Few doctors seek training to dispense buprenorphine

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(Host) A few Vermont doctors are prescribing a new treatment for heroin addiction. But so far only a small number of Vermont addicts are receiving the new drug, which promises easier access to treatment.

VPR’s Steve Zind reports:

(Zind) Vermont has one methadone clinic and it’s full. Even if it could take more patients, the Burlington clinic is a long drive from many parts of the state. That’s why buprenorphine is seen as a promising alternative to methadone.

The federal government recently approved buprenorphine as a treatment for heroin addiction. While it’s not as effective as methadone for longtime drug users, it’s considered especially useful in treating younger addicts. And it’s considered safer.

Because of the lower risk of abuse, buprenorphine isn’t limited to use in a clinic. It can be prescribed in a doctor’s office and dispensed with a simple prescription. That means treatment for heroin addiction could someday be available in doctor’s offices all over the state.

Doctor William Grass is a psychiatrist at the Brattleboro Retreat. Retreat Healthcare is currently using buprenorphine for six of its patients:

(Grass) “It’s kind of revolutionary because physicians haven’t had the ability in outpatient practices to treat opioid dependence. So now we have the ability to treat our patients who have the illness in the setting where they come for the rest of their medical care.”

(Zind) Grass says to be effective, addiction treatment also must include counseling and behavioral therapy. According to the U.S. Department of Health and Human Services, Grass is one of only five Vermont doctors who’ve received training to prescribe buprenorphine.

Alice Doreo is with the Vermont Harm Reduction Coalition. The coalition helps heroin addicts find treatment. She says of the five doctors approved to dispense buprenorphine, she hasn’t been able to contact one and another isn’t taking new patients. Doreo says she’s frustrated that more doctors haven’t volunteered for training in the use of buprenorphine.

(Doreo) “Especially when you’re in the middle of a heroin epidemic and these doctors are seeing people that are addicted to opiates, but they don’t know anything about it.”

(Zind) Doreo says most of the Vermont doctors trained to prescribe buprenorphine are psychiatrists. She says more primary care providers need to be brought up to speed in order for buprenorphine to become available to more people in need of treatment.

The Vermont Health Department says the use of the drug is also being limited by its availability and by the cost of the buprenorphine, which is considerably more expensive than methadone.

For Vermont Public Radio, I’m Steve Zind.

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