Variation in Use of Buprenorphine and Methadone Treatment by Racial, Ethnic, and Income Characteristics of Residential Social Areas in New York City
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Opiate agonist therapies for opiate dependence lower HIV incidence and arrest rates among injection drug users,1, 2, 3 thus enhancing access to these treatments is a major public health priority. Buprenorphine, a partial opiate receptor agonist approved by the US FDA in 2002 for treatment of opiate dependence, offers important advantages over methadone maintenance. Buprenorphine is less lethal in overdose than methadone.4 The most commonly prescribed formulation of buprenorphine, in which it is combined with the opiate antagonist naloxone, produces opiate withdrawal when injected, limiting its abuse potential.5 Because of these lower risks, buprenorphine can be prescribed by office-based generalist physicians, potentially increasing treatment access and reducing stigma in comparison to methadone,6 which is restricted to federally regulated methadone clinics.
Few physicians offer buprenorphine treatment despite its advantages.7While policies such as state Medicaid...
KeywordsYork City Buprenorphine Ecological Fallacy Public Clinic Opiate Dependence
This study was supported by the Substance Abuse and Mental Health Services Administration/American Psychiatric Association Minority Fellowship, the New York State Office of Mental Health’s Center of Excellence in Culturally Competent Mental Health, the Robert Wood Johnson Health and Society Scholars Program, and NIDA grant K01DA032674 (to H. Hansen).
Conflict of Interest
None of the contributing authors have conflicts of interest with regard to ties to manufacturers or promoters of treatments for opiate dependence.
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