In order to more fully comprehend what’s at stake and look at where this kind of thinking may be a bit off, let’s look at what Suboxone is and what it is intended to do.

Suboxone: What it Is

Suboxone is a brand-name for the medication buprenorphine. This is an opioid medication used to treat opioid addiction, either in the privacy of a physician’s office, in drug rehab, or dispensed for take-home use by prescription.

Suboxone (buprenorphine) is a safe and effective treatment for individuals addicted to opioids, according to the Center for Substance Abuse Treatment, Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction, Treatment Improvement Protocol (TIP) Series 40.

Buprenorphine is different than other opioids in that it is a partial opioid agonist. Because of this property, it may allow for the patient to experience less euphoria and physical dependence. It has a lower potential for misuse, a ceiling on opioid effects, and a relatively mild withdrawal profile.

Appropriate dosage of buprenorphine may suppress opioid dependence symptoms, decrease cravings for opioids, reduce illicit use of opioids, block the effects of other opioids, and help patients stay in treatment.

The Food and Drug Administration (FDA) approved Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) and Subutex (buprenorphine hydrochloride) for the treatment of opiate dependence in October 2002. These are the only buprenorphine-based products approved to treat opioid addiction. On October 9, 2009, the FDA approved a generic version of Subutex.

Examples of opioids are painkillers such as morphine, methadone, hydrocodone, and oxycodone. Heroin is also an opioid and is illegal. Opioid drugs are sold under brand names, including OxyContin, Percocet, Percodan, Vicodin, Tylox, and Demerol, among others.

What Works Better: Counseling and Medication

Because opioid dependence is more than just a physical condition, successfully overcoming addiction to opioids requires more than merely dosing the individual with prescription drugs, including Suboxone.

It’s no secret that individuals cannot "go it alone" to overcome their addiction. This applies to all types of addiction, whether to painkillers or alcohol or process addictions such as compulsive gambling, workaholism, or other types of compulsive behavior.

Yet it is amazing how many individuals come to believe, often with their doctor’s encouragement, that taking a prescription medication will end their troubles.

The truth is that, in the case of opioid dependence, cravings for the substance can occur months or even years after the patient last used the drug. And when such cravings do surface, they often appear so unexpectedly and with such an intensity that they propel the individual into a state of panic that may lead to relapse.

Here’s where evidence-based research comes into play. Studies have found that individuals who are being treated with prescription Suboxone and also take part in counseling have a much better outcome than those who continue on Suboxone alone. Why is that? Counseling can assist the individual in learning better ways to cope with events, circumstances and social situations that might otherwise lead them to using again. This is especially true of such events, circumstances, and social situations the individual associates with past drug use.

Since strong emotions and certain behavior patterns are part of the overall opioid dependence picture, it stands to reason that counseling would prove more effective at helping the individual begin to make changes in their behavior and lifestyle so that he or she can focus on long-term recovery goals. Suboxone helps reduce or eliminate the physical cravings associated with opioid dependence. That the counseling occurs in tandem with Suboxone treatment makes the process easier and more effective.

Detoxing and Getting Off Suboxone

Weaning off of opiates by using buprenorphine, Suboxone, or Subutex is the first step in the long-term process of overcoming dependence on opiates. But it shouldn’t be a life-long solution. Once you’re at the point where you have been detoxed and stabilized in drug rehab for opiate abuse, the ultimate goal should be to get off Suboxone completely.

Unfortunately, what often happens is that the individual makes the decision to quit taking Suboxone on his or her own, independent of the doctor’s advice. He or she may feel that it’s been long enough, and they don’t like the way they still feel a bit intoxicated from the drug. In addition, Suboxone tends to blunt the emotions, and what you want to feel is alive, not deadened.

There’s a problem with quitting Suboxone on your own, however, and that problem is a tendency to relapse during the withdrawal from Suboxone phase. Now, it may be true that you are the rare individual who can manage Suboxone withdrawal on your own, but the likelihood of this happening isn’t that great. When you start to feel anxiety and other issues cause the cravings to rare up with a vengeance, and they will, without clinical support and the appropriate tools, relapse is all but inevitable.

There is a safe and effective way to get off Suboxone. This is best accomplished in a detoxification from Suboxone maintenance program, and a facility that specializes in this service is the place to choose. If you’ve been previously treated in drug rehab and that facility did not offer a detoxification from Suboxone maintenance program, you can avail yourself of the opportunity to get off Suboxone by going to a facility that provides this specialized service.

