By Kelsey C. Priest, Alex K. Gertner: For More Info, Go Here…
On April 8, 2019, a coalition of health leaders from 22 US states and territories published a letterto the secretary of the Department of Health and Human Services (HHS) Alex Azar requesting “urgent federal action” to remove barriers to pharmacotherapy for persons with opioid use disorder (OUD). Federal authorities should heed this message and act as soon as possible. But in the meantime, there is plenty state leaders can do to enhance access to life-saving OUD treatments in their own jurisdictions.
First-line OUD treatment is opioid agonist therapy (OAT), which includes buprenorphine (with or without naloxone) and methadone. Buprenorphine and methadone are long-acting opioids that decrease opioid withdrawal symptoms and cravings while blocking the effects of short-acting opioids such as heroin. Decades of evidence support the use of OAT to reduce risky opioid use. OAT is endorsed by the World Health Organization, the American Society of Addiction Medicine, and recently the National Academies of Science, Engineering, and Medicine.
Despite official endorsements and decades of research, US federal policies surrounding OAT remain complex, restrictive, and antiquated. In their letter, state health officials recommend reforming an important federal OAT policy—the Drug Addiction Treatment Act (DATA 2000)—to meet the public health needs of the twenty-first century. DATA 2000 requires providers to undergo additional training to obtain a special Drug Enforcement Agency (DEA) certification—the X-waiver—before prescribing buprenorphine. Additionally, the policy limits the number of buprenorphine prescriptions a provider can write. These waiver requirement and prescribing restrictions do not exist for any other medication, including opioids prescribed for pain. Methadone for OUD treatment is even more federally restricted, dating back to laws and regulations enacted in the early 1970s.
In the letter to Secretary Azar, health leaders called for legislative action to remove the DATA 2000 restrictions to allow health professionals already registered with the DEA to prescribe buprenorphine without an X-waiver. Recently proposed federal legislation aims to do just that, with the Mainstreaming Addiction Treatment Act, sponsored by Representatives Paul Tonko (D-NY), Antonio Delgado (D-NY), Ben Ray Lujan (D-NM), Ted Budd (R-NC), Elise Stefanik (R-NY), and Mike Turner (R-OH).