Letter to Pharmacies Regarding the Buprenorphine Campaign

January 2010

Dear New York State Pharmacy:

The New York State Department of Health (DOH) has launched a media campaign to alert people addicted to prescription narcotics to the use of buprenorphine as a treatment option. Through a grant funded by the U.S. Department of Justice, a radio and internet banner campaign will draw attention to prescription narcotic addiction and encourage addicted individuals to seek treatment. In addition, State Health Commissioner Richard F. Daines, M.D., is calling upon physicians statewide to join DOH and the New York State Office of Alcoholism and Substance Abuse Services (OASAS) to increase awareness about buprenorphine. Pharmacies are also being asked to assist in this endeavor.

Physicians and pharmacies statewide are being provided with printed materials that highlight the fact that addiction can be effectively treated with buprenorphine, which can be prescribed in the privacy of a physician's office and dispensed by a pharmacy. Physicians are being encouraged to become qualified to treat their patients who are addicted to opioids or to advise such patients to obtain treatment from a qualified physician. Pharmacies are being asked to display the enclosed poster in their stores and also include the enclosed insert, at their discretion, when filling prescriptions for controlled substances.

Many people do not realize that prescription pain medication has the same potential for addiction, overdose and death as street drugs. DOH's Bureau of Narcotic Enforcement reports that in 2008, more than 9 million prescriptions were filled for an opioid-type drug. OASAS estimates that 1.8 million New Yorkers require assistance with chemical dependency. Emergency room visits due to abuse of prescription drugs are higher than the number of visits due to abuse of marijuana and heroin combined. For every person addicted to heroin, there are two persons addicted to prescription narcotics.

Buprenorphine has been shown to be an effective treatment option for opioid dependence, providing a safe, controlled level of medication to overcome the use of a problem opioid. The Drug Addiction Treatment Act of 2000 (DATA) and New York State regulations permit qualified practitioners to prescribe or dispense buprenorphine under the brand names Suboxone and Subutex for the treatment of individuals who are addicted to narcotics. In order to become a qualified practitioner, physicians must be licensed under State law to practice medicine and obtain a waiver from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) to prescribe or dispense buprenorphine. Such practitioners hold a modified DEA registration in which they are designated by a unique identifier (also referred to as an "X" DEAnumber").

The Public Health Law requires that every written prescription for a controlled substance contain the DEA registration number of the prescribing practitioner. Practitioners who are treating opioid dependent patients with buprenorphine must use their modified DEA registration when prescribing the drug. If the "X" DEA number is omitted from a buprenorphine prescription, the practitioner may orally furnish the number to the pharmacist and authorize him/her to enter such information on the prescription. When reporting buprenorphine prescription information to DOH, the pharmacy may (at this time) submit either the physician's regular DEA number or "X" DEA number, whichever is most easily accommodated by the pharmacy's data system. As a result of this campaign, pharmacies may notice an increase in the number of practitioners prescribing buprenorphine.

Please remain mindful that buprenorphine is a Schedule III controlled substance and follows all other prescribing and dispensing parameters for Schedule III controlled substances, including up to a 30-day supply and five refills.

Your assistance is requested in increasing awareness of this treatment option and ultimately promoting recovery from addiction. Additional copies of the poster can be obtained by contacting the Bureau of Narcotic Enforcement at 1-866-811-7957 (Option #6). The insert can be copied or downloaded for printing at www.nyhealth.gov/bupe/. Should you have specific questions about this campaign, please contact the Bureau of Narcotic Enforcement at 1-866-811-7957 (Option #2). More information about prescription drug abuse and associated treatment is also available at www.nyhealth.gov/bupe/. New Yorkers with questions about addiction problems can also contact OASAS' 24-hour, toll-free help line at 1-877-8-HOPENY (1-877-846-7369).

Sincerely,

Kenneth W. Post
Acting Director
Bureau of Narcotic Enforcement