What happens during this detoxification from Suboxone maintenance program? After an initial assessment, the dose of Suboxone will be gradually lowered. The tapering off schedule will be different for each client, based on dosage at the time of admission. Assessment of the client for physical or psychological effects of tapering will occur every couple of hours to ensure that withdrawal is as comfortable as possible. Some non-addictive medications may be used to ease withdrawal symptoms.

At Promises Treatment Centers, the emphasis is on integrative services, provided in individual and group formats. These include hypnotherapy, mindfulness meditation, EEG biofeedback or neurofeedback, hydrotherapy, acupuncture and Chinese medicine, restorative yoga, massage therapy, nutritional wellness groups, and other support as needed.

Does this sound like high-priced spa treatment? It may sound that way, but the fact is that these types of therapies are highly effective at helping to ease anxiety, cravings and fear during withdrawal from Suboxone.

The goal of the detoxification from Suboxone maintenance program is to give the individual tools, information and support needed to sustain his or her recovery on a long-term basis.

What About Relapse After Detoxing from Suboxone?

There are some people who may be at risk for relapse. For those individuals who have high anxiety about relapse, or who have chronically relapsed, a treatment plan at a drug rehab facility specializing in detox from Suboxone maintenance can be developed to meet their needs using a non-agonist medication that will be maintained for three to six months. The term non-agonist means that the medication does not bind to the same brain receptors as those of opiates. Suboxone is an opiate agonist. A medication called Vivitrol is not an opiate agonist.

Why is the distinction important? It is important because it means that Vivitrol is much easier for the individual to stop using at the end of his or her treatment period. Vivitrol also protects against relapse by making it impossible to get high from opiates. Let’s say that you have a moment of weakness and use opiates again, but are taking Vivitrol. You won’t get high because Vivitrol interrupts the physiological response to the opiate.

Questions to Ask Yourself

If you’ve come to the determination that you want to overcome your addiction to opiates, get off OxyContin or Percocet or Vicodin, ask yourself how willing you are to do what it takes to first detox from the opiate and then proceed with the kind of counseling and therapy you need to help ensure you will be able to maintain your sobriety once you leave treatment?

Ask yourself if you want to continue taking Suboxone indefinitely or if you ultimately want to be able to live your life without having to do Suboxone maintenance?

Do you think that taking medication forever is the best solution? Or do you believe that it should be only a short-term solution? The answers to these questions will put you in a better position to know which way to proceed.

In any case, you should not attempt to quit taking either opiates or Suboxone on your own. That’s simply a recipe for relapse. You might think you have enough willpower and determination to do it on your own, but as soon as the anxiety and the cravings kick in, that will be the end of your resolve. Believe it, because it happens every day to individuals who try to go it alone.

It’s also necessary to figure out your insurance coverage or to analyze your finances to see if you can afford certain kinds of treatment. Residential addiction treatment programs are the most expensive, generally speaking, and specialty services may cost more. There may be help that you can receive to assist in payment for treatment, and this is something to explore with the particular treatment facility you’re considering.

But don’t let money stand in the way of getting off opiates for good, including Suboxone which helps you wean off opiates in the first place.

One more thing, if you’re currently going to a doctor who prescribes Suboxone for you and doesn’t encourage you to get counseling, think about getting counseling anyway. You don’t want to short-change your own chances for effective recovery, do you? And you certainly don’t have all the answers yourself as to how to deal with triggers and cravings and urges. You need some powerful tools and strategies to help you, and you get them by going through therapy and participating in 12-Step groups.

Getting Started with Counseling

There are many ways to begin counseling. Each individual needs to choose the best path to getting started. For some, counseling will be a natural offshoot of a drug rehab or residential treatment program for opioid dependence or addiction. Others will have a discussion with their doctor, likely the same doctor prescribing Suboxone, and obtain a referral to an appropriate therapist.

There are different kinds of counseling available. Again, the individual should make the decision which kind of counseling works best for him or her.

• There is private one-on-one therapy with a trained professional.
• Group counseling may be another choice, alone or in conjunction with individual counseling
• Online group counseling with a trained professional and a group of peers is another counseling option.

