Providing buprenorphine treatment through physician offices is bringing patients into treatment who may not have been willing or able to access care in the traditional addiction treatment system.
In the evaluation sponsored by the Center for Substance Abuse Treatment, approximately one-quarter of buprenorphine patients were new to substance abuse treatment, 60% were new to medication-assisted treatment, and nearly 60% reported being addicted only to non-heroin opioids, a substantial difference from methadone programs where only 10% are addicted solely to pharmaceutical opioids (Substance Abuse and Mental Health Services Administration 2006a).
Sullivan and colleagues also found that patients coming for buprenorphine treatment in primary care settings were different from patients entering methadone maintenance. Patients were more likely to be employed full time. They were less likely to have had previous treatment with methadone or a history of injection drug use, and reported shorter periods of opioid dependence (Sullivan, Chawarski, et al. 2005). When patients who were entering treatment for the first time were compared, a similar pattern was noted. Buprenorphine patients were younger and more likely to be white, educated, and addicted to prescription opioids rather than heroin (Sullivan, Chawarski, et al. 2005) than new patients entering methadone treatment. They also had shorter durations of opioid dependence and lower rates of injection drug use and hepatitis C.
In the CSAT evaluation, buprenorphine patients were more likely to be employed, non-minority white, and to have some post-secondary education than patients entering methadone treatment. Half of patients treated with buprenorphine paid for the treatment themselves.
Treatment with buprenorphine may be more attractive and more accessible because it can be offered from physicians offices and integrated with other medical and/or psychiatric treatment. Buprenorphine is also more convenient than methadone for patients because very early on in treatment they can receive it as a prescription and take their doses according to their own schedule and without being observed. Patients, therefore, may be better able to maintain work and family commitments without having to travel to a clinic every morning. Patients also avoid the stigma and risk associated with methadone treatment programs (Rosenheck and Kosten 2001).