Suboxone Doctor

Here I want to discuss the different ways that a doctor in the United States can become certified to prescribe Suboxone. In order to be classified as a suboxone doctor, both the DEA (Drug Enforcement Agency) and the FDA (Food And Drug Administration) must give you official authorization. There are only a few thousand physicians approved in the U.S., and they can be difficult to find outside of major metropolitan areas.

Four Basic Ways To Be Suboxone Certified

Take an 8 hour course in prescribing buprenorphine.

This is by far the easiest and most common way doctors become certified. The 8 hour course covers how to diagnose opiate addiction, how to screen in and out patients for buprenorphine treatment, how to manage the detox and how to manage suboxone maintenance, as well as other factors in opiate addiction treatment. 

The advantage to this method is that it allows physicians with limited or no addiction treatment training to treat opiate addiction. The disadvantage is the same - it allows physicians with limited or no addiction treatment training to treat opiate addiction! It can be a "double edged sword".

My concern is that using the Suboxone is only one component of comprehensive addiction treatment. Suboxone doctors who only have this 8 hour course are not qualified or trained to deliver full addiction treatment services. They do not have experience with addiction psychotherapy, they may not be psychiatrists so they can't diagnose and treat co-ocurring psychiatric disorders. This has proven to be a potential problem. Many patients I treat have come to me after quickly relapsing to opiate addiction after treatment from such clinicians.

And the 8 hour course does NOT even need to be an in-person "hands on" seminar. It could be taken online.

This creates more problems because the doc taking the training online is not going to get appropriate feedback from a seminar leader - and may not even know they are not correctly learning the information.

Certification in Addiction Medicine

To become certified in addiction medicine you need to demonstrate knowledge and expertise in addiction treatment as put forth by the American Society of Addiction Medicine. This is more comprehensive than simply an 8 hour course, but there are things you should be aware of.

First, many physicians certified in Addiction Medicine are not psychiatrists. Thus, they do not have the expertise and training to fully diagnose and treat co-occurring psychiatric disorders. And this is important because at least 40 % of people with an addiction problem have another psychiatric disorder - such as depression or anxiety - that is independent of the addiction. This means proper treatment will entail a full psychiatric evaluation.

So addiction medicine specialist who are not also psychiatrists can miss the important psychiatric issues, and also not be trained in delivering psychotherapy.

Participate in a clinical trial studying buprenorphine in opiate addiction treatment

This too has limitations, as above. You would need to ask these physicians what specific addiction treatment training they have, etc.

I participated in original research on buprenorphine, but that's not the way I become certified to use it. This next way is the way I did.

Board Certification in Addiction Psychiatry

To become Board Certified in Addiction Psychiatry, a physician first has to be certified as a general psychiatrist. Training as a general psychiatrist covers diagnosis and treatment of all types of psychiatric disorders, the use of psychiatric medications (antidepressants, anxiety medications, etc.), as well as in-depth training and supervision in using many different types of psychotherapy. This takes four years to complete post medical school.

Then, to become an Addiction Psychiatrist, it takes one to two years of additional training just treating addictions, learning more specific addiction psychotherapy, and treating co-occurring psychiatric and addiction disorders.

It is much more intensive than an 8 hour "online" course.

I'm Board Certified in Addiction Psychiatry, did 2 years of advanced training in the field and performed original reasearch in the treatment of addictions.

The main focus of my practice is addiction treatment.

Click this link to discover the Suboxone Treatment Options offered by Dr. Gilman