naabt masthead for buprenorphine site

The National Alliance of Advocates
for Buprenorphine Treatment

Buprenorphine (Suboxone®, Subutex®3, Zubsolv™4, Bunavail) 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 to become eligible to prescribe buprenorphine:

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 24,726 of the 800,000 US physicians (2.9%) 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 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 current doctor to become certified.

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://buprenorphine.samhsa.gov/bwns_locator/index.html

Buprenorphine Matching System - TreatmentMatch.org:

Not all eligible physicians are on the government locator (only about 15,413) 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 only up to 100 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 area doctors, and doctors then 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 60,831 patients have been connected to physicians using the matching system.

Here’s how to register: http://www.treatmentmatch.org/

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. Recently, 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. A list of treatment centers that offer buprenorphine treatment is displayed at the bottom of the page. www.TreatmentMatch.org/local

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 : 07/05/2014

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. FDA approved 7/3/2013 see buprenorphine pipeline graphic
  5. Rejected by FDA 4/30/2013 - Future Unknown - Probuphine denied by FDA