#9: Patients are Extremely Inaccurate Self-reporters
Rumblin, Stumblin and Bumbling today! Much on my mind. If you don’t already realize this, patients are extremely inaccurate self reporters. They forget what they take, they don’t know what they take, and heavens forbid they sometimes lie about what they take. In a recent case I was privy to, a physician failed to check the PDMP and scripted Buprenorphine to a patient who didn’t report to the physician they were also taking Xanax. The physician scripted prior to getting a drug test report. The patient died from respiratory distress from taking too much of both drugs and a malpractice lawsuit ensued. Once the plaintiff’s attorney got the physician to admit he failed to check the prescription website and scripted prior to getting the drug test results, the trial was over in favor of the plaintiff.
Suboxone, generic suboxone, Zubsolv and Bunavail film all have the same chemical compounds. Regardless of which of these drugs the patient was prescribed, we test for and report Buprenorphine, Norbuprenorphine and Naloxone. It does not matter if Suboxone has 8mg of Bup and 2mg Naloxone or Zubsolv has 5.7mg of Bup and 1.4mg Naloxone or Bunavail has 4.2mg of Bup and 0.7 mg Naloxone. If you are concerned with not being accurate because the pharmacy changes Suboxone to one of the other three, put Buprenorphine and Naloxone down as prescribed drugs and the results will be appropriate for the drugs taken.
Fentanyl has now been found mixed in THC, Heroin, Methamphetamine, Cocaine, Xanax and MDMA. Lots of money to be made by producing a greater high and that is what Fentanyl does with severe consequences.
How many know that Buprenorphine is the number one contraband substance seized in prison systems? It is also the fourth most diverted controlled substance. Some studies show physicians feel as though diversion of Buprenorphine is not a problem due to the fact patients are “self-treating” because they can’t get access to treatment. Wrong!!! If a patient purchases/steals/burrows Buprenorphine on the streets they are “self-medicating” not self-treating, a huge difference! Have you ever considered, the availability of Buprenorphine on the streets actually keeps patients out of treatment?
Opiates are natural substances that come from Opium which is extracted from the opium poppy seed. Morphine and Codeine are Opiates. Opioids are semi-synthetic (made using some natural substances) or synthetic (produced artificially in a lab). Examples of semi-synthetic opioids are Oxycodone and Hydrocodone while Fentanyl and Methadone are two examples of synthetic opioids. Most people use the term Opioid for any substance (natural, semi-synthetic or synthetic) that acts upon one of the three main opioid receptor systems (mu, kappa, or delta) in the brain.
Your test will be mailed to you! Only kidding. Take a breath! “Your calm mind is the ultimate weapon against your challenges. So relax.” Have an awesome weekend. Thank you for your business.
President/CEO Industry Lab Diagnostic Partners