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Abuse of heroin and prescription opiates (such as oxycodone and hydrocodone) has spiked in the past decade, with an estimated 2 million people having used in the past year. Although methadone clinics offer effective treatment, only a fraction of those trying to quit opiates enter a clinic’s doors. Unlike methadone, the prescription drug buprenorphine can be taken outside a methadone clinic, which greatly increases treatment options for people unable or unwilling to receive a daily dose of methadone at a clinic. However, access to buprenorphine is somewhat limited; the only physicians who can prescribe it are those who complete an approved course or have board certifications in addiction medicine or addiction psychiatry and receive a special U.S. Drug Enforcement Administration number indicating that they are waivered from the special registration requirements in the Controlled Substances Act. In addition, the number of patients they can treat is restricted because of concerns that buprenorphine would be diverted to illicit use. Policymakers are examining ways to improve access, including increasing the number of patients a waivered physician can treat and allowing nonphysicians who receive waivers to prescribe it as well.

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Policies to Support a Better Treatment for Heroin and Prescription Opioid Abuse: Unlike Methadone, Buprenorphine Can Be Taken at Home, but Greater Access is Key