Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103488

Wendy Ring, MD, MPH and Phyllis Sovereign. Mobile Medical Office, 301 P Street, Eureka, CA 94401, 707 443-4666, wring@mobilemed.org

The Drug Addiction Treatment Act of 2000 made buprenorphine, a partial opioid agonist, available for the outpatient treatment of opiate addiction in physician offices. Since patients requesting treatment for substance abuse far outnumber the capacity of existing programs, office based use of buprenorphine has the potential to significantly expand access to treatment for patients addicted to heroin and prescription pain medications. Uptake of this new modality by primary care physicians has been low. Barriers include FDA restrictions, time constraints on medical visits, fear of attracting difficult patients to the practice, the frequency of concurrent psychiatric disorders and psychosocial issues, and addicted patients' need for more treatment than a simple pharmacologic substitute. Community health centers, which care for large numbers of drug addicted patients, can provide successful drug treatment with buprenorphine if these factors are addressed. Changes in Medicaid and Medicare reimbursement will be required to make drug treatment financially viable for community clinics, and would be cost effective in the long run, given the large proportion of health care and social service dollars expended to deal with the sequelae of substance abuse. Lessons learned from one community health center's experience with buprenorphine are reviewed.

Learning Objectives: