The Drug Addiction Treatment Act of 2000 paved the way for certain physicians to treat opioid addiction. Then, in October 2002, the drug buprenorphine received FDA approval for managing opioid addiction.
What's that mean to FPs? You can obtain a waiver to prescribe buprenorphine to patients undergoing detoxification or on maintenance therapy for addiction to opioids such as prescription pain medications and heroin. The only requirement is a minimal amount of special training. For more information on training opportunities, go to http://buprenorphine.samhsa.gov/training.html.
The waiver restricts a single physician -- or group of physicians -- from having more than 30 patients in opioid addiction treatment with buprenorphine at one time. (Waivers are issued by tax I.D. number.) The limit has created problems because the 30-patient ceiling includes both patients needing detoxification and those on maintenance treatment.
David Fiellin, M.D., associate professor of medicine at Yale University, New Haven, Conn., and chair of the American Society of Addiction Medicine Buprenorphine Training Subcommittee, estimates there are about 800,000 untreated heroin-dependent patients and as many as 2.5 million prescription narcotic-dependent patients in the United States. He estimates 1,200 physicians currently prescribe buprenorphine.
"There's a huge unmet need to provide treatment," he said. "I would guess 5 percent of family physicians' patients need this type of treatment service."
Patients can find a physician authorized to prescribe buprenorphine in their geographic area by logging onto the buprenorphine physician locator Web site at http://buprenorphine.samhsa.gov/bwns_locator/.
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