Trends in the Use of Methadone and Buprenorphine at Substance Abuse Treatment Facilities: 2003 to 2011

Excerpt

Background: An estimated 2 million people in the United States are dependent upon or abuse opioids, including heroin and prescription opioids such as oxycodone and hydrocodone. An effective treatment for opioid dependence and addiction includes medication-assisted treatment with the opioid medications methadone or buprenorphine, the only two opioids federally approved for the treatment of these conditions. Methods: Data from the 2011 National Survey of Substance Abuse Treatment Services (N-SSATS), an annual survey of all known substance abuse treatment (SAT) facilities, both public and private in the U.S., was analyzed. This report examines the trends in the use of methadone and buprenorphine in the treatment of opioid dependence at SAT; it includes data from Opioid Treatment Programs (OTPs) as well as facilities that did not have OTPs. It does not include data from private physicians who are not affiliated with a SAT program or facility. Results: The number of facilities with OTPs has remained constant at around 1,100 to 1,200 since 2003 (8 to 9% of all SAT facilities), the number of clients receiving methadone on the survey reference date March 31, 2011 increased from about 227,000 in 2003 to over 306,000 in 2011. The percentage of OTPs offering buprenorphine increased from 11% in 2003 to 51% in 2011; the percentage of facilities without OTPs offering buprenorphine increased from 5% in 2003 to 17% in 2011. The numbers of clients receiving buprenorphine increased between 2004 and 2011: at OTPs, from 727 clients in 2004 to 7,020 clients in 2011, and at facilities without OTPs, from 1,670 clients in 2004 to 25,656 clients in 2011. Conclusion: Methadone and buprenorphine are medications that permit addicted individuals to function normally within their families, jobs, and communities. While treatment with methadone is more established, it requires daily visits to an OTP. Not all individuals who could benefit from methadone treatment live within easy travelling distance of an OTP; the requirement for daily visits can interfere with jobs and other important activities. The introduction of buprenorphine for the treatment of opioid dependence has provided an alternative to methadone treatment for some opioid dependent persons. The dramatic increase in the number of clients receiving buprenorphine through SAT is an indication of the demand for safe and effective medications for the treatment of opioid addiction in the context of a broader treatment program.