title: Buprenorphine for office-based practice: consensus conference overview.
abstract: This overview of the March 2003 conference on the U.S. national buprenorphine implementation program is developed to inform the practitioner about the positive experience that has been accumulated worldwide on the use of buprenorphine for office-based practice. The first paper delineates the challenges for American psychiatry in moving buprenorphine forward into general practice. Most psychiatrists are unprepared to work with opiate-dependent patients or to use buprenorphine. The international successes with office-based buprenorphine from France and Australia are presented in the next papers, followed by presentations on several U.S. studies using buprenorphine in the community for detoxification and office-based maintenance. These experiences have thus far confirmed buprenorphine's utility and promise for opiate addiction treatment in the U.S. Finally, two national monitoring programs have been implemented to assess the public health impact of this new treatment opportunity. This opportunity has a three-year window, however, and a critical need will be to attract a sufficient number of physicians into prescribing buprenorphine/naloxone in order to allow our patients increased access to this treatment.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06516, USA. thomas.kosten@yale.edu
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kosten
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
mesh_terms: D001291:Attitude of Health Personnel; D002047:Buprenorphine / Q000627:therapeutic use*; D003153:Community Health Services; D003431:Cross-Cultural Comparison; D004059:Diffusion of Innovation; D005194:Family Practice; D006556:Heroin Dependence / Q000534:rehabilitation; D006801:Humans; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009819:Office Visits; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011358:Product Surveillance, Postmarketing; D011570:Psychiatry; D016896:Treatment Outcome; D014481:United States
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D002047:Buprenorphine