HHS Expands Access to Opioid Addiction Treatment

The US Department of Health and Human Services (HHS) has officially increased the limit on the number of patients for whom providers can prescribe buprenorphine from 100 to 275.

Buprenorphine is a medication-assisted treatment (MAT) for opioid use disorder, and certain physicians are permitted to prescribe or dispense the drug in their offices because it has low potential for abuse.

Buprenorphine products include Belbuca, the only formulation that can be delivered via dissolving film, and well as Buprenex, Bunavail, Suboxone, Zubsolv, Subutex, and Butrans.

In April, HHS proposed a rule to allow physicians to prescribe buprenorphine to more than twice as many opioid-addicted patients as they were able to at the time.

Now that the rule has been codified, Chris Jones, PhD, MPH, PharmD, science policy director of HHS’s Office of the Assistant Secretary for Planning and Evaluation, told MedPage Today that the office expects between 500 and 1800 providers to request to increase their patient limit on buprenorphine in the rule’s first year. If each prescriber increases his or her buprenorphine prescribing load by around 20 to 50 patients, the overall increase in the number of patients receiving the drug could fall between 10,000 and 90,000 within that same year.

Dr. Jones further estimated that the new rule could afford between 2000 and 15,000 new patients access to the MAT in later years.

Advocates of the prescription expansion feel that it’s especially critical for patients seeking help for an untreated opioid use disorder.

“In many cases, there are long patient waiting lists for prescribers who have reached the 100 patient limit,” explained Substance Abuse and Mental Health Services Administration Principal Deputy Administrator Kana Enomoto, in a press release. “Easing barriers to treatment is a major step to reducing prescription opioid- and heroin-related overdose, death, and dependence.”

However, health officials have stressed that it’s possible to abuse buprenorphine, and the drug’s use isn’t without risk. A study previously conducted by the US Centers for Disease Control and Prevention found that buprenorphine is one of just a dozen drug ingredients to blame for nearly half of all emergency hospitalizations for unsupervised prescription drug ingestions among young children.

The decision to expand buprenorphine access was part of a package of initiatives announced by HHS Secretary Sylvia M. Burwell to help tackle the nation’s opioid epidemic. Other initiatives announced by the agency are a proposal to eliminate any potential financial incentive for physicians to prescribe opioids based on patient experience and a requirement for prescribers and pharmacists in the Indian Health Service to check state Prescription Drug Monitoring Program databases before prescribing prescription main medications.

Administration officials took the rule announcement as an opportunity to further urge Congress to allocate more money to fund addiction treatment programs.

“At HHS, we are helping to lead the nationwide effort to address the opioid epidemic by taking a targeted approach focused on prevention, treatment, and intervention,” Burwell stated in a press release. “…However, if we truly want to turn the tide on this epidemic, Congress should approve the President’s $1.1 billion budget request for this work.”