Buprenorphine Initiative
Promoting Office-Based Treatment for Opiate Addiction

What is Buprenorphine?
Buprenorphine (bue-pra-nor-feen) is a medication used to treat opiate-addicted patients who are dependent on such drugs as heroin and morphine or prescription painkillers like Oxycontin, Demerol and Vicoden.

Since the Food and Drug Administration (FDA) approved the use of buprenorphine in October 2002, clinical trials found its use to be an effective form of detoxification and maintenance treatment. In fact, results from other countries demonstrated dramatic reductions in overdose deaths and HIV infections. Additionally, this form of treatment allows patients to receive care directly from their physician. They can also have prescriptions filled at a pharmacy, rather than seeking treatment at a methadone clinic. 

What is Office-Based Treatment?
Opiate-addicted patients typically find treatment from specialized clinics. The Drug Addiction Treatment Act (DATA) of 2000 allows qualified physicians to treat a limited number of these patients in their private offices. However, the Act also specifies that physicians must meet certain requirements to prescribe buprenorphine, including eight hours of specialized training.

As more physicians qualify to prescribe buprenorphine, addiction treatment will become more widely available, helping to reduce the harm associated with addiction to patients and society.

Why Aren’t More Physicians Adopting Office-Based Treatment? 
Studies have identified several barriers that discourage physicians from becoming certified and adopting buprenorphine treatment. The largest obstacle is the lack of adequate financial and organizational resources physicians need to treat chemically dependent patients. The government has also imposed a number of restrictions on the use of buprenorphine, including a 30-patient limit per physician. Physicians must be specially certified and registered with the Drug Enforcement Agency (DEA) in order to prescribe. Although these restrictions will help to ensure high quality treatment, they can also discourage physicians already reluctant to treat these patients.

What Are We Doing to Help?
Through partnerships with MedChi, The Maryland State Medical Society and other key representative organizations in the addictions community, efforts have been made to remove barriers that prevent the adoption of office-based buprenorphine treatment.

In April 2003, the Center for a Healthy Maryland began to promote office-based treatment for opioid addiction. A grant from the Open Society Institute-Baltimore funded a campaign to educate physicians and increase awareness within the medical community of the benefits of using buprenorphine. A study on physician willingness to prescribe buprenorphine was conducted through a subcontract with the Johns Hopkins School of Medicine.

The Center for a Healthy Maryland will continue its efforts to educate physicians through a specific set of activities over the next year: organizing training and certification events, providing linkages to physicians who have experience in prescribing burprenorphine and can offer practical tips, and making available resources to encourage more physicians to use this medication to treat addiction within their practice. Program efforts for 2005-2006 were supported by the Quality Health Foundation and United Way of Central Maryland.

For more information on buprenrophine, visit www.buprenorphine.samhsa.gov.

Elaine Gisriel
Project Coordinator
Ph. 410-539-0872, ext. 415
Email egisriel@medchi.org

Center for a Healthy Maryland, Inc.
MedChi, The Maryland State Medical Society
1211 Cathedral Street
Baltimore, Maryland 21201-5516
Tel: 800-492-1056 or 410-539-0872
Fax: 410-649-4131
www.healthymaryland.org
www.medchi.org