In lieu of congressional action, the White House is taking steps on its own to make it easier for people addicted to opioids to access treatment medication. That is, to an extent.
With Congress at an impasse over funding the national fight against opioid addiction, the White House announced Tuesday it will expedite a new rule broadening access to addiction treatment drugs. Doctors will now be allowed to prescribe the addiction-fighting drug buprenorphine to more than double the amount of patients permitted in the past. This new patient cap of 275 replaces the current 100 limit — and will provide an estimated 70,000 more people with the drug, according to the U.S. Department of Health and Human Services (HHS).
I think that HHS needs to remove the cap altogether
Buprenorphine — often referred to by its brand name, Suboxone — is an opioid itself, but one that comes with a milder high. Like its older competitor methadone, it intends to help users taper off of opioids gradually, with diminishing side effects and cravings.
It isn’t foolproof. For some people, Suboxone can be as addicting as heroin, and it has become a thriving black market product for those unable to get their hands on the real thing.
Nonetheless, it’s one of the only affordable treatments that exist. The market’s most successful drug, Vivitrol — which entirely blocks the effects of opioids and alcohol — can cost up to $1,000 a month. Until that price drops, Suboxone remains the federal standard.
Suboxone requires a prescription because it isn’t mandatory to take under doctor supervision. Since 2000, doctors authorized to prescribe Suboxone were only allowed to treat up to 100 patients with the drug. While the White House’s move will expand access to the drug, Suboxone still remains one of the only medications with a federally-mandated prescription cap.
“I think that HHS needs to remove the cap altogether,” said Dr. Andrew Kolodny, chief medical officer of Phoenix House, a New York rehabilitation nonprofit, adding that the government was likely “lobbied aggressively” by pharmaceutical representatives to keep the limit in place.
Kolodny is also the executive director of Physicians for Responsible Opioid Prescribing, where he’s been fighting for tighter regulations on the actual opioid-based pain medications that force people to access addiction treatment in the first place. These drugs, like OxyContin or Percocet, have never faced prescription limitations. http://thinkprogress.org/health/2016/03/22/3762456/fda-update-labels-opioids/“Doctors can prescribes thousands,” Kolodny said. “And they aren’t required to warn patients about the addictive qualities…some of them aren’t even aware themselves. I would like to see limits and real regulations on these types of drugs.”
This new rule won’t replace the all-encompassing efforts to address the opioid epidemic that are currently on hold in Congress.
Kolodny said he supports the Comprehensive Addiction and Recovery Act (CARA), the hefty piece of legislation currently stalled in Congress, and agrees with the congressional Democrats demanding its fully-funded passage. Like other major public health bills delayed in Congress — the continued argument over funding a response to Zika, for one — the disagreement comes down to lawmakers’ views on the federal budget. Republican lawmakers aren’t willing to sign off on the entire $1.1 funds initially requested by Obama. But many Democrats say they won’t okay a compromise bill unless it includes that total amount.
“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,” said HHS Secretary Sylvia Burwell in a press release.