Too few doctors trained in buprenorphine treatment for heroin

Print More

(Host) Vermont physicians are seeing an overwhelming demand for a recently approved treatment for heroin addiction. State officials say they’re working to increase the number of doctors trained to prescribe the treatment but there are some obstacles.

VPR’s Steve Zind reports.

(Zind) Last year, the federal government approved the drug buprenorphine for treatment of heroin addiction. While it’s not the right treatment for everyone, buprenorphine has a number of advantages over the more widely used drug methadone: it’s safer, can’t be abused and it doesn’t need to be taken daily.

Methadone must be dispensed by an approved clinic and currently there’s only one in Vermont, treating about 130 of the state’s estimated 3,000-4,000 people who are addicted to opiates like heroin.

Buprenorphine can be prescribed by a doctor. Potentially that means treatment for heroin addiction could be widely available through primary care physicians. To dispense it, doctors have to take a day-long training session. So far, 75 Vermont doctors are approved to prescribe buprenorphine. That’s not enough. Kimberly Bruno is a Morrisville doctor who is prescribing buprenorphine to about 10 patients. She says she’s being inundated by people who want buprenorphine treatment from her because their own doctors don’t offer it.

(Bruno) “What my big concern is that patients from outside my county and my community need these services but they’re not being provided by the docs in their communities. So they’re really putting a lot of pressure on those of us who provide this service and my answer to my fellow physicians is, you guys need to go out there and provide this service to your community so I can provide this service to the patients of my community.”

(Zind) Bruno says the biggest obstacle to doctors’ willingness to treat people with opiate addiction is the stigma attached to it. Vermont Health Commissioner Doctor Paul Jarris agrees. Jarris says too many physicians still see drug addiction as a legal problem and lifestyle choice, not a disease, because drug treatment wasn’t part of their education and training.

(Jarris) “We spent endless hours talking about the patho-physiology of the kidney. We had almost nothing on the brain changes that occur with addiction medicine. And we have all in society looked at this as a stigmatized behavioral problem. So physicians need to develop as people in that way, also.”

(Zind) Jarris says physicians need to view addiction as a chronic illness, just like diabetes or hypertension. The Health Department is working with the Vermont Medical Society to encourage more doctors to become certified to prescribe buprenorphine and to provide support. Tod Mandell directs the state’s alcohol and drug abuse programs.

(Mandell) “We’re trying very hard from the state perspective to say, ‘We’re not going to have you out there alone on this.’ And we say, ‘call us for everything.'”

(Zind) Counseling is a key part of treatment for opiate addiction and Mandell says counseling services will have to be expanded as buprenorphine becomes more widely available.

For Vermont Public Radio, I’m Steve Zind.

Comments are closed.