Buprenorphine Treatment Services in the 50 States and the District of Columbia: Lessons for New York City

In October 2002, the U.S. Food and Drug Administration (FDA) approved the drug, buprenorphine, for the treatment of opiate dependence. This drug’s approval created a path to dramatically change the way opiate addicts are able to manage their addiction. Buprenorphine can be prescribed in private physicians’ offices, and thus, offers a more anonymous and convenient alternative to seeking treatment in methadone clinics. The Capstone team researched and analyzed buprenorphine treatment services in other states to provide key information to the New York City Department of Health and Mental Hygiene (NYCDHMH) as it develops strategies for implementing services in New York City. The team administered telephone interviews to one federal and 30 state authorities and conducted a site visit to an established treatment service area in Pennsylvania. The purpose of the interviews and site visit were to identify the regulatory policies, financing, and implementation strategies of buprenorphine treatment services. Analyses of these findings suggest that a lack of organized implementation strategies, low physician certification, and high costs of buprenorphine are key impediments to building a successful treatment service. Recommendations on how to manage these challenges were presented to the NYCDHMH.