Addicts seeking treatment, and even referring doctors, know nothing of these issues. They are duped. I hear in my office regularly the question “why did the doctor do that?” when talking about either the large number of opiates and alprazolam they were prescribed or the large amount of buprenorphine they were regularly prescribed with no other real addiction treatment.
At this pint let me say, there are many well intentioned and ethical Suboxone providers that have been placed in a position of caring for a disease that is far more complex than what is taught in the online certification course. However, too many doctors are using it only as a profit center.
These problems and others have led to a general “bad rap” for buprenorphine in general. Evidence-based medicine practices strongly demonstrate the benefits of buprenorphine in the appropriate setting. This setting must include professional addiction counseling, treatment of co-occurring disorders, and strict accountability measures by the prescribing physician.
Addiction societies and others have been lobbying strongly to rectify these problems. It may be a while. In the meantime, we must do our best to make sure patients with addictions are appropriately treated by addiction specialists. Medicine-assisted treatment of addiction is proven to save lives. We must not judge the use of medicines for this brain disease because they are misapplied.
Primum non nocere. First, do no harm.
Terrance R Reeves, MD, FACS, ABAM