Overcoming policy and financing barriers to integrated buprenorphine and HIV primary care

Bruce R. Schackman, Joseph O. Merrill, Dennis McCarty, Jeffrey Levi, Christine Lubinski

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Treatment for substance abuse and human immunodeficiency virus (HIV) infection historically have come from different providers, often in separate locations, and have been reimbursed through separate funding streams. We describe policy and financing challenges faced by health care providers seeking to integrate buprenorphine, a new treatment for opioid dependence, into HIV primary care. Regulatory challenges include licensing and training restrictions imposed by the Drug Addiction Treatment Act of 2000 and confidentiality regulations for alcohol and drug treatment records. Potential responses include the development of local training programs and electronic medical records. Addressing the complexity of funding sources for integrated care will require administrative support, up-front investments, and federal and state leadership. A policy and financing research agenda should address evidence gaps in the rationales for regulatory restrictions and should include cost-effectiveness studies that quantify the "value for money" of investments in integrated care to improve health outcomes for HIV-infected patients with opioid dependence.

Original languageEnglish (US)
Pages (from-to)S247-S253
JournalClinical Infectious Diseases
Issue numberSUPPL. 4
StatePublished - Dec 15 2006
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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