“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Why Opioid Addiction Treatment Clinics Make for a Great Side Practice

Couple Climbing Help Mountain  - Tumisu / Pixabay

Opioid addiction treatment clinics, or “Suboxone” clinics as they are usually referenced as, are a great side practice to start if this type of niche interests you. Why? Because they have withstood the test of time and the demand only increases as the opioid epidemic silently worsens.

The opioid epidemic was big news back in 2018, but once COVID hit, it dropped off the mainstream radar. This is a real travesty because in 2020 opioid overdoses increased significantly, yet no one was bringing this up. This silent epidemic was brushed under the rug… People addicted to opioids need treatment now more than ever! For this reason, the demand for opioid addiction treatment services is through the roof!

The demand is fueled by the federal restrictions placed on providers for the amount of buprenorphine (Suboxone, Subutex) that can be prescribed. Providers are capped at how many active prescriptions they can have at any given time. This number ranges from 30-275 active prescriptions depending on how long you have had your buprenorphine waiver and a few other stipulations. This only creates a barrier to care which is responsible for the lack of providers willing to treat opioid addiction. Chances are, you could be one of the few practices in town offering these services.

This demand is also fueled by that lack of medical providers offering opioid addiction treatment because many are turned off by this niche service line. They believe they will be treating “dangerous drug addicts” and other potentially unlawful individuals. Many think their lobbies will be over ran with the stereotypical “junky.” That is total nonsense… You will treat everyone from the junky to the high functioning lawyer. Ultimately, it is going to be for YOU to decide who you treat. That is one of the beauties of having a cash accepting practice: you aren’t forced to see everyone that walks through the door like you are when you take Medicaid (to an extent). Yes, you should help every patient that is seeking treatment, but you can be selective with who you accept into your treatment program. Sometimes, some patients would be better served to be treated elsewhere, such as a methadone clinic. The most important thing you can do is to have a list of resources to refer patients to, which is simple to put together.

Many providers also believe that there is no money to be made with an opioid addiction practice. That couldn’t be further from the truth! Listen, these patients spend $500 a week on heroin… they can afford to pay you $200-400 a month for treatment. Trust me on that. The other good news is that insurance reimburses for this type of treatment if you want to go that route! Most patients will be seen every 1-2 weeks, so what does that mean? Billing standard E&M codes on a weekly basis. This will result in approximately $400-500 a month PER PATIENT.

Let’s do some basic math for the potential revenue of an opioid addiction treatment clinic and average the reimbursement on each patient at $300 monthly:

30 active patients a month x $300 each = $9,000 a month

You can see those 30 patients in approximately 10 hours a week or less. Not bad for a part-time side income huh?

What if you obtain the waiver where you can see 100 patients?

100 active patients a month x $300 each = $30,000 a month.

Not bad for 30 a week worth of work. Show me another nurse practitioner job that pays that much. You can’t because they don’t exist. Well, they can exist if you create it!

If you have the waiver that allows you to see 275 patients, then the revenue potential is very high. This will be a mixture of patients seen weekly to monthly, all resulting in $100-$400 a month in revenue. Do the math there…

Outside of the monetary incentive of an opioid addiction treatment practice, you also need to look at its simplicity. Opioid addiction treatment is fairly easy once you learn how to do it. Yes, you will deal with patients that can be very difficult, non-compliant, and to be perfectly frank, ones that you need to baby sit, so they are not all a piece of cake, but once you build a steady census of reliable and compliant patients over 1-2 years, it becomes a very simple practice to run! All it takes is the time to dedicate to your patients and to help them get better.

The initial visit typically takes between 30-60 minutes and follow ups can usually take 15-30 minutes. Of course, there will be patients who take longer and those that are shorter, but that is with any practice.

Treatment is straight forward and dosing is based off simple protocols. Dose adjustments are necessary but are easy to do. Monitoring treatment is also very simple and revolves around subjective wellbeing and urine drug screens. You will only be using buprenorphine, buprenorphine with naloxone, and/or naltrexone in terms of medication management. These are the foundational medications of an opioid addiction treatment program and learning how to utilize these medications within your treatment plan is very straightforward and easy to implement.

The liability is also pretty low. Opioid addiction therapy is safe when prescribed appropriately. The biggest risk is the patient relapsing and overdosing, but this is outside of your control and it would be difficult to prove that you were negligent if you were providing safe and standard treatment. You cannot monitor the patient after they leave your office, all you can do is provide treatment and help them get and stay clean. Unfortunately, we live in a real world where relapse and overdose can happen and you can only do so much for some patients. Outside of that rare occurrence, treatment is safe and low liability. The biggest legal risks are surrounding the prescription of a schedule III-controlled substance, but as long as you are following prescriptive law, there is little to worry about!

Most importantly though, is that you are making a true impact on the lives of your patients, their families, and your community. You will literally save the lives of countless patients. The disease of addiction is real and patients need your help. When you see a patient that presents to your practice in the thralls of opioid addiction do a complete 180 with their life due to the treatment you provided, the feeling is indescribable! You can see REAL change in a short amount of time with your patients when you treat their opioid addiction.

Overall, opioid addiction therapy is an in-demand service that will continue to grow. The reimbursement is favorable for a nurse practitioner looking to start a side practice and the treatment is relatively simple. The overall liability is low and most importantly you will be making a significant impact on your patients’ lives. All it takes is a little upfront work, due diligence, and some patience to open a part-time opioid addiction treatment clinic that can prove to be a rewarding and profitable side practice for any nurse practitioner.

If you are interested in providing opioid addiction therapy then check out The Opioid Addiction Treatment Clinic Course that is currently on sale until February 12th. This course provides everything from treatment protocols to policies and procedures to the exam and intake forms. It is literally an opioid addiction treatment clinic in a box! Check it out before the sale ends.

12 Responses

  1. I maintain several DEA numbers and plan on opening a practice in both California and WAshington State. My X waiver is on my Washington license number. How do I get the waiver on my California number so I can open a suboxone Clinic . I am a psych NP

    1. I believe you just do that through the DEA website or SAMSHA adds that to your license. They will need to be aware you have multiple DEA licenses though.

    1. If you are going to bill insurance, then yes, you need to be credentialed. I recommend going through a local medical billing company that understands your states processes!

          1. Also I saw that you need to be an OTP, doesn’t that require more than an office and a pen and paper? Does your course go over that? I’m wanting to purchase it but I see that it’s missing some information such as no longer need an X waiver

          2. You do not need to be an OTP unless you are dispensing this… But yes, x-waiver is not needed anymore. The course is up to date and relevant still.

  2. I’m looking at this course, but reading the SAMHSA guidelines makes this appear incredibly overwhelming. Is this course about treating addictions from a private practice and not becoming a certified OTP?

    1. Private practice. Opening an OTP is very complex and would be another course in itself which we don’t have.

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