My 22 yr. old daughter began suboxone therapy for an oxycodone addition three months ago. Suboxone dose was 12 mg for first month, 10 mg for second month and 8 mg third month. Two weeks after beginning suboxone therapy, she was developed mono and had acute symptoms for two weeks followed by moderate symptoms for two weeks. The drug treatment center performed a standard liver panel and the following tests were abnormal: direct bilirubin - 0.6mg/dl (repeated), alkaline phosphatase - 134, SGPT (alt) - 82. All other tests were normal. The drug/alcohol screen at suboxone clinic intake indicated oxycodone was the only drug tested. Subsequent routine screenings indicate no detected levels of drugs or alcohol except suboxone. She also takes Yaz birth control pills and, occasionally, Imitrex for migraines. (Has taken two Imitrex in last two months.)

Sub clinic counselor told her she needed to see her primary care physician for hepatitis testing. She has to wait four weeks for an appointment and, although the doctor has her results from the clinic, Dr. will not order the hep tests until my daughter is seen in the office. My daughter is in an extremely fragile emotional state right now. She is progressing well in her recovery but is lonely because she cannot hang around with her drug addict "friends." This concern about the hepatitis has her very depressed. I know she could have hepatitis but was wondering if the elevated liver enzymes and bilirubin could have other causes such as mono or suboxone use. If I could tell her that those tests could be abnormal due to causes other than hep B or C, I think it would alleviate her worries until she sees her doctor and has further testing.