower than for other opiates. Buprenorphine is dangerous when taken with sedative hypnotics, such as alcohol. Combining alcohol and Suboxone is dangerous, and potentially lethal.
Additionally, alcohol abuse or alcoholism is thought to reduce the likelihood of full compliance on medication protocols, and reduce the likelihood of success for take hope opiate therapy. Alcoholic patients are not suitable candidates for Suboxone.
6. You use or abuse benzodiazepines or barbiturates
Buprenorphine has proven fatal when combined with benzodiazepines and barbiturates. Patients addicted to these medications are not suitable candidates for Suboxone therapy.
7. You have used Suboxone before without success
If you have participated in multiple rounds of take home Suboxone therapy, your doctor may conclude that this type of treatment is not well suited to your needs.
Conversely, a person that has attempted to quit opiates by detox many times, but who has always relapsed, is considered a very good candidate for opiate replacement therapy with Suboxone.
Obviously, is you had any form of allergic reaction to the medication; you are also not a good candidate for continued use.
8. You have a condition that does not allow office based treatment
People with certain physical health conditions may not be appropriate candidates.
9. You are not motivated to quit
Patients who do not express a real desire to stop using opiates are not thought to be suitable candidates for take home Suboxone therapy.
It's not for everyone
Suboxone is a fantastic new addition to the treatment arsenal against opiate dependence, but it is not the best choice for every person in every situation. Discuss honestly your needs honestly and openly with your doctor, and get the treatment that is most likely going to work for you.