Beyond counseling, there are also support groups that the individual can participate in to help solidify his or her recovery. These 12-step support groups, including Narcotics Anonymous, are a terrific addition to therapy. Many individuals find them invaluable in their recovery because they are among peers with the same overarching goal: long-term sobriety.

To find an appropriate therapist, ask your doctor for a referral. You can also check out the National Alliance of Advocates for Buprenorphine Treatment (NAABT) to find a list of counselors near you.

The NAABT is a non-profit organization whose mission is to educate the public about the disease of opioid addiction and the buprenorphine treatment option, to help reduce the discrimination and stigma associated with patients with addiction disorders, and to help connect patients in need of treatment to qualified treatment providers.

Once you’ve selected the therapist, make an appointment for an initial consultation. Then, if you’re satisfied that you and the therapist are a good fit, you can get started with counseling.

Another avenue to finding therapy is to use the Treatment Facility Locator maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA). This is an online searchable directory of drug and alcohol programs showing the location of facilities around the country that treat alcoholism, alcohol abuse, and drug abuse problems.

Included are listings for residential treatment centers, outpatient treatment programs, and hospital inpatient programs for drug addiction and alcoholism. Select "Detailed Search" and click the box for "Buprenorphine Services" to search for treatment facilities offering such services in addition to detoxification and treatment (including counseling).

There is also the Buprenorphine Physician and Treatment Program Locator maintained by SAMHSA.

The randomized portion of Phase 3 clinical trials is to assess the efficacy and safety of new drugs under the U. S. Food and Drug Administration (FDA) trial protocols for new drugs.

BioDelivery Sciences International Inc. (BDSI) says that it expects to report top line results of the testing of BEMA Buprenorphine in mid to late September of this year. Dr. Andrew Finn, BDSI’s executive vice president of product development, adds that, “Assuming positive study results, we would hope to be in a position to file a New Drug Application (NDA) for this product in the first half of 2012.”

In order for any new drug to receive FDA approval, it has to go through a rigorous and lengthy clinical trial process involving various stages (Phase 1, 2, 3, and 4), after which, if all phases are completed successfully, an NDA can be filed.
What’s so important about BEMA Buprenorphine? According to BDSI, there is a significant and unmet medical need for potent new analgesics for the treatment of chronic pain. Because of BEMA Buprenorphine’s potent analgesic properties, along with its differentiating characteristics from other opioids and its Drug Enforcement Administration (DEA) Schedule III designation (which means there is less addiction potential than Schedule II products such as morphine and oxycodone), BDSI believes buprenorphine is an attractive option for chronic pain treatment.

If BEMA Buprenorphine is approved, it could be the first oral transmucosal form of buprenorphine to treat chronic pain in the U.S.

Opioid analgesic sales in this country are in excess of $10 billion and growing.

A recent Science Daily release finds that such newborns may be able to experience relief as a result of the same drug that helps adults who are addicted to opioids. Traditionally, infants born with opioid addiction have to endure opioid replacement treatment, which requires long hospital stays and interferes with parental bonding.

Now, a semi-synthetic opioid may offer potential in the treatment of addicted newborns. Testing has been completed by a team of researchers at the Thomas Jefferson University and if the treatment is successful, it could save hundreds of millions in annual healthcare costs.

The semi-synthetic opioid, buprenorphine, has been proven both safe and successful when used to treat 12 addicted infants. When compared with morphine treatments, the application of buprenorphine reduced treatment days by 40 percent to 23 days instead of the average 38 days.

Researchers hope that buprenorphine could provide a new standard of treatment in an area where a well-defined therapeutic approach still does not exist. It is estimated that as many as 16,000 infants are at risk each year for the withdrawal syndrome.

To know for sure that the treatment is effective, a double-blind randomized study would have to be conducted. Buprenorphine is not used in infants and will not become a formal treatment until this study can be conducted.

After a Phase 2 study produced favorable results, Walter Ling, M.D., of the University of California, Los Angeles, and his colleagues performed a phase 3 study of the implantable buprenorphine. They tested this form of treatment on 163 adults between the ages of 18 and 65, all of whom were addicted to opioids. Of the group, 108 received buprenorphine implants and 55 received placebo implants. The implants, placed below the skin on the nondominant arm, were removed after 6 months. The patients also received individual drug counseling.

The buprenorphine implant group had significantly more negative urine samples for opioids during the first six weeks. The average percentage of negative urine samples was 40 percent, compared with 28.3 percent for those receiving placebo.

