Buprenorphine

Researchers at Indiana University conducted one-on-one interviews with clinical providers and other stakeholders in the recovery arena to better understand the slow uptake of the drug most used to treat opioid use disorder. Biases against buprenorphine was the most consistent theme, though the reason for bias differed amongst stakeholders. Clinical providers and behavioral health care providers preferred the abstinence approach rather than use of medications.

n December 2022, Congress eliminated the DATA-Waiver program registration allowing providers to prescribe buprenorphine to treat patients for OUD. The University of Vermont Center on Rural Addiction, a HRSA Rural Center of Excellence on Substance Use Disorders, offers an incentive to help defray previous training costs of $750 to each qualifying provider who obtained a DATA-Waiver. To qualify, providers must be practicing in a HRSA-designated rural county in Vermont, Maine, New Hampshire, or Northern New York.

The Substance Abuse and Mental Health Services Administration released a notice of proposed rulemaking that would allow certified opioid treatment programs to begin prescribing the drug via audio-only or video-enabled telehealth. See additional information under Policy Updates below. The proposed changes come on top of recent findings by HHS of the positive impact of its revised Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder that removed two longstanding requirements for obtaining a waiver to treat up to 30 patients with buprenorphine: 1) the requirement for specific training, and 2) the need for otherwise eligible clinicians to certify their ability to provide or refer patients for counseling and other services. Rural primary care providers have obtained the DEA waiver at a lower rate than urban clinicians; decreased burden and greater flexibility in the guidelines, along with broader use of telehealth could help close that gap.

Buprenorphine (Suboxone) is an effective treatment for opioid use disorder (OUD). However, there have been widespread reports of diversion and misuse. This study examined motivations for nonprescribed buprenorphine use among rural residents.

In 2019, the Addictions, Drug & Alcohol Institute (ADAI) at the University of Washington launched the “Meds First” program to provide onsite, low-barrier access to buprenorphine in partnership with six syringe services programs across WA State. A key component of the Meds First service model was the addition of care navigation to support client engagement and retention in OUD treatment.

Buprenorphine utilization is an effective treatment for opioid use disorder (OUD). Given the recent increase in child maltreatment reports related to parental substance use, research should explore the correlation between buprenorphine treatment and child maltreatment–related outcomes.

Overview of the jail-based Medication Assisted Treatment program within the Adult Detention Center in Fairfax County, Virginia.

The purpose of this document is to provide detailed guidelines of the Nurse Care Manager Model of Office Based Addiction Treatment program for management of substance use disorders, with particular emphasis on treatment of opioid use disorder with buprenorphine (alone and in combination with naloxone) and naltrexone (oral and extended-release injectable formulations).

With the worst opioid overdose death crisis in the United States history, urgent new approaches to assist people who use drugs onto medication for opioid use disorder are necessary. In this commentary, addiction medicine clinicians and drug user union representatives align to argue that conventional ways of buprenorphine initiation that require periods of withdrawal must be augmented with additional novel approaches to initiation. 

This webinar focused on the crucial role of the emergency department (ED) in recognizing and treating opioid use disorder (OUD) patients with evidence-based medications for addiction treatment. Gail D’Onofrio, MD, discussed her pioneering work in creating the evidence for initiating ED buprenorphine treatment with ED patients presenting with opioid use disorder. Overall, the opioid epidemic intertwined with the COVID-19 pandemic has greatly escalated the need to mitigate the morbidity and mortality associated with the rising rate of fentanyl use. Data supporting the use of buprenorphine in the ED setting as well as the consequences of not initiating treatment will be discussed. While the use of ED prescribed buprenorphine has increased, universal adoption has lagged. Barriers to implementation of ED buprenorphine were discussed as well as strategies to overcome these challenges. Components of successful integration of an ED program with community partnerships was outlined. Current research by emergency physicians regarding innovative strategies such as high-dose buprenorphine inductions and use of extended release 7-day formulation of buprenorphine will be discussed. Initiation buprenorphine effectively, reduces withdrawal symptoms, improves adherence to treatment, and saves lives.