Expanding treatment options for opioid dependence: Physician acceptance of buprenorphine treatment

Caroline C. McLeod, PhD¹, Arlene Stanton, PhD², Wendy Kissin, PhD¹, L. Joseph Sonnefeld, MA³, and James W. Luckey, PhD¹. (1) Substance Abuse Research Group, Westat, 1650 Research Blvd., Rockville, MD 20850, 240 453-2786, carolinemcleod@westat.com, (2) Center Substance Abuse Treatment, 5515 Security Lane, Rockville, MD 20852, (3) Substance Abuse Research Group, Westat, Inc., 1650 Research Blvd., Rockville, MD 20850

Opioid dependence, including prescription drug dependence, is a growing public health problem. Until recently, medication-assisted treatment for opioid dependence has been limited primarily to highly regulated, specialized opioid treatment programs (methadone clinics), which tend to be concentrated in urban areas. The Drug Addiction Treatment Act of 2000 (DATA) could expand access to medication-assisted treatment beyond specialized clinics. Waivers provided under DATA allow qualified physicians to prescribe or dispense certain narcotic drugs approved by the Food and Drug Administration (FDA) for the treatment of opioid dependence from medical clinics and private offices. Buprenorphine is the first such medication to be prescribed under the DATA waiver. Physicians’ acceptance of this new innovation will be key to determining whether treatment for opioid dependence expands significantly to other medical settings. A survey of a probability sample of 935 addiction medicine physicians achieving an 80% response rate was conducted as part of an evaluation of the Waiver program funded by the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration. Using weighted estimates, analyses compare the characteristics of addiction specialists who did and did not obtain a Waiver and, among those with Waivers, those who did or did not actually treat with buprenorphine. Physician attitudes toward prescribing and referring for buprenorphine treatment, clinical and logistical challenges faced by physicians, and patient characteristics are described.

Learning Objectives:

At the conclusion of the session, participants will

• Have a basic understanding of DATA and the potential of this important legislation to increase treatment availability for opioid addiction;
• Be aware of factors that may influence whether physicians are willing to provide buprenorphine treatment or not, including individual characteristics and practice settings associated with prescribing buprenorphine;
• Obtain information on the characteristics of patients treated in the first year that this new treatment option became available; and
• More generally, be able to identify issues involved in the adoption of substance abuse treatment in medical settings.

Keywords: Substance Abuse Treatment, Access

Related Web page: buprenorphine.samhsa.gov/

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: -
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation

Fighting the Good Fight: Opioids and Buprenorphine

The 132nd Annual Meeting (November 6-10, 2004) of APHA