Of those with the buprenorphine implants, 65.7 percent of the patients remained in the study for the full 24 weeks, compared to 30.9 percent of the placebo patients. While 30.9 percent of the placebo group was classified as having failed treatment, no one in the implant group failed.

The researchers write that the implant group also had fewer withdrawal symptoms and cravings, and were more likely to improve than the placebo group. The authors conclude that the use of buprenorphine implants led to decreased opioid use, compared to placebo use.

Source: Science Daily, Implanting Medication to Treat Opioid Dependence Appears Beneficial in Decreasing Opioid Usage, October 12, 2010

A new study examines the misuse of buprenorphine. Schuman-Olivier and colleagues (2010) investigated whether opioid dependent individuals use buprenorphine improperly to achieve feelings of euphoria or if they are using it to alleviate the difficulties of opioid withdrawal.

The researchers also hoped to understand the pervasiveness of the use of buprenorphine as an illegal drug and how buprenorphine use is less common among opioid users who are enrolled in more comprehensive treatment for opioid dependence.

The study was conducted in an outpatient substance abuse treatment center in New England. The participants were all diagnosed as opioid dependent using DSM-IV criteria. The participants included 44 individuals who were interested in treatment using buprenorphine and 34 patients who were currently using buprenorphine.

The participants were asked to complete, along with other measures, the Buprenorphine Beliefs and Behaviors Questionnaire, to understand their motivation to use buprenorphine; and the Illicit Buprenorphine Use Questionnaire, to assess whether patients were using buprenorphine as an illicit drug. The questionnaires were completed again three months after the original administration by 42 of the participants.

Results determined that 49 percent of the participants who completed questionnaires in the first stage used buprenorphine illicitly. The remaining 61 percent of the illicit use was among new patients who did not yet have access to a doctor’s prescription.

The participants reported that they reduced distress by using buprenorphine, and did not use it as a way to get high. The participants used buprenorphine to self-treat opioid dependence, anxiety and pain. Illicit users were more likely to use buprenorphine to prevent withdrawal, ease pain and treat depression.

The study’s findings may be limited by its small sample size and its short duration. Three months may not be enough time to understand the use of buprenorphine over a long period of recovery from opioid addiction.
The illicit use of buprenorphine went down significantly after new patients were given access to buprenorphine by doctor prescription. Also, the study shows that the individuals who used illegal buprenorphine were using it to self-treat their opioid dependence, rather than using it to get high.
The study indicates that when given buprenorphine through a prescription, opioid users are reducing their illegal use of the medication. The information provided by this study may help policy makers understand use of buprenorphine in treatment for opioid addiction.
 

Kicking opiate addiction doesn’t have to be the painful and dreaded nightmare many addicts envision. There is replacement therapy that has been approved as an alternative treatment for opiate addiction.

What Constitutes Opiate Addiction?

First, however, it’s important to discuss what constitutes addiction to opiates. An individual can be addicted to numerous substances called opiates or opioids. In fact, opioids, commonly prescribed to treat pain, are one of three classes of drugs most commonly abused (the other two being central nervous system depressants and stimulants).

What are Opioids?

Opioids are analgesic medications – pain relievers – that, when taken as prescribed, are often effective in managing pain and rarely cause addiction. It’s when opioids are abused that addiction can occur, often in combination with other addictive drugs and/or alcohol.

Some of the compounds and brand names (in parentheses) within the opioids class are:

• Hydrocodone (Vicodin)

• Oxycodone (OxyContin)

• Morphine

• Fentanyl

• Codeine

• Propoxyphene (Darvon)

• Hydromorphone (Dilaudid)

• Meperidine (Demerol)

How Opioids are Abused

Abuse of the opioids includes snorting crushed powder from pills, taking pills orally, or injecting the medication. The National Institute on Drug Abuse (NIDA) says that injection and snorting have resulted in numerous overdose deaths, especially with the drug OxyContin, which was designed to be a slow-release medication. When an individual snorts or injects such medication, it causes an immediate release into the drug stream, resulting in exposure to high doses and potentially lethal overdose reactions.

But it’s the euphoric reaction that causes many users of opioids to become addicted. The opioids affect regions in the brain that mediate perception of pleasure. The resultant euphoria and/or sense of well-being that opioids users experience is a state that they want to return to again and again. Consistent and chronic abuse of opioids despite negative consequences leads to dependence or addiction to the substances.

