Buprenorphine

Buprenorphine is a partial agonist of opioid receptors that carries a low risk of overdose. Buprenorphine reduces or eliminates withdrawal symptoms associated with opioid dependence but does not produce the euphoria and sedation caused by heroin or other opioids. In 2000, Congress passed the Drug Addiction Treatment Act, allowing qualified physicians to prescribe Schedule III, IV and V medications for the treatment of opioid addiction. This bill created a major paradigm shift that allowed access to opioid treatment in general medical settings, such as primary care offices, rather than limiting it to specialized treatment clinics. Buprenorphine was the first medication approved under the Drug Addiction Treatment Act and is available in two formulations: Subutex®, which is a pure form of buprenorphine and the more commonly prescribed Suboxone®, which is a combination of buprenorphine and the opioid antagonist naloxone. Suboxone is a unique formulation with naloxone that causes severe withdrawal symptoms when addicted individuals inject it to get high. Physicians who provide buprenorphine treatment for detoxification and or maintenance treatment in office must have special accreditation. The government requires these physicians to have the capacity to provide counseling to patients when indicated or to refer patients to those who do. Treatment of opioid addiction in an office can be cost-effective approach that increases the reach of treatment and the options available to patients. Many patients have life circumstances that make treatment in the office of a physician a better option for than specialty clinics. For example, a recovering addict may live far away from a treatment center or have working hours incompatible with the clinic hours. Addiction treatment is available in the office of a primary care physician, psychiatrist and other specialists, such as internists and pediatricians. Patients stabilized on adequate, sustained dosages of methadone or buprenorphine can function normally. Recovering addicts can hold jobs, avoid the crime and violence of the street culture and reduce exposure to HIV by stopping or decreasing injection drug use and other risky sexual behavior. Patients stabilized on medications can also engage more readily in counseling and other behavioral interventions essential to recovery and rehabilitation.

More Resources

Substance-related disorders

Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association (APA) that includes all currently recognized mental health disorders. The coding system utilized by the DSM-IV is designed to correspond with codes from the International Classification of Diseases, commonly referred to as the ICD. Since early versions of the DSM did not correlate with ICD codes and updates of the publications for the ICD and the DSM are not simultaneous, some distinctions in the coding systems may still be present. For this reason, it is recommended that users of these manuals consult the appropriate reference when accessing diagnostic codes.

Alcohol-related disorders

• Alcohol
  • 305.00 Abuse
  • 303.90 Dependence
  • 291.8 -Induced anxiety disorder
  • 291.8 -Induced mood disorder
  • 291.1 -Induced persisting amnestic disorder
  • 291.2 -Induced persisting dementia
  • 291.5 -Induced psychotic disorder, with delusions
  • 291.3 -Induced psychotic disorder, with hallucinations
  • 291.8 -Induced sexual dysfunction
  • 291.8 -Induced sleep disorder
  • 303.00 Intoxication
  • 291.0 Intoxication delirium
  • 291.9 -Related disorder NOS
  • 291.8 Withdrawal
  • 291.0 Withdrawal delirium

Amphetamine (or amphetamine-like) related disorders

• Amphetamine (or amphetamine-like)
  • 305.70 Abuse
  • 304.40 Dependence
  • 292.89 -Induced anxiety disorder
  • 292.84 -Induced mood disorder
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 -Induced sexual dysfunction
  • 292.89 -Induced sleep disorder
  • 292.89 Intoxication
  • 292.81 Intoxication delirium
  • 292.9 -Related disorder NOS (includes Amphetamine Withdrawal Psychosis)
  • 292.0 Withdrawal

Caffeine-related disorders

• Caffeine
  • 292.89 -Induced anxiety disorder
  • 292.89 -Induced sleep disorder
  • 305.90 Intoxication
  • 292.9 -Related disorder NOS

Cannabis-related disorders

• Cannabis
  • 305.20 Abuse
  • 304.30 Dependence
  • 292.89 -Induced anxiety disorder
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 Intoxication
  • 292.81 Intoxication delirium
  • 292.9 -Related disorder NOS

Cocaine-related disorders

• Cocaine
  • 305.60 Abuse
  • 304.20 Dependence
  • 292.89 -Induced anxiety disorder
  • 292.84 -Induced mood disorder
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 -Induced sexual dysfunction
  • 292.89 -Induced sleep disorder
  • 292.89 Intoxication
  • 292.81 Intoxication delirium
  • 292.9 -Related disorder NOS
  • 292.0 Withdrawal

Hallucinogen-related disorders

• Hallucinogen
  • 305.30 Abuse
  • 304.50 Dependence
  • 292.89 -Induced anxiety disorder
  • 292.84 -Induced mood disorder
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 Intoxication
  • 292.81 Intoxication delirium
  • 292.89 -persisting perception disorder
  • 292.9 -Related disorder NOS

Inhalant-related disorders

• Inhalant
  • 305.90 Abuse
  • 304.60 Dependence
  • 292.89 -Induced anxiety disorder
  • 292.84 -Induced mood disorder
  • 292.82 -Induced persisting dementia
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 Intoxication
  • 292.81 Intoxication delirium
  • 292.9 -Related disorder NOS

Nicotine-related disorders

• Nicotine
  • 305.1 Dependence
  • 292.9 -Related disorder NOS
  • 292.0 Withdrawal

Opioid-related disorders

• Opioid
  • 305.50 Abuse
  • 304.00 Dependence
  • 292.84 -Induced mood disorder
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 -Induced sexual dysfunction
  • 292.89 -Induced sleep disorder
  • 292.89 Intoxication
  • 292.81 Intoxication delirium
  • 292.9 -Related disorder NOS
  • 292.0 Withdrawal

Phencyclidine (or phencyclidine-like) related disorders

• Phencyclidine (or phencyclidine-like)
  • 305.90 Abuse
  • 304.90 Dependence
  • 292.89 -Induced anxiety disorder
  • 292.84 -Induced mood disorder
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 Intoxication
  • 292.81 Intoxication delirium
  • 292.9 -Related disorder NOS

Sedative-, hypnotic-, or anxiolytic-related disorders

• Sedative, hypnotic, or anxiolytic
  • 305.40 Abuse
  • 304.10 Dependence
  • 292.89 -Induced anxiety disorder
  • 292.84 -Induced mood disorder
  • 292.83 -Induced persisting amnestic disorder
  • 292.82 -Induced persisting dementia
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 -Induced sexual dysfunction
  • 292.89 -Induced sleep disorder
  • 292.89 Intoxication
  • 292.81 Intoxication delirium
  • 292.9 -Related disorder NOS
  • 292.0 Withdrawal
  • 292.81 Withdrawal delirium

Polysubstance-related disorder

• 304.80 Polysubstance dependence

Other (or unknown) substance-related disorder

• Other (or unknown) substance
  • 305.90 Abuse
  • 304.90 Dependence
  • 292.89 -Induced anxiety disorder
  • 292.81 -Induced delirium
  • 292.84 -Induced mood disorder
  • 292.83 -Induced persisting amnestic disorder
  • 292.82 -Induced persisting dementia
  • 292.11 -Induced psychotic disorder, with delusions
  • 292.12 -Induced psychotic disorder, with hallucinations
  • 292.89 -Induced sexual dysfunction
  • 292.89 -Induced sleep disorder
  • 292.89 Intoxication
  • 292.9 -Related disorder NOS
  • 292.0 Withdrawal