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National policy makes it easier to prescribe opioid treatment

Published: Apr. 29, 2021 at 6:56 PM MST|Updated: Apr. 29, 2021 at 6:55 PM MST
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TUCSON, Ariz. (KOLD News 13) - Health and Human Services released new guidance, making it easier for more medical professionals to prescribe a common medication to treat opioid abuse.

More than 90,000 drug overdose deaths likely happened in the U.S. during the 12 months leading up to September 2020 alone, according to the Centers for Disease Control and Prevention. It’s the highest number ever recorded in a 12-month period.

The Trump administration eased regulations during the pandemic for more access, and in December 2020, the CDC issued a health advisory regarding overdoses—telling health providers to increase access to addiction services.

Dr. Beth Meyerson, research professor at the University of Arizona, studies how these temporary and new regulations impact the opioid crisis, in hopes some could become permanent.

“Our federal and state policy partners will want evidence of the impact of these policies, so they can say ‘well moving in this direction is good,’” said Dr. Meyerson.

To further expand access, HHS under the Biden administration is taking away some of the barriers to prescribing treatment for opioid abuse — buprenorphine. Along the lines of methadone, it helps curb drug cravings and withdrawal symptoms. The Trump administration had a similar policy in January that was put on hold during the change in administration, then expanded.

“It seems like less than a fifth of people with opioid use disorder are on methadone or buprenorphine or have access to it,” said Dr. Melody Glenn, assistant professor, University of Arizona College of Medicine’s Department of Emergency Medicine.

Before physicians would have to take an eight-hour course and other advanced practice providers, like nurse practitioners or physician assistants, would have to take a 24-hour course to prescribe buprenorphine, then apply for a waiver from the DEA. The new guidance removes the need for the courses.

“When you look at that requirement in comparison to what we need to prescribe oxycodone or vincodine or percocets, these arguably more dangerous medications that do cause overdoses, we don’t need any kind of special training to prescribe those,” Glenn said.

This opens the door for more prescribers, which are greatly needed.

As of March 2021, according to Dr. Benjamin Robert Brady, a researcher with the University of Arizona, a little more than 2,300 providers had received their waivers to administer buprenorphine in Arizona. About 370 of those were in Pima County, with most being in Tucson. Yuma, Sierra Vista and Nogales all had under 20 providers who could prescribe buprenorphine.

Brady said the general amount of providers with the correct waivers is increasing, but it is worth noting not every provider who can prescribe this, is doing so. From January 2020 to March 2021, the number of Arizona providers with a DEA waiver increased from 2,139 to 2,320, an 8.5% increase. The increase is representative of national trends as well.

“The advent of buprenorphine and the ability to prescribe medication for opioid use disorder in office-based settings has increased potential access to OUD (Opioid Use Disorder) treatment in rural and underserved communities. Having a DEA waiver only represents “potential access” because having a wavier doesn’t mean a provider is actively treating patients with OUD,” Brady wrote in an email.

Experts agree the new policy is a great start, but more needs to be done. The new recommendations from HHS also caps providers to treating only 30 patients at a time, which was in place before too.

“I believe this policy change will further increase the number of providers who will request and receive a waiver to prescribe buprenorphine,” Brady said. “I would not be surprised if this becomes an expected standard of medical programs, to encourage graduates to submit a notice of intent to SAMHSA requesting a DEA waiver.”

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