When you’re ready to start Suboxone (buprenorphine/naloxone) for opioid use disorder or opioid addiction, you face the challenge of finding a provider to prescribe it. Here is some information to help clear up your confusion about who can prescribe Suboxone.
Who can prescribe Suboxone (buprenorphine/naloxone)?
Most providers can prescribe Suboxone, but not everyone. Buprenorphine, the primary active ingredient in Suboxone, is a Schedule III controlled substance. This means that in order to prescribe it (like other controlled substances), a provider must be registered with the Drug Enforcement Administration. To qualify for registration, a provider needs to have completed a total of eight hours of training on opioid or other substance use disorders. As I said, most providers are registered with the DEA.
If they can prescribe Suboxone, why won’t some doctors do it?
There are a few reasons a provider may hesitate to prescribe Suboxone.
First, unfortunately, there remains a disturbing amount of stigma about medication for substance use disorders (often called medication-assisted treatment (MAT) or pharmacotherapy). Even doctors who should know better can sometimes fall prey to prejudices about MAT. This means that some providers refuse to prescribe Suboxone because they believe the misinformation that it’s cheating or that it’s just as bad as illicit opioid use. To be clear, the evidence clearly shows that buprenorphine saves lives. But doctors are human, and are capable of being wrong just like any other person.
Second, and more forgivably, many doctors who don’t specialize in addiction medicine don’t know much about Suboxone. They want to keep their patients safe, so they don’t feel comfortable prescribing a medication they know little about. In this case, the provider may give you a referral to a different provider who knows more about Suboxone.
Why is there confusion about who can prescribe Suboxone?
One of the main sources of confusion is that the law changed in 2023. Before that, it was harder for providers to prescribe Suboxone.
Congress passed the Drug Addiction Treatment Act of 2000 (DATA 2000) which allowed providers to treat opioid addiction with opioids that are Schedule III-V (buprenorphine is Schedule III) in office settings—which lowered barriers—but required them to get a waiver from the DEA—which put up new barriers. In order to qualify for the waiver, a provider had to take a course on opioid addiction treatment. DATA 2000 also established a cap on how many patients a clinician can have on buprenorphine depending on their qualifications and year as a waivered provider. So even when they had the waiver, it was very possible for a provider to have met their cap, and be unable to prescribe to any other patients.
The need for this waiver (DATA waiver or X-waiver) was eliminated in 2023. Because this change happened relatively recently, providers who don’t keep up with addiction medicine might not be clear on the change.
How do I find a provider who will prescribe Suboxone?
- Try out telehealth. Workit Health providers can prescribe Suboxone in the states where we’re active, and there are other telehealth companies in states that we don’t serve.
- There are some directories you can use to find a local provider who prescribes Suboxone. Try SAMHSA’s Buprenorphine Practitioner Locator or FindTreatment.gov. Many states also have initiatives to help people who need treatment to connect with providers.
- Do an internet search for “buprenorphine treatment [YOUR STATE]” or “buprenorphine treatment near me.”
- Talk to your primary care doctor to see if they would be willing to prescribe Suboxone now that they no longer need a special waiver to do so. If they won’t or can’t, ask for a referral.