Expert Info

Posted by Lizzie's View
on 30 Jul 2019

Hello! First, let me introduce myself. My name is Liz Hawkins and I am considering relocating to Sweden. I apologize that I am not certain how to use the "edit summary" box, so I'm just skipping it. I hope that's ok. :-)

I am currently on a medication that I will most likely be on for life. It is a treatment for narcotic addiction much like Suboxone (a strip that dissolves in the mouth); however, Suboxone has an additional ingredient called Naloxone that gives me terrible migraine headaches. For this reason, the doctors that treat me have opted to give me only the active ingredient, Buprenorphine (Subutex is the brand name). If I stop taking this medicine, it will make me violently ill, somewhat like narcotic withdrawals. I currently take one 8 mg tablet sublingually      (under the tongue until it dissolves) two times daily.

My concern is availability and cost. And what would I have to do to obtain it in Sweden? There is a LOT of red tape to get it here in the states because it is considered a controlled substance, so I am not sure I would be able to get it over there at all. The doctors here will not write the script with a refill, so whatever requirements I would need to meet would have to be done quickly as I would have at most 30 - 60 days to have the prescription finalized for me. 

Any information you could provide would be greatly appreciated.

Thank you,

Liz Hawkins

 

Meagan on 30 Jul 2019

Hi Liz,

This is a tricky question to answer as it's quite specific but I'll do my best to help. You can read the basics of the Swedish healthcare system here for a start. I also did a bit of extra research and I dug up a few facts:

  • To start with the bare minimum: it seems that buprenorphine is routinely used in some contexts in Sweden: "Today substitution treatment using Subutex/Subuxone and methadone is provided by the county councils at 114 places in Sweden" Source, p8 (this resource also has some info on the substance use policies and treatments in Sweden)
  • This WHO country profile from 2009 has a section on opioid agonist treatment and also specifically mentions buprenorphine. It seems that it's mainly used in public drug treatment centres and not in primary healthcare, however. Then again, though this is the most recent report, it was published a decade ago so some things might have changed. (It also says that the cost of a 2mg tablet of buprenorphine costs 23 Swedish Krona, but again, that price is likely to be outdated.)

I think your best bet would be to acquire private health insurance so that you are at least covered for costs when you move to Sweden. All residents are entitled to public healthcare but my understanding is that getting enrolled takes some time. Then, with regards to the availability of the medication – it looks like you might have some difficulty there too. Your best shot would probably be to bring the prescription and a letter from your doctor with you to Sweden, explaining your history and reason for being on the medication. If there are regulations in place that don't allow for chronic administration of buprenorphine, this won't help much but it's better to have the documentation in any case.

It's probably also necessary to plan for a worst-case scenario with your doctors, and decide what the best course of action would be if it happens that you can't obtain the medication you need in Sweden. Hopefully it doesn't come to that but it's best to be prepared.

You might be able to find out more with some intensive googling – there must be more recent resources surely, but I didn't come across any.

Hope this still helps in some way. Best of luck.

– M

Lizzie's View on 1 Aug 2019

Thank you so very much for responding to my question and for taking the time to research the information.

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