Legislation signed by President Bush last month could open up a treatment option to millions of Americans addicted to opioids.
The FDA approved buprenorphine, marketed in two different formulations as Subutex® and Suboxone®, in 2002 for treatment of opioid addiction. Since that time, access to the drug has been limited by a shortage of physicians prescribing the drug and by a rule that placed a limit on the number of patients a single physician or an entire physician practice group could have in treatment at one time.
The new law lifts the 30-patient cap for groups of physicians. If a practice has five, 25 or even100 physicians, each of those physicians can now have 30 patients in treatment with buprenorphine.
David Fiellin, M.D., associate professor of medicine at Yale University, New Haven, Conn., is chair of the American Society of Addiction Medicine's buprenorphine training subcommittee. He estimates there are currently 3.5 million patients that need the drug and just 2,500 to 3,000 physicians prescribing it. He hopes the new law will improve access to this promising treatment.
"The lifting of the 30-patient limit will mean that a substantially larger number of patients, especially those who receive their care within large group practices, some HMOs and academic medical centers, will be able to benefit from this important treatment," said Fiellin.
Fiellin also said that the removal of the patient limit reflects the government's realization that office-based treatment for opioid addiction is no different than office-based treatment of other medical conditions.
"We have seen a great deal of success in the first three years of the availability of the new treatment option, with little or no evidence of adverse public health consequences," said Fiellin.
