Doctors Say '30 Minutes' Suboxone Billboard Increases Addiction Medicine Stigma, Call for Re

Tennessee Recovery Coalition President Paul Trivette could barely believe his eyes when he drove through Bristol earlier this week and saw a billboard advertising “Bristol’s Best Suboxone Doctor.”

The problem, according to Trivette and other concerned addiction medicine physicians, isn’t the boastful self-proclamation, but the small phrase, “Most patients are in and out in 30 minutes!”

“Immediately, when I saw it, I was extremely disheartened by it. Within our coalition and within the community, we’re trying to change the perception (of medication-assisted treatment) and encourage evidence-based treatment,” Trivette said.

“Saying that this person is a ‘Suboxone doctor’ implies that an individual can walk into that practice, get a prescription for Suboxone and leave in less than 30 minutes. That is not evidence-based treatment of substance-use disorder.”

The billboard, located along Volunteer Parkway, advertises the practice of Dr. John Bandeian for $300 a month.

Since counseling is widely accepted as a crucial component to treating substance-abuse disorder, Tennessee Society of Addiction Medicine President Tim Smyth said the billboard implies patients aren’t receiving comprehensive wrap-around services because they’re being discharged in 30 minutes.

“This implies to me, if you’re going to be in and out in 30 minutes or less, you’re not delivering counseling services. You’re not delivering any wrap-around services. You’re a drug dealer. You insert money, you get a script,” Smyth said.

“This is what makes it difficult for any of us who’re trying to provide care for people with addiction.”

Bandeian, who is also a plastic surgeon, said he’s been prescribing buprenorphine to treat addiction for a few years.

Speaking to the Johnson City Press on Friday, Bandeian said the “out in 30 minutes or less” statement is true for the 25 to 30 patients treated at his practice. He also mentioned many of his patients receive third-party counseling.

“When patients come in, they don’t waste time waiting in my waiting room. They’re being seen almost immediately, unlike all other Suboxone clinics,” Bandeian said.

“I am the only one who sees the patients in my office. I do the urine drug screens. In all other offices, the patients have to wait to see the doctor, they have to wait to see the counselor, they have to wait to give a urine specimen. I do everything myself,” he continued.

Although each patient’s needs differ, Smyth said most experts agree that weekly counseling is the “standard of care” for treating opioid addiction.

“That means at least 20 minutes (a week) with a doctor face-to-face in a one-on-one setting, or at least 50 minutes in group counseling session led by someone who is qualified,” Smyth said.

Bandeian did say first-time patients are required to undergo at least an hour of counseling.

Regardless, Smyth is afraid the billboard is further compounding the negative public perception of buprenorphine treatment.

“We’re trying to decrease stigma, and signs like this stigmatize all the way around,” Smyth said.

“It certainly turns the public off when they see a sign like that because the public is familiar with Suboxone, and many of them think it’s evil, it’s terrible and the No. 1 drug on the street.”

Trivette and Smyth, among others, want the billboard gone.

“We’re calling for this billboard to be removed. We’re calling for this physician to become more educated in the treatment of substance-abuse disorder and the use of medications in that treatment modality, and hope he will yield to that,” Trivette said.

Bandeian said he did receive a call from Dr. Stephen Loyd, director of the state’s Substance Abuse Services, who also saw the billboard and wanted to know how he could possibly treat patients in 30 minutes.

“I explained to him the bottom line is patients don’t waste time waiting to be seen when they’re with me,” Bandeian said.

“If a patient has nothing complicated, it might be less than 30 minutes, but on the other hand, it could easily be an hour if a patient has lots of problems they need to talk about with me.”

http://www.johnsoncitypress.com/Health-Care/2017/09/01/Local-doctors-organizations-say-Suboxone-billboard-increases-stigma-calls-for-its-removal.html