The National Alliance of Advocates
for Buprenorphine Treatment
Buprenorphine (Suboxone®, Subutex®) 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 (Suboxone®) Treatment
Finding Buprenorphine treatment
Once you have made the decision to talk with a doctor about buprenorphine treatment, you will find not all doctors can prescribe it. In fact only about 20,000 of the 700,000 US physicians (2.9%) have the necessary credentials to prescribe buprenorphine for addiction. In addition those who can precribe have further limits on how many patients they can treat. To become certified doctors must take an 8 hour course and file a request. This can be done online. See http://www.naabt.org/providers.cfm#pc You can ask your doctor to become certified.
Buprenorphine Locator:
To find a doctor already certified near you, the governmnet maintains a list online. SAMHSA (Substance Abuse and Mental Health Administration) has a list sorted by zip code of certrified doctors who have opted to be listed publically. http://buprenorphine.samhsa.gov/bwns_locator/index.html
Buprenorphine Matching System:
Not all doctors are on the locator (about 13,000) and many who are listed are not currently accepting new patients. So finding one near you could be tough in some areas. To make 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 only up to 100 after that. If that didn’t make it hard enough, many doctors still 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 area doctors, and doctors then respond when they have openings. Many of the doctors that participate in this program are not on the locator list. Patients have used this when they were unable to find a doctor on the list, or when searching at night or on weekends, 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 41,000 patients have been connected to physicians using the matching system.
Here’s how to register: https://www.naabt.org/patient_doctor/patient_login.cfm
Buprenorphine Clinical studies:
Sometimes you will be able to find clinical studies 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 clinics- Some methadone clinics also offer buprenorphine. However they must adhere to the same regulations as they do for methadone, so no monthly prescriptions. Most allow patients to qualify for take home doses after a set time, but most require daily visits for dispensing of the tablets, at least initially. A list of treatment centers that offer buprenorphine treatment is displayed at the bottom of the page. www.naabt.org/local
The Three day rule: Any doctor can administer (not prescribe) Suboxone 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 buprenorphine 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
Other related links:
Is buprenorphine treatment just switching one addiction for another?
How do I know if I'm paying too much?
Where can I get credible facts about buprenorphine?
Talk with actual addiction survivors and learn how they did it
- U.S. Food and Drug Administration, FDA Talk Paper, T0238, October 8, 2002, Subutex and Suboxone approved to treat opiate dependence.
- 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.