Process for getting on Suboxone UK?

[Jax42]

Hi guys, first of sorry if this breaks any rules I'm slightly confused if this would be as its not technically drug seeking/sources etc?

I have first appt with addiction counsellor next week, well 2nd after my initial interview etc I stated on the interview how I heard subs will help and they said that is something we can look into although they did state how you have to be clean and get liver test etc

Thing is though I've heard online that in order to get them you need to test positive for opiates and others say you actually have to show your clean and in wds to get on them? Do any of you know the actual process? I've been using codeine recently (only h rarely) however I'm not sure if I should make sure not to take any codeine before my next appt or if I should the day before so I test positive??

All advice greatly appreciated and again sorry if this breaks any rules! Xoxo

 

[Sadie]

This does not break any rules love. There are a fair few people here with experience with subs on the NHS. Shambles says it really does have a lot to do with your area as rules seem to vary almost greatly. His advice as I read your post to him is to speak to your drugs councillor for better clarification on practices in your area.

Hopefully he, along side a few other seasoned BL veterans will be able to help you out and advise you a bit better.

Well done and the best of luck on your journey. Your strength is to be greatly admired and something to be very proud of.

Sorry I couldn't be of more help but I am certain you'll get lots of advice from others to follow xxx

 

[Jax42]

Thanks Sadie and Shambles ^_^

I phoned my counsellor and they said I'll get a diary to right down what I'm using and how much etc

Does anyone know if I'll be able to get the subs started at my first visit or will it take longer?

 

[Sadie]

Couldn't tell ya babe. I think that may be down to areas and doctors. I have heard from some that it's usually the next day.

Im hoping someone will chime in to offer a bit more advice.

Nice work speaking to your councillor. You're well on your way hunnie.

Hopefully, if possible, you'll keep us updated on your progress.

 

[Jax42]

Alright thanks and will do, it's all kinda stemmed from having to stop drinking and smoking weed and the likes as I would always get carried away with that and codeine etc was my new way of "unwinding" :S

Hopefully get benzos for my anxiety but that could be a long way of / might not be possible with my history, on sertraline for 2 months but that's not done anything. They did say they can look at stuff for that with me aswell as its all part of their service ^^

 

[Sadie]

As per request this is a copy paste job from another bl'er that cannot reply atm but wanted me to pass this on for you.

Tbf, as an HR site I would have thought you'd have gotten more advice so far. No matter, onwards and upwards m'dear.

Said message:

Oh can u tell the guy on the suboxone question on bl that he will need to have opiates in his system to qualify for any replacement therapy but will need to show signs of wds before they will actually give him any (and you will still have opiates in your system during the early stages of wds). Depending on what you've been taking it usually means waiting 24-48 hours after your last dose before starting the subs to avoid precipitated wds. They usually test for opiates during the initial assessment and again on the prescribing appointment (when u should be in early wds). A liver function test is also performed before the subs are started and again a few weeks later as they can possibly compromise liver function..

You can cut and paste the info. "



So there you go, hope that helps you any.

 

[steewith2ees]

Thanks Sadie and Shambles ^_^

I phoned my counsellor and they said I'll get a diary to right down what I'm using and how much etc

Does anyone know if I'll be able to get the subs started at my first visit or will it take longer?

They will need to confirm that you are an opiate / opioid user and that will involve providing a positive screen for OPI (the usual abbreviation for opiates on instant tests that detect opiates (Morphine, heroin + codeine)). You will not provide a positive sample if you have been using opioids, as Methadone is usually the only synthetic narcotic they test for.

As has been re - iterated time and time again in this thread, it all depends on the drug service providers individual policies, but regardless - don't expect a prescription overnight. If it is buprenorphine that you wish to be prescribed you will not only have to provide a positive sample, but also a negative sample and / or clear signs of moderate to severe withdrawal approx 48 - 72 hours after the initial confirmation that you are an opiate user (and self confessed dependent) before they would even administer a test dose of bupe. It's a tricky medicine to get a prescription for if you have never been in treatment as you have to prove that you are BOTH dependant on opiates / oids AND then subject yourself to the symptoms of withdrawal so that buprenorphine can be started without causing precipitated discomfort.

EDIT: If you have been using synthetic opioids then a positive screen for such can still be obtained through a gas chromatography–mass spectrometry (gc/ms) screen performed at a bespoke laboratory, but as it cannot be performed 'on site' then waiting on such a positive result may delay thngs even more...

 

[Sadie]

Thanks Stee

 

[fightingthetoot]

Mate got my first app, they talk about treatments, you decide suboxne, go back next time and if heroin showed up in the sample, theyll then tell you to come back usually the next day totally rough and you need to be because you can end up getting a rattle like you've never suffered before.

The man above gave a great answer, I just wanted to type lol

 

[Shambles]

Does vary a bit but just to add my experience to the pile... I've been scripted Subutex several times over the last two decades and the procedure has always been the same (probably more by chance than anything else as this has been in quite varied areas)...

Get appt, discuss history of drug use, agree to a programme of some kind and sign summat to say as much.
Provide dirty tests - up to three but sometimes two is enough.
Confirm date of script commencement.
Turn up in mild-moderate withdrawal - depends on opi of choice but usually requires 24-48h since last dose taken.
Take first supervised dose.
Stick to agreed programme or risk sanctions of various kinds.

Best of luck

Incidentally, as noted I've been scripted Subutex multiple times over many years in both England and Wales and have never been required to give - nor even offered the chance of - a LFT. Anybody know why some places seem to require this and others don't?

 

[Jax42]

Hey all, thanks very much for the informative replies and advice! Xoxo

As promised a quick update, had my appt with key worker and we discussed drug use etc and I've got a diary to fill out and also booklet on anxiety (another of my problems I'm dealing with) also a questionaire / form thing to fill out stating how I'll avoid drugs etc.

Have meeting next week to get naloxone trained (don't think I'll need it for just codeine, what I'm trying to stick to only taking atm) however it's best to know how as I may not need it but if I ever need to help someone else out atleast I'll know how! Asked if i had had lft and other tests which I had the works done about a month ago after Iv'ing h for first time in years and they came back clean so she was happy I was able to confirm that.
Didnt get tested but admitted how I have had some codeine Monday which is my doc atm
She also stated that she'll need to discuss with her manager about the sub treatment as I live rural she isn't sure if my pharm provide the service and as I work a couple times a week I wouldn't be able to attend the pharm on those days, leave to early, get back too late.
Think I started experiencing physical wd's for first time (other than anxiety and insomnia which I've had before) although it might just be a bad cold I've caught. Have taken 96mg codeine about 30mins ago, not much but feeling slightly better, throats not hurting as much lol

Thanks again for the advice guys and I will keep you all updated xoxo

 

[davestate]

If you only use heroin rarely and mostly only use codeine mostly, buprenorphine seems like a hell of a step up, how much codeine do you use? Does the drug counsellor know all this?

 

[Jax42]

Use anywhere from 100-300 mainly 250mg and 4-5 times a week now compared to every couple weeks a few month ago