Training rural practitioners to use buprenorphine; using The Change Book to facilitate technology transfer

J Subst Abuse Treat. 2004 Apr;26(3):203-8. doi: 10.1016/S0740-5472(03)00247-2.


The Opiate Medication Initiative for Rural Oregon Residents trained physicians and counselors in Central and Southwestern Oregon to use buprenorphine and develop service models that supported patient participation in drug abuse counseling. The Change Book from Addiction Technology Transfer Centers was used to structure the change process. Fifty-one individuals (17 physicians, 4 pharmacists, 2 nurse practitioners, and 28 drug abuse counselors and administrators) from seven counties completed the training and contributed to the development of community treatment protocols. A pre-post measure of attitudes and beliefs toward the use of buprenorphine suggested significant improvements in attitude after training, especially among counselors. Eight months after training, 10 of 17 physicians trained had received waivers to use buprenorphine and 29 patients were in treatment with six of the physicians. The Change Book facilitated development of county change teams and structured the planning efforts. The initiative also demonstrated the potential to concurrently train physicians, pharmacists, and counselors on the use of buprenorphine.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Buprenorphine / therapeutic use*
  • Counseling / education*
  • Education, Continuing*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Opioid-Related Disorders / drug therapy*
  • Oregon
  • Program Evaluation
  • Rural Health Services*
  • Technology Transfer
  • Workforce


  • Analgesics, Opioid
  • Buprenorphine