Pandemic rule change could make it easier to get treatment for opioid addiction in Alaska

Physician Assistant Sarah Martin sits at the front desk of Ideal Option, a drug-assisted addiction treatment clinic in Juneau. (Kavitha George / KTOO)

Doctors in Alaska have obtained temporary state permission to use telehealth to prescribe a controlled, but life-saving drug used to treat opioid addiction. State officials say they would like to make the change permanent.

Once a patient says they are ready for treatment, doctors like Dr. Janice Sheufelt want to give them the drug that prevents withdrawal symptoms as soon as possible.

“Honestly, even a few days makes a difference due to the number of people dying from opioid overdoses in our state,” she said.

She was able to get around a significant barrier to caring for people addicted to opioids during the pandemic – the clinic visit. That is, until February, when the state emergency ordinance lapsed and the state tightened restrictions on telehealth.

This meant that she and her patients had to make an in-person appointment with another doctor to prescribe the drug, buprenorphine. It is also referred to by its brand name, Suboxone. An extra step, and extra time, when withdrawal symptoms can show up within hours.

“Every patient I talk to tells me about their friends or family who have passed away. So I really think time is running out and even a few days can make a difference. I’ve seen people overdose and die while they waited for treatment, ”said Dr Sheufelt.

Last week, the state medical board approved an emergency order from the state health department to reinstate prescriptions for buprenorphine through telehealth for 120 days. But there was a four-month period when providers had to make in-person appointments to get prescriptions.

Meanwhile, Dr Sheufelt says more than 200 patients have requested to start drug treatment at his clinic alone.

The lapse came at a critical time: Hospital visits for overdoses involving heroin have increased dramatically in the state since March. The overdose visits from March to May of this year are more than double the visits from last year over the same period.

State medical council officials declined the taped interviews, but wrote in a statement that the council would work to make the change permanent and allow Alaskan doctors to prescribe and renew buprenorphine prescriptions. without an appointment in person.

“Medication is a key part of helping people with opioid use disorders quit,” said Jeannie Monk, senior vice president of the Alaska State Hospital and Nursing Home Association, or ASNHAH.

She testified before the medical board on behalf of the doctors in Alaska who said the change was necessary to help their patients. She said the COVID-19 pandemic had highlighted a real need.

“Because people couldn’t go to doctors and people in rural areas couldn’t travel, giving them access to truly life-saving drugs through telehealth was essential,” she said.

Buprenorphine usually requires an in-person visit for a prescription, as it is classified as a controlled substance. It works to block withdrawal symptoms but does not get users high like heroin or fentanyl does.

“It took a while for the State Medical Council to sort of understand the situation and take action,” Monk said.

Even though current federal and state laws do not allow prescribing this type of drug without an in-person visit, the state medical board is working to keep the exemption in place. He cites high rates of opioid overuse, overdose and death in the state as reasons he will work for permanent change.

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