As Opioid Deaths Rise, Biden Team Moves to Bring Buprenorphine Treatment Mainstream – NPR news

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The Biden administration wants to make buprenorphine, a drug proven to help people with opioid addiction, more available.
Image Credit: Joe Raedle



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The Biden administration says new federal guidelines released Tuesday will allow many more doctors to prescribe buprenorphine, a drug proven to reduce opioid relapses and overdose deaths.

The change lowers regulatory hurdles that critics say are severely limiting use of the life-saving medication at a time when drug deaths are on the rise.

“We’ve made this much easier for doctors, but also for other doctors,” Dr. Rachel Levine, assistant secretary of health, told NPR.

The new rules eliminate an education requirement and allow a wider range of health professionals to offer buprenorphine treatments, including nurse practitioners, physician assistants and certified nurse midwives.

β€œThere is a lack of doctors in many rural areas of the country,” said Tom Coderre, acting chief of the federal Substance Abuse and Mental Health Administration.

β€œBy expanding [buprenorphine guidelines to include] these additional practitioners, we are more likely to expand access to treatment to those rural areas,” he added.

This move comes at a dire moment in the country’s opioid epidemic. Experts say the spread of illicit fentanyl coupled with disruptions from the COVID-19 pandemic has led to a devastating rise in fatal overdoses.

According to the latest estimates from the Centers for Disease Control and Prevention, more than 90,000 Americans died during the 12-month period ending September 2020. Deaths linked to fentanyl increased by 55%.

The Biden administration has acknowledged growing pressure to respond to the crisis and expressed its hopes of making buprenorphine more widely available.

The drug works by reducing opioid cravings and withdrawal symptoms, which helps people avoid relapses.

“We’re definitely looking at what’s within the federal government’s remit to lower those barriers,” Regina LaBelle, chief of the White House Office of National Drug Control Policy, said in an interview with reporters earlier this month. “We know it’s urgent.”

The Biden administration was criticized earlier this year after the cancellation a plan to relax buprenorphine rules unveiled by the Trump White House in January.

These new guidelines now go further as more practitioners are allowed to prescribe the medication. Health professionals will still need additional training and federal exemptions if they plan to treat more than 30 patients with the medication.

dr. Patrice Harris, head of the American Medical Association’s opioid task force, said disability could pose a problem for emergency room physicians who see large numbers of patients with opioid disorders.

But Harris described the new guidelines as a “step in the right direction” that will see more primary care physicians include addiction treatment in their practices.

dr. Yngvild Olsen of the American Society of Addiction Medicine also praised the change. She said her organization will continue to urge Congress to pass legislation that removes remaining barriers to prescribing buprenorphine.

“Having a separate category of training focused on this one drug has inadvertently promoted the stigma of people with addiction,” she said.

Doctors are not immune to that stigma. Studies show that many doctors are reluctant to treat patients with addiction een even as better medical treatments such as buprenorphine become available.

Keith Humphreys, who studies addiction at Stanford University, said a test of these new buprenorphine guidelines is whether doctors are beginning to view opioid use disorder as a chronic illness, treatable with appropriate medications.

“That would be a big change,” Humphreys said. “However, it does require the health care system to respond … to say, OK, they’ve opened the door for us, let’s walk through it.”

Copyright 2021 NPR. For more information, visit https://www.npr.org.


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