Maryland Buprenorphine Initiative

	News & Events   Article for the MedChi Physician: Treating opiate addiction in the office-based setting Baltimore Sun Op-Ed 12/24/07 Buprenorphene: The little orange pill that offers hope to many Change in Prior Authorization Effective July 1, 2007, Maryland Physicians Care will no longer require prior authorization for SUBOXONE or SUBUTEX utilization, and are now only requesting notification of their use. The SUBOXONE/SUBUTEX notification form is very brief, and requires information such as member demographics as well as a brief outline of the treatment plan and expected prognosis. Maryland Physician's Care requests that physicians complete this form and fax it within one week of treatment with SUBOXONE/SUBUTEX.   June 2007 Report Released Center for a Healthy Maryland releases Improving Patient Access to Buprenorphine Treatment through Physician Offices in Maryland, which examines health plan policies and procedures for treating drug addiction and the experiences of physicians in offering buprenorphine treatment.

Improving Access to Office-Based
Treatment for Opioid Addiction

Since 2003, with the assistance of an Advisory Committee of experts in buprenorphine therapy, the Center for a Healthy Maryland has been at the forefront of attempts to educate and engage Maryland physicians in providing office-based treatment for opioid addiction.

Opioid addiction is a chronic medical disorder that has both physical and behavioral traits, and is one of the fastest growing health concerns in the United States. Individuals who are opioid addicted can experience both physical and psychological dependence, risk premature death, and often suffer from HIV, Hepatitis B and C, and other sexually transmitted diseases.

Buprenorphine, a medication approved by the FDA in October 2002, is used to treat opioid-addiction to drugs such as heroin and morphine or prescription painkillers like Oxycontin, Demerol and Vicodin. As an alternative to other treatment modalities for opioid addiction, patients can be managed in a physician’s office. This medication has been proven to be safe and effective, but physicians need to be specially certified to prescribe it, and also must meet certain requirements to provide office-based treatment.

Center Program Activities

Research

1. June 2007 report, Improving Patient Access to Buprenorphine Treatment through Physician Offices in Maryland, which examines policies and procedures for treating drug addiction through Medicaid Managed Care Organizations (MCO), commercial insurers, and described the experiences of physicians in offering buprenorphine treatment.
2. 2007 Physician Survey about the use of buprenorphine in the physician office setting in Maryland.
3. 2004 Physician Survey, by Johns Hopkins University, regarding willingness to prescribe buprenorphine for opioid addiction; barriers to office-based prescribing; and resources required for prescribing buprenorphine.

Advocacy

1. Held forum in June 2007 to share findings from Improving Patient Access to Buprenorphine Treatment through Physician Offices in Maryland with physicians, policymakers, and stakeholders.
2. Meeting individually with Medicaid MCOs to share practice barriers.
3. Providing ongoing feedback and recommendations regarding policies and procedures, particularly issues around prior authorization and reimbursement, to DHMH.
4. Continuing to assess policies, procedures, and practice barriers through physician interviews and other reporting mechanisms, such as Advisory Committee discussions.

Physician Communications

1. May 2007 mailing of report summary with key findings to over 3000 physicians.
2. Articles in weekly listserve MedChi News and quarterly newsletter MedChi Physician.
3. Information and updates on Center and MedChi websites.

Physician Education

More than 500 physicians attended continuing medical education programs about the use of buprenorphine in treating opioid addiction, and more than 300 physicians in Maryland have completed the certification requirements to prescribe buprenorphine.

Activities include a physician awareness campaign, joint sponsorship of eight-hour certification programs, practice tips trainings, grand rounds presentations at more than 15 Baltimore area hospitals, and the distribution of informational materials and brochure about buprenorphine to over 3000 physicians in Maryland.

Physician Requirements to Prescribe Buprenorphine

Resource Center

1. Connecting physicians with information about buprenorphine certification procedures, training opportunities, and changes in regulations. 
2. Linking newly certified physicians with drug treatment and counseling resources, as well as with other prescribing physicians in the role of Clinical Support Mentor. 

Physician Resources

Contact Information

For more information about the Maryland Buprenorphine Initiative, please contact:

Elaine Gisriel, M.S.
Project Coordinator
Phone 410.539.0872 or 800.492.1056, ext. 415
Fax 410.649.4131
Email egisriel@medchi.org