President Bush recently signed into law a measure that could dramatically expand access to buprenorphine treatment for opiate addicts.

An amendment to the Drug Abuse Treatment Act of 2000, included in the Office of National Drug Control Policy (ONDCP) reauthorization signed by Bush on Dec. 29, increases from 30 to 100 the number of buprenorphine patients that individual doctors may treat in their medical offices.

The 30-patient cap was included in the original DATA-2000 legislation, which also limited group medical practices to treating a maximum of 30 patients. The latter restriction was lifted by Congress in July 2005. "This new law has brought tens of thousands of patients into treatment, who would never have sought treatment in methadone programs," noted Sen. Carl Levin (D-Mich.), a lead cosponsor of the original DATA bill.

The new law allows doctors who have been certified to prescribe buprenorphine for at least one year to treat up to 100 patients. "Bupe has been hailed as a 'miracle drug' by medical professionals and addicts alike, and it has been successful in helping thousands of addicts get off -- and stay off -- heroin," Levin added. "This common-sense fix allows many more Americans to rehabilitate their lives with bupe."

"H.R. 6344 vastly increases patients' access to one of the most effective opioid addiction treatments available today. Furthermore, it suggests that lawmakers are working to address the public-health implications of untreated or under-treated substance use disorders," agreed the American Society of Addiction Medicine, a longtime supporter of buprenorphine use.

Buprenorphine, sold under the brand names Suboxone and Subutex by Reckitt Benckiser Pharmaceuticals, has been widely hailed as an alternative to methadone treatment for opiate addiction. The commercial formulations of the drug include naloxone, which causes unpleasant withdrawal-type symptoms if users attempt to crush and inject or snort the drug recreationally.

Physicians who receive special training and a DEA waiver may prescribe buprenorphine out of their private offices, whereas methadone can only be obtained at methadone clinics, which are often located in inner-city neighborhoods and difficult to access for rural or suburban addicts.

Lack of access to opiate treatment has become a particular problem in recent years, as cheap heroin has become more prevalent in rural and suburban communities and more people in these areas have become addicted to opiate-based prescription pain medications.

Some supporters of buprenorphine said that addicts have been forced onto waiting lists for treatment because of the 30-patient cap. While the new law may allow certified doctors to take on more buprenorphine patients, anecdotal reports suggest that some may be reluctant to do so out of concerns about the impact on the rest of their practice.

Also, only about 5,300 doctors nationwide have completed the necessary certification to prescribe the drug, meaning that many communities do not have access to the methadone alternative at all.

A review of the Substance Abuse and Mental Health Services Administration's database of bupe-certified doctors shows that a disproportionate number are located in the Northeast; New York alone has 785 certified physicians, for example, while states like South Dakota, North Dakota, and Iowa have just 2, 5, and 6 doctors, respectively, who can legally prescribe buprenorphine in their private practices.