Treatment Thoughts on Suboxone via telemedicine and home delivery?

[ophelia_z]

I am in recovery (from basically everything except opioids) and I just started working with an organization that is trying to bring down barriers to getting Suboxone by walking doctors through the certification needed, using telemedicine and home delivery of medications (initial visit is in-person per the law in NY). I don't have personal experience with MAT so I'm trying to just get takes from people who know through experience:

-Would this work for you? Do you think it's a good idea?

I know that everyone's recovery is unique but I'm also curious if there is support that would be universally helpful to people starting MAT or switching to suboxone, like having peer support available to answer questions throughout the process?

Please take a moment to respond if you have experience! The science shows that MAT saves lives and that is the mission of this org. but I need to insights from the wider community to make sure we're on the right path. Thanks!

mod edit CH: Removed link.

 

[SKL]

The problem with increasing access to Suboxone is that many doctors who prescribe it are only interested in monthly cash infusions of a few hundred bucks from however many patients they are allowed. Clearly not all suboxone doctors are like that even those, like mine, who exclusively take cash, but it's a major problem. Just look through the suboxone directory and find shittons of foreign medical graduates in the hood who do little else. Cause this to be something that's easily accessed online and the system will be widely abused. On the other hand, decreasing access to suboxone by things like requiring drug tests or attendance at groups/therapy is also a terrible thing for harm reduction as it will decrease the reach of suboxone and especially if you're talking about cutting people off will increase risks of overdose. A careful medium must be reached.

 

[Captain.Heroin]

I think this thread/link is not allowed as per the rules. I will let staffers take a deeper look at this later.

 

[SKL]

Also, I'm pretty sure that you have to see someone in person in order to prescribe Suboxone every time, at least in NY. Was definitely the case for me. Maybe it is because my doctor, who had already dealt with a DEA audit, was trying to be responsible, but actually I'm pretty sure an in-person visit for controlled substances is required by the DEA since a fucklong time ago, the NROP era.

 

[S.J.B.]

I think this thread/link is not allowed as per the rules. I will let staffers take a deeper look at this later.

Should be fine without the link.

 

[achemicalreaction]

Also, I'm pretty sure that you have to see someone in person in order to prescribe Suboxone every time, at least in NY. Was definitely the case for me. Maybe it is because my doctor, who had already dealt with a DEA audit, was trying to be responsible, but actually I'm pretty sure an in-person visit for controlled substances is required by the DEA since a fucklong time ago, the NROP era.

I haven’t looked into it in a while either but I guess in 2020 Cuomo is trying to make MAT via Telemedicine a thing - who knows if it’ll happen but I would think having a larger network would hopefully cut down on how expensive it can get. Which would help access, which I think is a good thing. (Finding a psychiatrist who will treat dual disorder is $$$$$$$$) any system will be abused to some degree. I can see it being a good thing.
I currently do telemedicine (medication mgmt) and am prescribed controlled substances, but I pay out of pocket so I’m not sure if that has something to do with it, as well as having initially gone into their offices for over a year.

Via https://www.governor.ny.gov/news/go...state-banning-fentanyl-analogs-further-combat


“This year, Governor Cuomo is proposing a series of aggressive actions to expand access to medication assisted treatment, including:

• Expansion of the Medication Assisted Treatment and Emergency Referrals (MATTERS) Program: Governor Cuomo proposes expanding a pilot that provides MAT to patients identified with Opioid Use Disorder in Emergency Departments. These individuals will rapidly be transitioned into long-term treatment at a community clinic of their own choosing, all within 24-48 hours.
• MAT Telemedicine Program: The Governor proposes improving access to MAT by connecting emergency departments with doctors who can prescribe buprenorphine through telehealth.
• Expanding Access to Telehealth and Mobile Clinics: The Governor will direct OASAS to continue to expand access to these resources in underserved communities across the state by adding 10 new mobile clinics, one in each economic development zone statewide. In addition, in order to ensure access to addiction treatment in every region of the state, the Governor will direct OASAS to develop telehealth capacity by funding equipment for at least one addiction treatment program in each county across the state.
• Expanding Access to Medication Assisted Treatment in Correctional Settings: Governor Cuomo will direct DOCCS to expand access to Medication-Assisted Treatment by providing buprenorphine in the 7 facilities currently offering methadone. In addition, the Governor will direct DOCCS to seek national certification and accreditation to operate an Opioid Treatment Program, creating the Nation's first state corrections-operated OTP in the country.