As addiction treatment remains out of reach for many individuals in the United States, a growing black market has emerged for buprenorphine, a medication often used in medication-assisted treatment (MAT).
Buprenorphine in Medication-Assisted Treatment (MAT)
MAT combines prescribed medications with counseling and behavioral therapies to support addiction recovery. Buprenorphine, methadone, and naltrexone are FDA-approved drugs often used in MAT.
Currently, prescribers must be certified and obtain a special waiver to prescribe buprenorphine. Federal rules also limit the number of patients a prescriber can treat with buprenorphine. While nurse practitioners and physician assistants can apply for waivers, physicians are typically restricted to treating up to 275 patients. Congress is exploring legislation to increase these limits.
Barriers to MAT and Buprenorphine Use
Although MAT has shown effectiveness in addiction recovery, several barriers limit its use:
- Insurance Limitations: While insurers must cover addiction treatment benefits, not all plans cover all MAT medications. Restrictions on dosages and refills can make MAT unaffordable for some patients, especially those requiring ongoing treatment.
- Social Stigma: Many addiction recovery communities emphasize total abstinence, creating resistance to MAT. Since buprenorphine is sometimes misunderstood, critics argue that it substitutes one dependency for another.
Despite these challenges, evidence shows that MAT can be an effective and long-term treatment for many individuals. However, debates around lifelong treatment continue to affect perceptions of recovery.
The Emergence of a Buprenorphine Black Market
Some regulators believe tighter control of buprenorphine is necessary to prevent diversion, where individuals sell or give away their prescriptions.
However, healthcare professionals argue that limited treatment access has driven diversion. For many, obtaining buprenorphine through unofficial channels is a way to manage withdrawal symptoms when legitimate treatment is inaccessible.
Studies indicate that individuals who use diverted buprenorphine are often self-treating symptoms of addiction, pain, or depression rather than seeking to misuse the medication. Research at Harvard Medical School supports this, showing that most diverted use serves as a substitute for more harmful substances.
Support for Addiction Treatment Professionals
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