Buprenorphine Treatment: How Is It Working?

 

            When the medication buprenorphine was approved by the Food and Drug Administration for clinical use in 2002, it was hailed as a milestone in the treatment of addiction to illicit opiates such as heroin and certain prescription painkillers such as codeine and oxycodone.

            Buprenorphine is said to be long-lasting, with minimal side effects and a low potential for abuse.  It is also the only controlled substance approved for the treatment of opioid addiction that may be prescribed by physicians in an office-based setting as opposed to a specialty clinic.

            With these advantages, buprenorphine increases the number of tools service providers can use to treat addiction.  This medication also expands the availability and accessibility of substance abuse treatment—a priority for the Bush Administration, the U.S. Department of Health and Human Services, and SAMHSA.

            But the availability of a new medication is only one part of the story; its adoption into clinical practice is another.  Incorporating buprenorphine into treatment raises many questions.  For example:

 

§         What special training do physicians need to prescribe or dispense buprenorphine and how do they obtain this training?  How do physicians coordinate buprenorphine treatment with addiction treatment counselors and what kind of training do these counselors need?

§         What are some of the challenges and barriers to the use of buprenorphine in clinical practice, and how can SAMHSA help surmount these?

§         How do addiction treatment providers see buprenorphine affecting their clinical practices?  How can lessons learned from using buprenorphine in clinical practice increase acceptance and enhance the overall use of medical approaches in the treatment of addiction?

 

These kinds of questions are of particular concern to us at SAMHSA.  Our Agency seeks to serve as the conduit between the information gained from research and the knowledge gleaned from clinical practice; the synapse between science and service.  We view the constant interchange between the two as a catalyst that fuels the advancement and enhancement of recovery.

Medications such as buprenorphine, along with psychosocial supports, can help people addicted to opiates stop craving their drugs and re-establish productive and fulfilling lives in the community.  Buprenorphine alone is not a silver bullet for opioid addiction, but it can open the door to recovery and provide the opportunity to regain lost lives.

 

Charles G. Curie, M.A., A.C.S.W.

Administrator, SAMHSA

Substance Abuse and Mental Health Services Administration News, March/April 2004