Drug expands options for addiction care

Potential use of buprenorphine may increase in-office access to therapy for opiate abuse, although, at least initially, it will remain in the domain of specialists.

By Victoria Stagg Elliott, AMNews staff. Nov. 4, 2002.

Addiction experts believe that a new medication and a change in federal regulations allowing office-based physicians to prescribe it will significantly expand access to treatment for patients with addictions to heroin and other opiates.

The Food and Drug Administration approved two formulations of buprenorphine last month and the Drug Addiction Treatment Act of 2000 gives doctors with appropriate training the right to prescribe it. But it is unclear whether primary care and other general physicians will seek out that training.

"Buprenorphine will allow patients to be treated for addictions in the same manner as they are treated for other chronic illnesses, such as diabetes or hypertension," said Charles G. Curie, administrator of the Substance Abuse and Mental Health Services Administration. "A qualified physician will be able, for the first time, to prescribe an anti-addiction medication in an office setting and treat opiate addiction as any other chronic disease."

Doctors who are not already certified by one of the addiction medicine specialty societies must take an eight-hour course on buprenorphine, then file a waiver with SAMHSA.

Currently, patients needing treatment for opioid addiction face significant barriers, and this new therapeutic option is expected to remove at least some of them.

"My personal hope is that it will reach a population that is largely unserved or underserved at this time," said J. Thomas Payte, MD, an addiction medicine specialist in San Antonio. "Those who are not so severely involved in their addiction that they would go to a more traditional methadone program, they might see their internist or another primary care doctor if it were a little less complicated." [...]