Buprenorphine without naloxone; prescription limitation. (SB1178)

Introduced By

Sen. Ben Chafin (R-Lebanon)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Prescription of buprenorphine without naloxone; limitation. Provides that buprenorphine mono or products containing buprenorphine without naloxone shall be issued only for a patient who is pregnant. Read the Bill »


Bill Has Passed


01/10/2017Prefiled and ordered printed; offered 01/11/17 17101156D
01/10/2017Referred to Committee on Education and Health
01/16/2017Assigned Education sub: Health Professions
01/17/2017Impact statement from VDH (SB1178)
01/19/2017Reported from Education and Health with amendment (15-Y 0-N) (see vote tally)
01/20/2017Constitutional reading dispensed (38-Y 0-N) (see vote tally)
01/23/2017Read second time
01/23/2017Reading of amendment waived
01/23/2017Committee amendment agreed to
01/23/2017Engrossed by Senate as amended SB1178E
01/23/2017Printed as engrossed 17101156D-E
01/24/2017Impact statement from VDH (SB1178E)
01/24/2017Read third time and passed Senate (39-Y 0-N) (see vote tally)
01/31/2017Placed on Calendar
01/31/2017Read first time
01/31/2017Referred to Committee on Health, Welfare and Institutions
02/14/2017Reported from Health, Welfare and Institutions with substitute (22-Y 0-N) (see vote tally)
02/14/2017Committee substitute printed 17105311D-H1
02/14/2017Impact statement from VDH (SB1178H1)
02/15/2017Read second time
02/16/2017Read third time
02/16/2017Committee substitute agreed to 17105311D-H1
02/16/2017Engrossed by House - committee substitute SB1178H1
02/16/2017Emergency clause added
02/16/2017Passed House with substitute BLOCK VOTE (97-Y 0-N)
02/16/2017VOTE: BLOCK VOTE PASSAGE (97-Y 0-N) (see vote tally)
02/20/2017House substitute agreed to by Senate (40-Y 0-N) (see vote tally)
02/20/2017Title replaced 17105311D-H1
02/22/2017Bill text as passed Senate and House (SB1178ER)
02/22/2017Impact statement from VDH (SB1178ER)
02/22/2017Signed by President
02/22/2017Signed by Speaker
02/23/2017Enrolled Bill Communicated to Governor on 2/23/17
02/23/2017G Governor's Action Deadline Midnight, March 27, 2017
03/20/2017Governor's recommendation received by Senate
04/05/2017Senate concurred in Governor's recommendation (39-Y 0-N) (see vote tally)
04/05/2017House concurred in Governor's recommendation (98-Y 0-N)
04/05/2017VOTE: ADOPTION (98-Y 0-N) (see vote tally)
04/05/2017G Emergency clause deleted by Governor's recommendation
04/05/2017G Governor's recommendation adopted
04/05/2017Reenrolled bill text (SB1178ER2)
04/05/2017Signed by President as reenrolled
04/05/2017Signed by Speaker as reenrolled
04/05/2017Enacted, Chapter 812 (effective 7/1/17)
04/05/2017G Acts of Assembly Chapter text (CHAP0812)


This bill was discussed on the floor of the General Assembly. Below is all of the video that we have of that discussion, 1 clip in all, totaling 58 seconds.

Duplicate Bills

The following bills are identical to this one: HB2163.


Steve writes:

This is a dangerous bill. This will kick patients that are already in treatment and have a documented allergy to Naloxone on file out of treatment. These patients don't deserve to lose treatment because they have an allergy. It will also prohibit federally licensed opioid treatment clinics (methadone clinics from dispensing it in take homes. The patients have earned those take homes went for 9 months or more to earn a weeks worth. Making the OTP clinics switch medications will put undue financial burden on patients. Most patients cannot afford this The OTPs are also conservative in providing patients with any take home medication. When take home medication is provided to the patient through the OTP, the OTP must meet eight clinical standards, which have been enforced singe the regulatory authority of the FDA that continued under the regulatory oversight of SAMHSA. These criteria include absence of recent drug abuse, which is determined through toxicology reports in addition to established regularity of clinic attendance, absence of serious behavioral problems, absence of known recent criminal activity, stability in the patient's home environment, length of time comprehensive maintenance treatment, ensuring that take home medication can be safely stored within the patient's home whether the rehabilitative benefit the patient derives from decreasing the frequency of clinic attendance outweighs potential risk. Compliance with the regulations is mandatory. They bill needs to be amended to include people that have an allergy on file to ba able to get a prescription, and it needs to let the clinics continue to dispense it in take homes. The problem is these pain management clinics writing the tablet form of medication for pain, when they should have a patch. The tablets were not approved for pain they were approved for addiction treatment, and taking these patients out of treatment will have serious consequences. It will tear families apart, people will go back to crime, and some will die from an overdose.

Naloxone isn't the active ingredient in suboxone that blocks opioids, the active ingredient that blocks the mu receptors is buprenorphine. the company claimed Naloxone was added to deter abuse when in reality it does hardly anything. Naloxone binds to the same receptors as buprenorphine and if there was enough to knock the buprenorphine off the receptors it would send people into withdraws and make the buprenorphine ineffective. The only reason they could patent Subutex was they were the first to market a sublingual formulation. Naloxone was also added to it so Reckitt-Benckiser could patent it.federal investigations and congressional hearings into the escalating costs of treatments and life-saving drugs used to combat an opioid addiction crisis that has claimed more than 250,000 lives in the US over the past 15 years. The case against Reckitt Benckiser accuses it of “product hopping,” in which a company tweaks its product slightly, often without any actual improvements, and then applies for a new patent with the intent of keeping its market share intact. In Reckitt Benckiser’s case, the product switch was from the orange Suboxone tablets it had been successfully marketing to a new dissolvable film strip that was developed by co-defendant MonoSol RX.

In short, I ask if this bill to be amended or vetoed because buprenorphine/naloxone doesn't do anything that buprenorphine doesn't do except make treatment harder to get due to price. This bill at least needs to be amended to include patients with an allergy on file because some people cannot have Naloxone, and leave the otp clinics out of it. They have more oversight than any other kind of treatment buisness. These professionals know what they are doing. Medically buprenorphine with naloxone has no added benefits over buprenorphine. Buprenorphine is what will put people in withdraw if they use another opioid on top of it not Naloxone.

Patricia Whitman writes:

This bill needs to be vetoed!! It's a dangerous bill. This will effect thousands of people in recovery, who have worked hard to get where they are. Buprenorphine has saved thousands of lives. The naloxone was put suboxone so the drug company could patent this medication. Buprenorphine is the medicine that binds to your receptors and keeps you from feeling euphoria from narcotics. Buprenorphine is the medicine that fixes your receptors and makes you feel normal, kinda fixes your brain. Passing this bill will effect so many people. There are people like myself that have a hypersensitivity to naloxone in suboxone. It gives me blinding headaches, nauseous and makes my depression worse. There at least needs to be exemption for people allergic to naloxone. This medicine is no way shape or form like a full on antagonist like methadone. Methadone is in the same category as heroin. You are actually able to overdose on methadone. Buprenorphine you aren't going to feel euphoric so you are less likely to overdose, if not impossible. Please educate yourself on this medication. It scares me to death that politicians are acting like doctors. You are dangerous taking thousands of people's recovery in your hands. Are you willing to have blood on your hands, when thousands of people are denied their medicine and have a potential to overdose. This will push people like myself to go back on methadone, because I take subutex for pain and addiction. This will push people back to having to be back on a narcotic when they are unable to receive their subutex. Please reconsider this bill!!

Michael A Dowdy writes:

Please veto this was a hastily wrote bill with no clauses for people who are unable to take subutex there is far worse issues with drug addiction they need to be dealing with than taking an avenue of help away from people without having any solid evidence that it's being abused this is nothing more than a favor for big pharma to keep digging into our wallets

Kyle Miles writes:

This bill needs to be vetoed, or rewritten. It will endanger the lives of patients, and make loved ones suffer. People that live in rural areas cannot reach clinics everyday nor should they have too. Methadone is far more dangerous and abusable than buprenorphine and they get to keep their take homes. If you want to put restrictions in place do this. Let doctors write it people that have an on file allergy/hypersensitivity , and tell the medical board to allow patients that have earned take homes of this medication at OTP'S to be able to keep them. They earned those take homes, and it isn't fair a more dangerous, more valuable drug methadone will be dispensible unless you plan to take those too. Which a lot more patients are in trouble then, All this will do is cost people their lives, jobs, freedom, and families or all of the above. No other state has done it and the organization that is the authority of it deems it a safer option than methadone that is why the allowed it to be a treatment option. Suboxone has done nothing but keeps the price of generic formulations costing more, and that is why the state of Virginia and many other states are suing the maker of it. People can get a prescription for suboxone so most clinics don't offer it as a option because of that and the price they have to charge. People go to those clinics to have that as their treatment and they do what is necessary to earn take homes. Most addiction/opioid dependence specialists won't prescribe buprenorphine to anyone unless a person cannot have it. Not every patient lives 5 miles from a clinic, most are in rural areas and drive an hour or more to the clinic.

