Opiod dependence is a significant problem in the United States Of America and is undertreated .Only 20 % of patients get help inspite of effective treatments being available .The United Nations report that worldwide approximately 16 million people abuse opiates but only 7.8% receive treatment.

The new office based opiate agonists improve access to patients that are otherwise reluctant to use the federally supervised Methadone or Opiate treatment programs. I will review the assessment of opiate dependence and treatment options available and present my experience to date with patients on Buprenorphine.

In 2002 the US Food and Drug Administration approved 2 sublingual formulations of Buprenorphine for treatment of opiate addiction to be used for detoxification and maintainence therapy of inpatients and outpatients under the Drug Addiction Treatment Act of 2000.The Drug Addiction Treatment Act enables physicians with 8 hours of training to obtain a waiver so that they may treat opiate dependent patients in any setting they are licensed to practice in .The hope is to allow more patients to get into treatment and allow more physicians to provide treatment.