Thread:

I received an email from PNAP’s executive director today regarding my decision to begin bupe. This is her reasoning behind why PNAP will not advocate for me to have my license reinstated and are forcing me to withdrawal from the program.

“However, Buprenorphine is an opioid partial agonist and like opiates, it can produce effects such as euphoria and altered mental status. Because health care professionals are typically engaged in safety-sensitive work with considerable consequences

when errors occur, research suggests that abstinence-based recovery is recommended. The use of opiate receptor blockers such as Naloxone is suggested and permitted.”

I have been on 8mg of buprenorphine for 14 days. I experience the same amount of euphoria from my daily dose of metoprolol as I do from bupe, none. The impact of stigma and misunderstanding is astonishing.

I’m also interested in the “research” that shows abstinence based recovery is best.

In the email she defended their position on abstinence only by this statement:

“It appears that you are angry and frustrated with the guiding principles of our prog. I’m sorry you feel that way. However, like many tx centers across the nation and most other peer assistance programs for nurses, PNAP observes an abstinent based protocol for all participants.”

Never mind dismissing the factual, evidence based criticism of the program I provided by insinuating I’m just a disgruntled participant, but defending an archaic design by pointing out you mirror other treatment centers around the country doesn’t say much.

Most addiction treatment in America is terrible, I’ve tweeted about this often. In my letter to PNAP I explained that with some modifications and effort PNAP could be a state of the art program that genuinely helps nurses. I’ve asked to be a part of this process for 2.5 years.

PNAP made it clear in their email that they have no intention on changing. They will continue to be an abstinence only, mandated 12-step program. Despite their claim that they have 11 years of documented success (whatever success means), their program hurts nurses.

They really could be a premier organization who understands the dynamic nature of recovery and champions autonomous control over ones path to wellness. They could be an advocate for what we know works for substance use disorder treatment, namely individually designed

Courses of treatment tailored to the individual. But, instead they are using their ambiguous “success” rate to keep the status quo and force people to jump through their hoops through mandated 12-step fellowships and denying them effective medications. Tragic.