naabt masthead for buprenorphine site

The National Alliance of Advocates
for Buprenorphine Treatment

Buprenorphine (Suboxone®, Subutex®3, Zubsolv®4, Bunavail™5, Probuphine®6) is an opioid medication used to treat opioid addiction in the privacy of a physician's office.1 Buprenorphine can be dispensed for take-home use, by prescription.1 This, in addition to the pharmacological and safety profile of buprenorphine, makes it an attractive treatment for patients addicted to opioids.2

How to find Buprenorphine Treatment

Finding buprenorphine treatment may not be as easy as simply calling a doctor and getting an appointment, like it is with all other medications. Federal law limits how many patients a physician can help with buprenorphine at any one time. This distortion to the normal supply/demand dynamics predictably results in shortages of treatment, high prices for office visits, and reduced acceptance of private insurance and public entitlement. The list below is intended to help you access the best treatment option available to you.

Ask your current doctor (or NP and PA) to become eligible to prescribe buprenorphine:

Once you have made the decision to talk with a provider about buprenorphine treatment, you will find not all providers can prescribe it. In fact only about 35,064 of the 800,000 US physicians (3%) have the necessary credentials to prescribe buprenorphine for addiction. In addition, those who can prescribe have further limits on how many patients they can treat. To become certified providers must take an 8 hour course and file a request. This can be done online. See Physician Training Link You can ask your current doctor to become certified. Nurse Practitioners and Physician assistants can now become certified as well (where not prohibited by state law). -more-

Buprenorphine Locator:

To find a physician already certified near you, the government maintains a list online. SAMHSA has a list of certified doctors who have opted to be listed publicly. Unfortunately, not all doctors choose to be listed and about half of the doctors who are listed are not accepting new patients http://www.samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physician-locator

Buprenorphine Matching System - TreatmentMatch.org:

Not all eligible physicians are on the government locator and many who are listed are not currently accepting new patients. So finding one near you could be tough in some areas. Making things even harder and more unfair, each doctor is limited by law to only helping 30 patients at any one time during the first year of certification and up to 100 (or sometimes 275) after that. If that didn’t make it hard enough, many doctors don’t accept insurance for addiction treatment even though most insurers now reimburse for it. You can file your own claim directly and overcome this in some cases. To help, NAABT.org created a matching system. Patients apply anonymously, emails go out to participating area doctors who respond when they have openings. Many of the doctors that participate in this program are not on the public locator list. Patients have used this when they were unable to find a doctor on the list, or when searching after business hours, doctors have responded at all times of the day or night, on weekends, and holidays. It has also been useful when locating a doctor that does accept insurance or can also treat a co-occurring illness. Over 107,000 patients have used TreatmentMatch.

Here’s how to register: https://www.TreatmentMatch.org/

Your Health Insurance Provider:

If you are covered by health insurance, your provider will have a list of doctors certified to prescribe buprenorphine for the treatment of opioid addiction. Some companies are more helpful than others so be prepared to go through a few departments to finally get the list. If they are unable to produce one, they have provided you with grounds to ask for a self-reimbursement form so that you can go outside of the network, since they are unable to to help you within network. Each company has their own rules regarding out-of-network direct reimbursement, but it allows you to find any doctor with an opening, pay cash (or credit card), get a receipt and submit the claim directly to your insurer for reimbursement. - more on insurance -

Buprenorphine Clinical studies:

Sometimes you will be able to find clinical trials being conducted in your area. These can be a great way to get top quality treatment for free. You must carefully read the qualifying criteria and the details of the study. Studies that include “blind” or “placebo” mean that you might not be certain you are receiving the medication or a sugar pill. Look for “open label” “phase IV” studies. This means you know what they will be giving you and it is already FDA approved. www.clinicaltrials.gov keeps a list of ongoing studies.

Methadone/buprenorphine clinics:

Some methadone clinics also offer buprenorphine. However they must adhere to some of the same regulations as they do for methadone. In January of 2013, the regulations on the dispensing schedule of buprenorphine have been relaxed and allow for take-home doses to be earned with less restriction than with methadone. With the clinic's discretion and considering the patient's history, a patient may be able to receive a 30 day supply of buprenorphine. However, most clinics require daily visits for dispensing of the tablets (or film), at least initially.

Buprenorphine by The Three day rule:

Any doctor can administer (not prescribe) opioids, including buprenorphine for up to 3 days even if they don't possess the training or waiver required by law. The idea is in emergency situations any doctor can administer opioid-based medications to relieve withdrawal symptoms while permanent treatment is being arranged. Few physicians are aware of this provision. Here is the law to print out and bring with you if you need immediate help but cannot find a certified physician.

www.naabt.org/documents/Three-day-rule.pdf

This page was last modified on : 05/20/2017

The Purpose of Buprenorphine Treatment:

To suppress the debilitating symptoms of cravings and withdrawal, enabling the patient to engage in therapy, counseling and support, so they can implement positive long-term changes in their lives which develops into the new healthy patterns of behavior necessary to achieve sustained addiction remission. - explain -

The National Alliance of Advocates for Buprenorphine Treatment is a non-profit organization charged with the mission to:

  1. U.S. Food and Drug Administration, FDA Talk Paper, T0238, October 8, 2002, Subutex and Suboxone approved to treat opiate dependence.
  2. Center for Substance Abuse Treatment. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40. DHHS Publication No. (SMA) 04-3939. Rockville, Md: Substance Abuse and Mental Health Services Administration, 2004.
  3. Subutex Discontinued in the US market in late 2011.
  4. Zubsolv (bup/nx sublingual tablet) FDA approved 7/3/2013 see buprenorphine pipeline graphic -in pharmacies now.
  5. Bunavail (bup/nx bucal film) FDA approved 6/6/2014 see buprenorphine pipeline graphic -in pharmacies now.
  6. Probuphine FDA approved 5/26/2016 - FDA Probuphine press release