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 30,386 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 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.
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 19,385) 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 80,421 patients have been connected to physicians using the matching system.
Here’s how to register: http://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.
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.