Emergency Buprenorphine Supply
Should you have an emergency supply of buprenorphine and how much?
unpredictable emergencies could leave you without medication. People have committed suicide after being
suddenly cut off from opioid medication. It pays to
be prepared. Talk with your doctor about
creating an emergency supply.
What if you can't get your buprenorphine?
Should you have extra buprenorphine in case of emergency? This is an individual decision that must take into account how stable you are in treatment and how much risk there is for a medication interruption. For stable patients (meaning patients who are at a steady dose and are able to take the medication as directed) a 30 day supply is suggested. FEMA recommends a 2 weeks supply of medications1, but buprenorphine is more difficult to get in non-emergency times and will be particularly difficult to find a prescribing doctor in an emergency. At minimum, stockpiling enough to conduct a taper is advisable in the case future supplies are cut off indefinitely . Use this form to calculate how much buprenorphine you will need to taper from your current dose.
The stress of being near the end of your prescription and not knowing where the next refill will come from could be enough to trigger a relapse. Dealing with whatever the emergency is may already be stressful enough, adding in the not knowing where the medication will come from is unnecessary added stress.
You never know...
Consider just a few situations where you could find yourself without medication:
- Your doctor suddenly:2
- Is arrested
- Is closed by the DEA
- Inexplicably stops treating you
- Heat wave
- Nuclear accident
- Chemical spill
- Terror attack
- Martial law
- Medication shortage
- Cyber Attack
...and many others, although some rare, any of them could become between you and your medication. People suffered after Katrina and super storm Sandy, when doctor offices and pharmacies were wiped out leaving no record of their prescription. What unknowns associated with the unfolding of the Affordable Care Act could turn into a problem getting your medication (like not being able to keep your doctor)? For these reasons and many more not listed, it pays to be prepared.
Even if there is no disaster, the piece of mind knowing that you have a cushion in case there's an interruption is a relief.
How do I get an emergency supply of buprenorphine?
First, ask your doctor to prescribe extra medication and discuss the reasons above. If your doctor is unwilling to prescribe more, and you have decided that you want the reserve anyways, try taking ½ your dose every 3 or 4 days and slowly build up a reserve. You may find you can skip a day occasionally without feeling any different whatsoever. Going against doctor's advice is not something we would normally suggest, but we strongly believe that not having a safety margin is the greater risk. People have committed suicide after being suddenly cut off from opioid medications. It's a choice you will have to make and take responsibility for either way.
Doctors: Given the reasons listed above, the desire to maintain a supply of medication is prudent preparedness rather than a manifestation of ongoing addiction. The motivation to acquire a margin of assuredness is in fact a desire to remain in compliant stable treatment, not a way to misuse or circumvent treatment. This should be encouraged and efforts to assist patients with this should be made.