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,
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.
- 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
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.
This issue of SAMHSA News explores some of the
emerging developments as buprenorphine is integrated into
treatment. Articles also describe SAMHSA-funded efforts to
train service providers to administer the medication and grassroots
efforts that include buprenorphine to combat opioid use and
addiction in the community.
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.