Buprenorphine delivered in office based settings is effective for the treatment of opioid dependence and is likely comparable in effectiveness to traditional methadone maintenance treatment.
Buprenorphine provides another treatment option for opiate addiction. Like methadone, it can block illicit opiates and control withdrawal but, unlike methadone, there are fewer limits to its dispensation by physicians. Thats because the different chemical properties of Buprenorphine and its use in a combined tablet with another medication, Naloxone, that blunts the effect of opiates are seen as making it safer and less prone to abuse.
While Buprenorphine treatment is new in the US, other countries have substantially expanded capacity for opiate addiction treatment through the use of Buprenorphine in office-based practices. In France, for example, expansion of access in a minimally regulated environment has led to a reduction in opioid overdose deaths (Auriacombe et al., 2001), but also to abuse of Buprenorphine. However, in France Buprenorphine has been used primarily without the Naloxone that is intended to reduce such abuse (Obadia et al, 2001).
There is evidence that Buprenorphine delivered through primary care physicians is as effective as traditional methadone treatment programs in dealing with opiate addiction (O'Connor et al., 1998). Its efficacy appears to remain constant whether administered to those already in treatment or those just initiating treatment (Harris et al., 2005). But more research is needed to guide doctors in identifying patients more likely to be successful with Buprenorphine as opposed to methadone, and to help improve adherence to Buprenorphine treatment (Fiellin et al., 2006). There is some evidence that patients who are employed and receive counseling are more likely to stick with the treatment program (Stein et al., 2005).