Ronald Blagg writes:

This is INSANE....Are ya'll in bed with Invidor or whoever Rekitt is called these days?
A gross sales of $1.4 Billion dollars tells me Suboxone got themselves a CASH COW! RIDE THAT MONEY MACHINE WHILE US REGULAR FOLKS DIE!
7 day limit on Generic Bupe...OMG....Wouldn't wanna deduct too much of Suboxone Money, now would we?
I'm 68 years old, old enough to know when someone is an IDIOT...GUESS WHAT....YA'LL QUALIFY AT THE TOP!

Crystal writes:

Hopefully this will go through

Kyle Miles writes:

Hopefully it won't, as some patients cannot have suboxone and have a documented allergy to Naloxone on file. These patients shouldn't lose treatment just because they have an allergy, are you insane?

Brittany writes:

This is dangerous for some of us. As an addict Bupe saved my life. Methadone is a joke and many people where I live only have that option unless you want to drive an hour and a half away everyday. Methadone has caused a lot of deaths and overdoses more so than Bupe. I have been working a program since Dec 29 2014 and have had to take subutex due to an allergy with required epenephrine injection due to the anaphylaxis/ allergy. I am not able to drive to my program everyday to dose it's an hour away and I receive Medicaid. I can't afford the $20 a day at the clinic which the closest is an hour away. I'm scared to go back Tuesday and be told they can longer treat me because of this. I am in recovery and have done amazing and wouldn't be where I am without my Subutex Perscription. Please at least make a clause for those of us, which is no fault of our own that we are allergic to continue our treatment. Again, I hate to lose where and how far I have come today because my body can't take the naloxone.

Autumn writes:

This bill needs to be vetoed!!! As a mother of 3, a wife, a daughter, and a sister, I take buprenorphine every day because not only do I breastfeed, but suboxone gives me headaches, sometimes rashes, and makes me so naeseous I cannot even get out of bed. I also do not have insurance! I work, so you can see how that is an issue. When my doctor switched me to subutex, it saved my life. I was depressed and not knowing what to do when I was first prescribed suboxone. I wasn't going to go back to my doctor when my family begged me to give it one more try, when I did, she switched me to subutex. I've been clean ever since. Never failing a drug test, never missing a random call in for a pill count, I've even done blood tests. Why must you play God and decide what people need and do not? You are not my doctor and you do not what is best for me. And trust me this isn't going to help but just put people back on the streets looking for pills or worse, herion. I am very upset and everyone who agrees with me, we can't just sit back and let them do this! We need to start a petition and when the time comes go out and VOTE! We are people too! Just because we had an addiction doesn't mean we aren't smart, deserving, or shouldn't be treated like human beings! Would these politicians make their child, grandchild, mother or significant other suffer from a medicine allergy?! NO! They would do everything in their power to take away any suffering! We need to stand up and fight for what we think is right! Power to the people!

Erica Best writes:

All this bill is going to do, is make street prices of pills and other substances go up. These politicians need to stop playing GOD and get out of bed with these pharma companies and get back to worrying about other things instead of my monthly script of Subutex that keeps me from active addiction!!! I am still in shock that Subutex and NOT methodone was limited???? All this just goes to show that it's all about the $$$$ and all they are doing is getting richer and passing the cost onto the consumer. So now when my doctor switches me to something else my insurance company is going to send me a huge packet that has to be filled out saying why I have to be on something more expensive than a generic form of the substance that I've been taking successfully for years!!! Shame shame shame on you all, you corporations that only think about their own pockets!!

Brenda Shaver writes:

Today I went to my doctor and was switched to suboxone,even though I have a well documented allergy to naloxone! My doctor said his hands were tied! So, after almost 2 years of doing great and getting my life back...they're sending me back to the streets! THANKS VIRGINIA!

BlackHat writes:

Really? Pillon, Kilgore, & O'Quinn sending everyone to the streets. Doctors are laughing at this. This is certainly going to make matters much worse. You will send people to illegal drugs and more dangerously scheduled painkillers. If it runs it's course, you will have lives lost. Buprenorphine and Naloxone does nothing to Buprenorphine but make those who have adverse reactions suffer.

I'm so glad I have a handy list of everyone who voted on this, you will all certainly be hearing from me.

Play with your own lives, not others.

If you really want to make an impact on the "Opioid Epidemic" and "Pill Mill" crisis, then you need to seriously rethink/rewrite & repeal this and stop making collateral damage and matters worse. This won't end well.

Chase writes:

This bill is ridiculous. All of this stems from the heroin/real opiate epidemic, so why target those who are not involved with such things? I am hypersensitive to naloxone and am having a hard time getting my prescription filled. Shame on you Virginia Board of Medicine.