The steady rise in opiate addiction rates has prompted the development of new medication therapies. Though methadone (the long-time standard medication treatment) offers many benefits for those struggling with addiction, it’s nonetheless a tightly controlled substance, which hampers the drug’s availability. As addiction rates continue to climb, the existing number of methadone facilities cannot handle increasing demands for help.
Suboxone, derived from buprenorphine, improves upon methadone’s effectiveness as a therapeutic agent as well as in its overall availability. Suboxone doctors play a pivotal role in making this drug readily available to those eligible for treatment.
While not as tightly controlled as methadone, Suboxone doctors must still meet certain eligibility requirements. Federal guidelines also dictate how Suboxone medications can be dispensed throughout the course of treatment. Ultimately, Suboxone doctors offer people recovering from opiate addictions a much more flexible treatment option than methadone.
Suboxone’s effects mostly derive from its main ingredient buprenorphine, though naloxone, a secondary ingredient also serves an important purpose. Like methadone, buprenorphine’s effects work to reduce the degree of withdrawal and cravings effects addicts so often experience in recovery. Naloxone works as an antagonist agent, meaning someone who abuses opiates while on Suboxone will experience uncomfortable withdrawal effects.
Subutex, another treatment medication similar to Suboxone contains buprenorphine as the sole active ingredient. Suboxone (and Subutex) stimulate certain key cell sites in the brain just as methadone does. Suboxone effects differ in that the drug doesn’t fully stimulate cell sites, which makes for a more long-lasting therapeutic effect. This somewhat “muted” effect also reduces the likelihood a person will become addicted to Suboxone.
The Drug Abuse Treatment Act
Methadone’s classification as a Schedule II narcotic accounts for the tight regulations surrounding the drug’s use. Since buprenorphine delivers a less potent effect than methadone, Suboxone holds a Schedule III classification, which comes with fewer regulatory controls.
The Drug Abuse Treatment Act of 2000, also known as DATA, allows Suboxone doctors to prescribe and dispense the drug out of their offices provided they meet certain federal qualification requirements, according to the National Center for Biotechnology Information. DATA legislation specifically applies in the case of Schedule III, IV and V drug classes. Suboxone and Subutex exist as the first medications approved under the DATA guidelines.
The Drug Abuse Treatment Act is actually a “spinoff” of an earlier piece of legislation known as the Narcotic Addict Treatment Act of 1974. This earlier version makes provisions for a waiver, which essentially opened the door for Suboxone doctors to work out-of-office.
Suboxone Doctors’ Requirements
DATA qualification requirements for Suboxone doctors include the following –
- Meet certain addiction training requirements
- Hold an addiction-related certification
- Obtain an identification number (for prescription purposes)
- Be able to provide or refer patients for supportive services, such as psychotherapy and drug counseling
- Treat no more than 30 patients at a time whether working out of an individual or group-based practice
In effect, these requirements help to ensure Suboxone doctors provide much of the same types of treatment services offered through methadone clinics. As opiate addiction comes with a high potential for relapse and abuse of treatment medications, these guidelines work to reduce the likelihood of abuse and provide recovering addicts with the supports needed to maintain abstinence.
Suboxone vs. Subutex
As Subutex only contains buprenorphine as an ingredient, it’s most often used during the first few days of detox treatment. During this time, addicts experience excruciating withdrawal effects, which can be greatly reduced by Subutex’s effects.
In effect, Suboxone’s added naloxone ingredient would be counterproductive during the detox stage as addicts would experience even worse withdrawal effects. For this reason, Suboxone works best as a long-term, maintenance therapy to prevent patients from abusing the medication as well as reducing the likelihood of relapse.
Suboxone Doctor Requirements in Outpatient Treatment Settings
Outpatient treatment settings offer treatment interventions designed to help recovering addicts maintain abstinence on a long-term, daily basis. It wasn’t until the year 2003 that the law allowed Suboxone doctors in outpatient settings to administer Suboxone as a long-term, maintenance therapy.
Much like the private/group practice requirements, outpatient clinic facilities must obtain the necessary certifications for dispensing a Schedule III narcotic drug. Unlike private practices, outpatient programs do not have to limit their patient quota to 30 or less at any given time.
Like private/group practice settings, outpatient programs must provide supportive services along with Suboxone medication therapy in the form of –
- Necessary medical treatments
- Drug counseling
- Drug screenings
While Suboxone doctors can administer the drug within authorized outpatient settings, doctors wanting to dispense Suboxone out of their own practices must still meet the DATA waiver requirements regardless of whether they already work out of an outpatient facility.
During the early stages of treatment, Suboxone doctors are required to supervise patients when administering daily dosage amounts, according to the U. S. Food & Drug Administration. As a person’s physical and psychological condition starts to stabilize, doctors can be more flexible in terms of how they administer and dispense the drug.
After the first month or two of treatment, Suboxone doctors can dispense take-home doses depending on a person’s progress in the program. Factors considered when determining a person’s “readiness” for take-home doses include –
- Attending required treatment sessions, such as psychotherapy and counseling
- Attitude towards treatment
- Drug screening results
- The drug’s effectiveness at alleviating withdrawal and cravings symptoms
While Suboxone’s mix of buprenorphine and naloxone does a good job at preventing recovering addicts from abusing the drug in injection form, Suboxone can still produce a “high” effect when taken in large dosage amounts. For this reason, Suboxone doctors must follow strict protocols in cases where take-home doses are reported as lost or stolen.
Under the Narcotic Addict Treatment Act of 1974, substance abuse treatment providers must maintain confidentiality regarding a patient’s treatment status as well as his or her personal information. HIPAA laws also provide an added layer of privacy and confidentiality for patients receiving Suboxone treatment.
Under these provisions, Suboxone doctors must obtain written consent from a patient to disclose the contents of his or her records. These requirements also apply when doctors call in or fax prescriptions to pharmacists.
Overall, people who may be uncomfortable with frequenting methadone clinics on a daily basis will likely find Suboxone treatment options more convenient. Likewise, the ability to obtain opiate addiction treatment through Suboxone doctors’ offices makes it possible for a person to get needed treatment who otherwise might not be eligible for methadone program treatment.