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30-Patient Limit

Born of fear that local doctor’s offices might turn into “pill mills”, physicians were limited to (treating with Schedule III, IV or V medications) 30 opioid-addicted patients under their care at any one time. (DATA-2000) Leaving the rest of the patients in need in the community, untreated, was somehow seen as a logical solution. It is now clear that these fears were unfounded and this rationing of care is only creating another obstacle for those in need of this life-saving treatment.

Senators Carl Levin (D-Michigan) and Orrin Hatch (R-Utah) held a symposium and press conference August 3, 2006, in the Russell Senate Office Building. The purpose was to bring attention to the success of buprenorphine since its introduction nearly four years ago. The leading experts in the country were in attendance. “It can’t be a secret weapon,” said Levin. “It’s got to be known. It’s got to be available.”

Bill S.2560 was introduced in the Senate 4/6/2006 that if passed would eliminate the 30 patient limit for physicians who have had their waiver for more than one year. It is part of a larger bill to reauthorize funding for the Office of National Drug Control Policy (ONDCP) Levin said he hopes for a September vote. For more details see:

30-Patient Petition banner

NAABT has an online petition in support of the removal of the 30-patient limit.
Just click on the above banner to go to the petition page. If you have your own
website you may download the above banner for inclusion on your site. This will allow your visitors an easy way to add their support. For instructions see:

To check on the status of the 30 limit see:

Buprenorphine Study Published in the New England Journal of Medicine: Counseling and Treatment Outcomes Evaluated

Buprenorphine treatment is proving to be an effective solution to a shortage of
treatment options for opioid addicted patients. Certified physicians (including those in primary care and office-based practices) are now able to treat opioid addicted patients in the privacy of their offices, giving the patients alternatives over Methadone and brief detoxification programs.

Literature indicates that counseling is a useful component for effective treatment.1 Some questions remain and include: What type of counseling? How much counseling? Where can counseling be delivered when a Primary Care doctor prescribes buprenorphine but isn’t able to offer counseling from his or her practice?

A study conducted at Yale and recently published in the New England Journal of Medicine by Dr David Fiellin, et al (NEJM August 27, 2006) attempts to answer some of these questions.

166 patients were randomly assigned to one of three groups and treated for six months with a medically based counseling model that incorporated aspects of Motivational Enhancement Therapy, 12-step facilitation and Cognitive Behavioral Therapy. The counseling was performed by nurses who had no prior experience in providing drug counseling but received training and supervision prior to and during the study. All patients received daily buprenorphine/naloxone at an average dose of 17 mgs per day. The variable was the amount of counseling each patient received and number of weekly visits to the Primary Care Center that patients made. Some received 20 minutes of nurse counseling weekly; others received 45 minutes per week. Some patients came to the clinic for medication once a week; others came to receive medication thrice weekly. All patients met with a physician monthly for approximately 20 minutes. Patient outcomes were favorable and similar in all three groups. In fact, the results showed a slight advantage, although statistically insignificant, for the 20 minute counseling sessions and once per week clinic visits with 44% opioid negative urines vs. 40% in each of the other two groups.2

– Kathleen Gargano, RN

1Fiellin, Kleber, Trumble-Hejduk, McLellan, Kosten. Journal of Substance Abuse Treatment. 27(2):153-9, 2004 Sep.

2From the Departments of Internal Medicine (D.A.F., L.E.S., P.G.O.) and Psychiatry (M.V.P., M.C.C., B.A.M., R.S.S.), Yale University School of Medicine, New Haven, Conn. Fiellin, et al (NEJM August 27, 2006)

Patient-Physician Matching-System

The NAABT Patient Physician Matching System has been tested in a few select cities and has successfully connected 96% of the patients with a physician. One unexpected result was that the system has provided a non-intimidating way for patients to reach out for help. This will possibly drive patients to treatment sooner. Since patients can apply 24-7, they can effectively reach out for help as soon as they first feel they need help. We have expanded the service areas to include: ME, NH, VT, MA, RI, CT, MD, GA and western PA. There have been a few cases where patients have been contacted by physicians with hours of registration, and some have been offered an appointment the same day. National Launch will be sometime in September. What is the National Patient/Physician Matching System?

Fentanyl Update

From about mid April of this year patients with fentanyl overdoses began to show up in ERs across the country. The powerful narcotic was being used in conjunction with heroin. With many recent arrests it seems to be on the decline.

> Fentanyl Summary Sheet

The NAABT Discussion Board now has over 1,260 members who have posted over 21,500 posts, over the last 12 months. The main educational site receives an average of 1,500 visitors a day. Although the discussion board is not a substitute for counseling, many have reported benefit from the anonymous peer based forum.

We have added to our Literature Page – consolidating some of the pertinent material available on the web.

The Physician Locator (Doctor/Patient button) sorts physicians by distance in geographic proximity, regardless of city, town, county, or state borders. Click here to try it for yourself.

Current Newsletters are available at the homepage. Past editions are available on our Literature page, under Other Literature.

Disclosure: NAABT, Inc. has accepted funding from Reckitt Benckiser (Richmond, VA, pharmaceutical company that manufactures buprenorphine products) in the form of an“Unrestricted Educational Grant.” The grant is “unrestricted” so that there are no “strings” attached. NAABT, Inc. has complete control over how the funds are used, there are no restrictions on the content or mission of this site, and Reckitt has no control over the content of the site or NAABT’s activities. Reckitt is currently the only FDA approved maker of a buprenorphine based product for addiction. NAABT, Inc. is not affiliated with Reckitt Benckiser.

Click here to learn more about NAABT.

The National Alliance of Advocates for Buprenorphine Treatment is a non-profit organization formed to help people, in need of treatment, find treatment providers who are willing and able to treat opioid dependency in the privacy of a doctor’s office. Our website offers answers to frequently asked questions, a glossary, actual patient experiences, a discussion board, information on the history and treatments of opioid addiction, current news on the subject and more.

This newsletter is provided to keep you informed on matters relating to Buprenorphine Treatment. Please feel free to contact us at with feedback, suggestions, or perhaps you would like to contribute a story. Also feel free to photocopy or print as many as these newsletters as you wish for distribution.

To add yourself or someone you know to the mailing list, please either write us or email us at

The National Alliance of Advocates for Buprenorphine Treatment NAABT, Inc. • P.O. Box 333 • Farmington, CT 06034 Tel: 860.269.4390 • Fax: 860.269.4391 • email: