This Treatment Improvement Protocol (TIP) addresses the clinical use of buprenorphine in the treatment of opioid addiction. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts in the fields of addiction psychiatry, medical detoxification, and substance abuse treatment, and reviewed by independent experts. The first chapter introduces the current state of opioid addiction treatment, gives practical guidelines for physicians, and explains the new treatment option of buprenorphine for opioid addiction. Chapter two explores the pharmacology and effectiveness of buprenorphine, alone and in combination with naloxone, as well as the issues of adverse reactions and interactions with other drugs. Chapter three focuses on the patient: determining the presence and nature of the patient's opioid use disorder, and his or her suitability for buprenorphine treatment. The fourth chapter contains treatment protocols for patient opioid detoxification, maintenance and management with buprenorphine. Chapter five discusses special populations of people with opioid use disorder, including pregnant women, adolescents, patients with pain and/or co-morbid conditions, and healthcare professionals who are addicted to opioids. Regulations, policies, procedures, and legal issues are covered in chapter six. Appended are: (1) Bibliography; (2)Assessment and Screening Instruments; (3) DSM-IV-TR Material; (4) Consent to Release of Information Under Title 42, Part 2, Code of Federal Regulations; (5) Clinical Toolbox: Chapter 3 Supplemental Information; (6) Federation of State Medical Boards--Model Policy Guidelines for Opioid Addiction Treatment in the Medical Office; (7) Stages of Change; (8) Sample Treatment Agreement/Contract; (9) Glossary; and (10) Field Reviewers. (Contains 6 figures.)