Drug tests and Suboxone (buprenorphine)

Even some treatment professionals and medical professionals have mistaken ideas about drug testing for buprenorphine.

Because it’s a man-made opioid, buprenorphine won’t show as an opiate on a drug screen. It won’t cross-react with tests for oxycodone or hydrocodone. A specific test for buprenorphine must be done in order to detect its presence. In the past, this test was expensive, but now can be added to a drug test fairly cheaply.

I test for buprenorphine because I need to make sure my patients are taking their medication, and haven’t given it or sold it to someone else. Fortunately, I’ve never had a patient to whom I’m prescribing Suboxone have a urine drug screen that didn’t show the medication.  

My patients ask me if the Suboxone I prescribe for them will show up on employment testing, and I answer no, it’s unlikely. Most employers don’t check for methadone, and are even less likely to check for buprenorphine. Employers won’t know unless you tell them you’re on Suboxone. (Methadone, like Suboxone, has to be tested for on a separate test, and won’t show as an opiate.)

Should you tell them? That’s a question you’ll need to answer for yourself. Ordinarily I’m an advocate of honesty, but because Suboxone is usually prescribed to treat opioid addiction, disclosing this information more or less informs them you’ve had a problem with addiction. Is that your employers business? No, I think not, unless it’s a “safety sensitive” job, and even then it’s often not appropriate to tell your employer.

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22 responses to this post.

  1. Posted by db89g23 on June 23, 2011 at 10:14 pm

    Definitely good advice about keeping quiet about Suboxone in the workplace. Unlike other prescription drugs (ironically even pain killers), the mere mention of it will cause those around you to forever see you as an addict. While that may be the truth, nobody needs this sort of judgement on them.

    Reply

  2. Posted by richard sergi on July 2, 2011 at 4:24 am

    how long does it for suboxone to get out your body

    Reply

  3. Posted by Greg on August 21, 2011 at 11:17 pm

    Do I have a potential lawsuit?
    Here is my story……..

    I was hired a year ago….I work as a maintenance manager in what is called a safety sensitive position. I am on a medication called suboxone, that is a type of narcotic, but also prevents the effects of norcitics…I got hooked on pain killers after a surgery and been on it for a few years. When I was hired I went for a company physical, I told the doctor that I was taking this medication (suboxone) and he said it was ok, he listed it on the report and why I was taking it, all is good….. I got a medical card for my CDL and I was hired and life goes on… …

    A year later, I needed another physical, to renew my medical card for my CDL license, I went to the company doctor again, and told him I was still taking this medication (suboxone) he passed me and renewed my medical card and listed it on the report. A few days later, my boss told me that the company didn’t allow me to be on this medication,

    They will most likely fire me, or something…I have been cleared by two doctors and two company physicals and gotten my medical card renewed by DOT standards and been cleared to be on this medication, but they still say it’s a non listed SSL medication, what ever that means ?? So I am not allowed to take it. I have done everything that is required of me; I never hide the medication… I can not just stop taking this medication; with out getting horribly sick…if I stop, I will be in no condition to work or function…

    My questions are, can they terminate me? What are my rights? I can not afford to be off of work with no income, I am not an addict, and it’s none of their business how I came to be on it…It wouldn’t make any difference, but I will tell you any ways. I donated my kidney to my nephew, after the surgery I got physically dependent on pain killers, as part of my rehab, I been put on suboxone.

    Reply

    • Hello and thanks for writing. Your question is a good one!
      Jobs requiring a cdl, or commercial driver’s license, are regarded as safety sensitive positions. This means there are restrictions for these jobs that you don’t have for jobs that don’t somehow endanger the public. The DOT regulations prohibit “narcotic, or other habit forming drugs.” What does that mean? In my opinion it’s poorly worded and too vague. First of all, what is a narcotic? The legel definition is different from what most doctors regard as a narcotic. And what is meant by habit forming? Physical dependence? Psychological dependence?

      It would be far better if the DOT prohibited drugs and medications that impair driving. For example, benzodiazepines like alprazolam (Xanax) can affect reaction time. But numerous studies of patients on maintenance doses of methadone and buprenorphine (Suboxone) show these patients aren’t impaired.

      You should probably consult a lawyer about your rights. Should it make a difference that you disclosed Suboxone from the start? I don’t know the legal answers, only the science, and sadly they often don’t have any correlation.

      Reply

  4. Posted by Lynn on September 8, 2011 at 5:47 am

    Hello,
    I am on Suboxone and have been clean from all drugs and alcohol since I have been on it (almost 2 & 1/2 years). I feel like I am finally a normal person and getting back on track in every aspect of my life. But today my disease came back to haunt me…

    I just got a job offer at a veterinary clinic (I am in school to become a vet-tech), and I went to give a drug screen tonight. I am terrified they are going to test for suboxone because of the pharmacy in the clinic. I caught a quick glimpse of the collectors computer screen and I saw that the company had added Tramadol and Benzos to the screen, but I couldn’t see past that.

