Feds Expand Buprenorphine Access to Fight Opioid Epidemic

The White House announced a new rule July 6 expanding access to medication-assisted treatments for opioid addiction. The move was one part of a new effort by the Obama administration to combat the opioid epidemic.

The Substance Abuse and Mental Health Services Administration announced it was increasing the number of buprenorphine prescriptions a physician can write in one year from 100 to 275. The federal regulating authority for behavioral health care acknowledged that the previous limit created a barrier to treatment for people with an opioid use disorder.

Policymakers had initially limited the number of prescriptions to 100 because buprenorphine has potential for abuse. While the drug does not cause the intense effects that heroin or morphine produce, it can be abused in high doses.

Today, many physicians prescribe medications that combine buprenorphine and naloxone such as Suboxone, which has no potential for abuse. Naloxone reverses the effects of opioids.

The White House also announced improvements to federal health care programs:

  • Prescribers at the Indian Health Service will be required to check state Prescription Drug Monitoring Programs (PDMPs) before writing opioid prescriptions for more than seven days.
  • The Department of Veterans Affairs now requires its physicians to check PDMPs before prescribing controlled substances and to check the records of a patient receiving controlled substances at least once a year.
  • The Department of Defense is evaluating its own PDMP and developing recommendations for improvement.

The Obama administration is also continuing efforts to improve prescriber educational programs, encourage safe pain management, accelerate research on pain management and expand telemedicine to rural communities.

However, the efforts may be wasted if legislators are unable to secure funding for the proposed programs.

Congress Split on Funding for Opioid Bills

A July 6 conference meeting between senators and representatives ended in disappointment for Democrats hoping to secure $920 million in funding for addiction treatment efforts, according to The New York Times.

In February, Obama asked Congress for $1.1 billion to fund efforts to combat the opioid epidemic. The Department of Health and Human Services (DHHS) outlined numerous prevention and treatment efforts that required the funding, including expanding access to buprenorphine.

The DHHS achieved that goal July 6, but most of the other goals are in jeopardy without proper funding. In March, the Senate passed the Comprehensive Addiction and Recovery Act (S. 524) to support prevention and treatment efforts. However, senators denied an amendment to the bill that would have allocated $600 million in funding to support the measures.

Two months later, the House passed the Comprehensive Opioid Abuse Reduction Act (H.R. 5046), a companion bill that included $103 million in annual funding for five years. Companion bills contain similar language, but the House and Senate must agree on a single bill before sending it to the president.

Republicans and Democrats disagree about the effectiveness of the bill without accompanying funding and the potential for other committees to find funding in the future. Some experts believed Democrats would attempt to stall the bill without funding, but the House approved the new bill July 8. The senate approved the bill July 13.

President Obama is expected to sign it into law despite funding concerns.

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