What Happens When you Stop Taking Opiates

Even patients who are prescribed opiates for short-term management of pain may develop a physical dependence on them. This physical dependence, however, is not the same thing as addiction. Physical dependence means that, over time, the patient develops a tolerance to the drug and thus requires more of it and more often to achieve the same (pain relieving) effect. Sudden cessation of opiates for which a physical dependence exists brings about withdrawal symptoms.

Withdrawal from opiates, whether the patient is physically dependent on the drugs or has developed an addiction to them, should never be undertaken without careful medical supervision. Such medical monitoring helps to reduce or eliminate severe withdrawal symptoms such as restlessness, bone and muscle pain, cold flashes (“goose bumps”), vomiting, diarrhea, insomnia, and involuntary leg movements.

Prerequisite for Treatment for Opiate Addiction

Before treatment for opiate addiction can begin, the patient must be detoxified of all the drugs in their system. This detoxification also must be medically supervised in order to help ensure minimal withdrawal symptoms. So, the first step in treating opiate addiction is detoxification.

Types of Replacement Therapy for Opiate Addiction

There are four types of medications used in replacement therapy for opiate addiction.

Methadone

Methadone, which is a Schedule II synthetic opioid, is the first and oldest treatment used for opiate addiction. It has been successfully used to treat opiate addicts for more than 30 years. It has also been widely used to treat heroin addicts. The advantages of methadone are that it eliminates withdrawal symptoms and helps reduce craving.

According to a 2002 publication from the Centers for Disease Control and Prevention (CDC), Methadone Maintenance Treatment, methadone a) blocks the sedating and euphoric effects of opiates, b) relieves craving for opiates that is a major factor in relapse, c) relieves symptoms associated with withdrawal from opiates, d) with stable dosing, does not cause euphoria or intoxication itself, thus allowing the individual to work and participate in society normally, and e) is excreted slowly, so it can be taken only once daily.

Methadone replacement therapy for opiate addiction generally takes a minimum of 12 months, according NIDA recommendations, although some individuals benefit from continuing to take methadone maintenance treatment for several years. Methadone is safe when taken for 10 years or longer, according to the NIDA.

Methadone treatment has not escaped criticism and controversy over the years. Some argue that it’s just substituting one addiction for another. Since some patients have diverted their own methadone supplies to augment their income, thus serving as a magnet for crime, methadone treatment in the U.S. is heavily regulated and strictly controlled. Previously, methadone treatment was only available through federally licensed methadone clinics. Following revised guidelines introducing office-based opiate replacement therapy, the Drug Addiction Treatment Act of 2000, methadone maintenance treatment is now available through physicians’ offices, licensed clinics and hospital outpatient and other health care settings. Patients who are taking methadone therapy for opiate addiction must be monitored closely if they are also receiving antiviral therapy for HIV infection, to avoid potential medical interactions.

Buprenorphine

Buprenorphine, another synthetic opioid that is classified as Schedule III, is a more recently-approved treatment for opiate addiction as well as addiction to heroin. Buprenorphine is a derivative of thebaine, an opium extract. According to the NIDA, buprenorphine is the first medication developed to treat opiate addiction in the privacy of a physician’s office. This medication has less risk of addiction than methadone. Buprenorphine binds to the same receptors as morphine, but does not produce the same effects. Buprenorphine’s weaker opiate effects are less likely to cause overdose problems and produce a lower level of physical dependence. This means that patients who discontinue taking buprenorphine have fewer withdrawal symptoms than those who stop taking methadone for opiate addiction.

Like methadone, buprenorphine reduces cravings for heroin and other opiates and also reduces withdrawal symptoms. Buprenorphine also has a ceiling effect in that increased doses of the drug do not produce increased effects beyond a certain point. In some individuals taking buprenorphine, higher doses can actually precipitate withdrawal symptoms. It is, therefore, not as effective as methadone in treating severely opiate-addicted individuals who require high doses of methadone daily. According to the Substance Abuse and Mental Health Administration (SAMHSA), the best candidates for buprenorphine therapy are those who receive 30 milligrams or less of methadone. It is estimated that buprenorphine is effective for about one-half to two-thirds of the population of opiate abusers.