    I am not sure what to do because I am supposed to put in my two week notice at my other job tomorrow, and I don’t want to lose that job if the vet doesn’t hire me because of the Suboxone.

    Do you have any advice or insight?

    Thank you!

    Reply

    • It’s rare that companies screen for buprenorphine (Suboxone). But it really doesn’t matter, because (hopefully) you are getting it by prescription from a doctor. That means that unless you are in a safety-sensitive position, like airline pilot, doctor, nurse, it shouldn’t be an issue. I’m not sure about vet offices, but if they are worried you’ll take medication, you’re less likely to be tempted since you are in treatment. It’s the people using drugs and not getting help that they hopefully are screening for.

      Please write back and let us know what happens. I believe you should be fine, but then I’m not a lawyer.

      Reply

  5. Posted by Lynn on September 12, 2011 at 1:07 am

    Thank you for your response. Everything turned out fine and I start next week. Thanks!

    Reply

  6. Posted by mark on April 22, 2012 at 5:48 am

    My work just tested me and found saboxone but i dont have ascipt but i do have a scipt for hydrocodone

    Reply

  7. I went to a coal mines today and went to a job interview and everything was doing fine. thay where going to hire me .and then thay talked aboult a drug free work invierment and them thay asked me if i was on any meds and i told them i am on soboxone and its perscribed by a doctor and that acked like i im a drugy and sead that it is the same thing as doing drugs that pepole use it as a cruch and now thay ack like thay r not going to give me a job do i have a law suit

    Reply

    • Yes, I’d talk to a lawyer. I don’t know how strong your case is, but since addiction is a protected illness under the Americans with Disabilities Act, and since Suboxone is an approved medication to treat this disorder, I suspect you have a case. Not being a lawyer, I can’t say for sure.
      Even if the job you applied for involves running heavy machinery, there’s no evidence you would be unable to do that job. Most studies show reaction times of patients on stable doses of suboxone are the same as non-medicated people.
      If there’s a way you can prove they denied you employment because you have the disease of addiction, and/or are prescribed suboxone, do so. I’d try to get something to that effect in writing. Many times after employers say something stupid like what you describe, later they change their story, and lie. They blame not hiring you on something else.
      The same is not true of other drugs, like benzodiazepines. Even with a prescription, this class of drugs can impair your abilities, meaning there is a safety issue, and a legitimate reason not to hire a person operating heavy machinery.

      Reply

  8. Posted by Jeff b on January 27, 2013 at 12:08 pm

    Im a recovering addict and have got my life all straitened out with the help of counceling and sub films. This is a miricale drug and im proud to say im in the midst of tapering down to 3mg every am. Ive worked for a company for 7 years doing route sales on a strait commision pay scale. Do to the large growth I now drive a dual axle truck where a medical dot card is required.(massachusettes) long story short they disqualified me . My doc that perscribes me says sub is safe enough for a pregnant woman and that the dot examaner is incorrect. Thats all well and good but how do I retake the test with that on my file? The examiner says ill be able to get my card when I have written document stating ive completed the program. What do I do? Is the examiner wrong or is my sub dr wrong? Is this a state dot law or is this dot a fedral organization? Please if anyone has an answer please help! Thank you!

    Reply

    • I don’t know. You may want to consult a lawyer. I do know patients on methadone can’t get a DOT card, not because it impairs them, but because theoretically they could relapse back to illicit opioids. I imagine the DOT’s reasoning is the same for buprenorphine The sad thing is that if you hadn’t told them, they wouldn’t know, because the DOT doesn’t test for buprenorphine (Suboxone) or methadone.

      Reply

  9. Posted by drawfire2 on March 21, 2013 at 9:10 pm

    I guess the DOT does not require a check for buprenorphine but does any1 know if the bigger companys do?

    Reply

  10. Posted by drawfire2 on March 21, 2013 at 9:11 pm

    as in bigger trucking, sorry

    Reply

    • I don’t know. Guess you’d have to ask them. But I haven’t yet heard of any company doing screening for buprenorphine.

      Reply

      • Posted by John K on April 28, 2013 at 1:41 pm

        Many companies do in fact test for buprenorphine now. Most probably do not, but its becoming more and more common. My GF just went to take a pre-employment drug screen this morning and buprenorphine showed up on the instant test she was given. They are now having her go to a laboratory for a test tomorrow morning.

  11. Posted by Kendall on June 13, 2013 at 12:54 am

    Does dot test for AutoZone when you have pre-employment screen from motor carrier solutions…?

    Reply

  12. Posted by Kendall on June 13, 2013 at 12:54 am

    Suboxone

    Reply

  13. Posted by kim on November 29, 2013 at 2:31 pm

    does any one know if the union ibew test for suboxone.

    Reply

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