Office-Based Therapy for Opiate Dependence

The Buprenorphine Program for opiate maintenance and detoxification at NewYork-Presbyterian Hospital/Columbia University Medical Center specializes in the induction and stabilization phase of a buprenorphine maintenance program, as well as the use of buprenorphine for detoxification.

What is Buprenorphine?

Buprenorphine is a prescription medication for the treatment of heroin, methadone and opiate pain medication dependence. It is available in two forms: buprenorphine alone (Subutex) and buprenorphine with naloxone, (Suboxone). Buprenorphine blocks the effects of other opiates. In addition, it eliminates the major motivation for opiate abuse by preventing withdrawal symptoms such as pain, chills, nausea, and opiate cravings.

What is Buprenorphine Used For?

	Maintenance for opiate addiction. Buprenorphine has a lower risk profile than methadone. Unlike methadone, it can be prescribed by physicians in private practice
	Detoxification from opiate dependence. The withdrawal and detoxification process is much milder with buprenorphine.
	Treatment of chronic pain

Induction, Stabilization and Maintenance

There are two phases of buprenorphine maintenance treatment. The first is induction and stabilization onto the medication. The second, separate phase, is maintenance.

Induction onto buprenorphine can be a complex procedure. At the Buprenorphine Program, the induction is handled by a team of experienced specialists. The induction process is done on an outpatient basis. Following stabilization (normally a 1-2 week process), the patient is referred to a physician who holds the special license required to prescribe buprenorphine. The patient can also continue at the Buprenorphine Program for maintenance therapy.

While some individuals prefer and need ongoing maintenance, others may wish to withdraw from all opiates. The Buprenorphine Program uses the most comprehensive and well-tested methods to achieve this goal. This is usually accomplished through outpatient treatment, but inpatient care at NewYork-Presbyterian Hospital is also available.

Eligibility

Buprenorphine is an appropriate treatment for those dependent on opiates, either illicit heroin, methadone or prescription drugs.

What are the Benefits of Buprenorphine Maintenance?

	Buprenorphine may be prescribed by qualified physicians in private practice. Patients do not need to go to a clinic to receive this maintenance medication
	Maintenance treatment provides emotional stability, providing an opportunity to address psychosocial problems.
	Buprenorphine is long lasting. Once maintained, the frequency of prescription is determined by the physician and can vary from weekly to monthly, depending on the patient's needs.
	Buprenorphine is much safer than heroin or traditional prescription opiates; buprenorphine alone is unlikely to result in an overdose.
	Health problems are reduced or avoided, especially those related to IV drug use, such as HIV and hepatitis B and hepatitis C viruses, skin infections and vein problems.

Treatment Team

The Buprenorphine Program team consists of a psychiatrist, an internist, a nurse practitioner, and a psychotherapist, all of whom have special expertise in dealing with opiate dependence and the transition to buprenorphine. The team provides support for patients throughout all phases of treatment and detoxification.

Referrals

Referrals can be made by healthcare professionals, including psychiatrists, internists, nurses, psychotherapists, pain management specialists, and addiction specialists who can provide ongoing treatment.

Patients will be:

	Inducted onto Buprenorphine
	Stabilized on Buprenorphine
	Referred back to their providers, or assisted in finding private physicians certified to prescribe buprenorphine for maintenance treatment.

Patients can also be maintained at the program

The Buprenorphine Program requires payment in full by each patient at the beginning of treatment. ATM/Debit cards are accepted.

David McDowell, MD – Medical Director
Jeanne Manubay, MD – Assistant Medical Director
Cynthia Cocke, MSW – Program Director

To make a referral or for more information about the program or about special licensing requirements, please call:

Monday	9:30 a.m. - 6:30 p.m.
Tuesday	9:30 a.m. - 5:30 p.m.
Wednesday	9:30 a.m. - 6:30 p.m.
Thursday	9:30 a.m. - 6:30 p.m.
Friday	9:30 a.m. - 2:30 p.m.

(212) 342-1496

All other times, (212) 305-6001

NewYork-Presbyterian Hospital/
Columbia University Medical Center
635 West 165th Street
Eye Institute, 6th Floor
New York, New York 10032