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133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA |
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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:
Keywords: Community Health Centers, Drug Abuse Treatment
Related Web page: www.mobilemed.org
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA