Pulse
New Option for Old Problem
The FDA’s approval of buprenorphine represents a shift in treatment for opioid addictions.
Until recently, the only pharmaceutical approach for treating opioid addictions, other than abstinence combined with naltrexone (PreVia), was methadone maintenance. But now, some physicians are saying that buprenorphine represents a real treatment shift because patients are unlikely to overdose on it and, unlike methadone, it can be administered from a physician’s office rather than a federal treatment program.
In 2000, the FDA approved sublingual buprenorphine and the combination of buprenorphine and naloxone for the treatment of patients addicted to painkillers, heroin, and other opioids.
The drug, which is an opioid, counteracts cravings without producing a euphoric high, blocks the effects of other opioids, and when stopped has very mild withdrawal symptoms, if any, according to Scott McNairy, M.D., an addiction psychiatrist who has used the medication with patients at the Veterans Affairs Medical Center in Minneapolis. McNairy says buprenorphine has helped many of his patients lead normal lives for the first time in years and made it possible for them to participate in meaningful recovery.
Peter Friedmann, M.D., an internist and an associate professor of medicine at Brown Medical School in Providence, Rhode Island, who has researched addiction treatment in the primary care setting, has high hopes for the medication. “This really represents a sea change in how we will manage opiate problems,” he says.—Scott D. Smith
To prescribe buprenorphine, physicians must obtain a waiver from provisions of the federal Controlled Substances Act and complete eight hours of training. To learn more and find a list of physicians qualified to prescribe this drug in Minnesota, visit www.buprenorphine.samhsa.gov or call 866/287-2728. An online course for physicians is available at http://www1.buprenorphinecme.com/PageReq?