The Food and Drug Administration (FDA) approved buprenorphine tablets in 2002. Two formulations of FDA-approved buprenorphine are available. Subutex (buprenorphine hydrochloride) is used in the initial stages of opiate replacement therapy. Suboxone (buprenorphine hydrochloride and naloxone hydrochloride) is used in the maintenance stage.

Naltrexone

Naltrexone is another medication that blocks the effects of morphine, heroin and other opiates. According to a NIDA report, naltrexone, a long-acting opioid receptor blocker, can help prevent relapse. How it works is that the drug blocks the pleasurable effects of heroin and is therefore useful in treating highly motivated individuals. One caution is that it can only be used with someone who has already been detoxified, due to the severe withdrawal effects it can produce in someone who continues to abuse opioids.

Depending on the dose, naltrexone lasts from 1 to 3 days. Naltrexone has proven effective in preventing relapse in former opiate-addicted prisoners released on probation.

Naloxone

This is a short-acting opioid receptor blocker. Naloxone counteracts the effects of opioids and can be used in treatment of overdoses.

Buprenorphine/Naloxone

This combination drug of buprenorphine and naloxone is a formulation designed to minimize abuse.

Other Drugs

Two other drugs may be prescribed to help reduce the severity of withdrawal symptoms from opiate addiction.

Clonadine, according to the NIDA report, is of some benefit, but it has nasty side effects of sedation and hypotension.

Lofexidine, launched in 1992, is a “centrally acting alpha-2 andrenergic agonist” specifically for use in treating patients with opiate withdrawal symptoms.

Is Replacement Therapy Right for Opiate Addiction?

Experts in treating addiction to opiates have a wide range of treatment programs at their disposal. Weighing the benefits of one medication versus another to treat opiate addiction is part of the overall treatment program specifically designed and tailored for the individual patient.

Taking buprenorphine, for example, is more long-lasting than methadone, and can be taken more conveniently – in take-home prescriptions, for example – than going to a clinic each day.

But just taking replacement therapy for opiate addiction will not get at the root causes of the addiction. That’s why a multi-disciplinary approach to treatment works best, using behavioral therapies in conjunction with pharmacologic treatments. This may involve contingency management therapy, cognitive behavioral therapy (CBT), hypnotherapy, and others. Contingency management therapy uses a voucher-based system of points, based on negative drug tests, which the patient can use to exchange for items designed to encourage healthy living. CBT is intended to help modify the patient’s behaviors and expectations related to drug use, as well as to provide them with effective coping mechanisms to deal with life’s daily stressors.

It is important to note that replacement therapy for opiate addiction is not a “magic bullet” that will instantly take away all cravings and prevent relapse. This type of therapy isn’t something that the patient can take now and forget about. It also takes time. To be effective, the patient needs to commit to staying on the medication for however long it takes – usually a period of years. Also of importance is the fact that co-occurring disorders, multiple addictions, and/or a mental disorder, can complicate the treatment program for opiate addiction. According to clinical reports, buprenorphine may make some psychiatric symptoms worse. In that case, addiction treatment professionals may recommend an effective addiction treatment program that includes methadone instead of buprenorphine.

For the best results, patients need to be fully committed to overcoming their addiction to opiates (and any other co-occurring disorders, multiple addictions and/or mental disorders). In many cases, the best results may be obtained through a residential treatment program at a facility that specializes in the treatment of the particular addiction or addiction the patient has.

Bottom line: if you or someone you know is addicted to opiates and is sincere about overcoming addiction, seek professional help as soon as possible. With detoxification, treatment and counseling, opiate addiction can be overcome. As with all addictions, it will never be cured, but the patient can return to a normal, productive and satisfying life.

For More Information

To find a treatment facility specializing in opiate addiction, use the SAMHSA Substance Abuse Treatment Facility Locator or call them at their toll-free number of 1-800-662-HELP. There’s also the Spanish-language helpline at 1-800-662-9832 and TDD at 1-800-228-0427.

SAMHSA also operates the Buprenorphine Physician and Treatment Program Locator. Note that the number of patients that physicians can treat with buprenorphine is limited by law. Therefore, some of the physicians listed in the locator may not be accepting new patients. Since the site is updated weekly, SAMHSA recommends checking back regularly.

Another SAMHSA site for methadone treatment centers is located at the following website: http://dpt2.samhsa.gov/treatment/directory.aspx

More information on treatment is available at the Center for Substance Abuse Treatment (CSAT).