Improving Access to Office-Based Buprenorphine Treatment in Maryland

The report, "Improving Access to Office Based Buprenorphine Treatment in Maryland' was commissioned by the Center for a Healthy Maryland, Inc., and funded by the Open Society Institute in Baltimore. The study was conducted by researchers from the Johns Hopkins School of Medicine. Researchers sought to assess physician willingness to prescribe Buprenorphine. In the Fall of 2006,telephone interviews were conducted with seventeen Maryland physicians who are certified to prescribe Buprenorphine. These interviews revealed problems with the use of Buprenorphine for maintenance in an outpatient setting. Physicians explained that the disease of addiction affects patient behavior, impacting on how they manage their practices. The physicians stated that there were significant psychological and behavioral factors associated with Buprenorphine treatment. These significant differences include:

• Increased time and physician attention required
   
• Need for immediate treatment for an addict already in withdrawal
   
• Effects of addict behavior and the detoxification process on both office staff and other patient
   
• Payer requirements add substantial burdens on the provider
   

Due to the intensity and demand from Buprenorphine maintenance treatment some practice-based physicians were unsure if they would increase the number of patients they treat, if legally possible. Others voiced objections to place a limit on the number of Buprenorphine maintenances.