Health workers with legal prescribing privileges once again obtained revised federal guidelines making it easier for them to help addicts to strong opioid pain relievers by prescribing buprenorphine, another strong medicine.
This action could be beneficial in tackling the opioid abuse and drug overdose crisis that has diminished in recent times, then worsened during the coronavirus pandemic, killing hundreds of thousands of Americans in total. .
As the Washington Post reported on the latest decisions from regulators:
“Doctors, physician assistants, nurse practitioners and other health care providers will no longer need to undergo training before they are allowed to prescribe. [this] form of treatment known to reduce overdose deaths. Studies have shown that people who take the drug are less likely to develop HIV or hepatitis C, or to be unemployed or imprisoned. “
Congress had passed laws requiring prescribers not only to obtain federal clearance, but also to undergo special training and counseling before receiving an “X waiver” to use buprenorphine with patients. This was done because experts feared early on that the drug, itself a type of opioid, could create its own nightmares if used too freely. But the X waiver has become a barrier to wider and appropriate use of a drug that has been shown to be less harmful than methadone and beneficial in treating the opioid addict.
This is how the Pharmacology experts from the Oregon University of Health and Sciences describe buprenorphine:
“Buprenorphine, approved by the Food and Drug Administration in 2002, relieves withdrawal symptoms and pain, and normalizes brain function by acting on the same targets in the brain as prescription opioids or heroin. It is one of three drugs approved by the FDA to treat opioid dependence, along with methadone and naltrexone. “
The Trump administration has attempted to ease the prescription of drugs at the end of its term. But officials in the Biden administration said the rushed executive decree of their predecessors was legally problematic and overturned it. For several months, the buprenorphine prescribing process was again scrambled and the current administration strained for it. As the Washington Post reported, however:
“Under the new guidelines, physicians and other health care professionals must still apply for an exemption from the Drug Enforcement Administration, but they no longer need to undergo training, as long as they do not prescribe the drug for more than 30 patients at a time. . “
Experts welcomed the new guidelines, the newspaper also noted:
Patrice A. Harris, outgoing president of the American Medical Association and chair of its opioid task force, said the guidelines are “a critically important first step” that removes “burdensome and stigmatizing requirements Which discouraged doctors from being certified to prescribe buprenorphine. . But Harris and other doctors have called on Congress to pass legislation that would remove waivers for prescribing the drug, rather than just making it easier to get clearance. Miriam Komaromy, medical director of the Grayken Center for Addiction at Boston Medical Center, predicted that the new rules will have “a measurable but modest effect.” Komaromy said the guidelines could help a doctor or other practitioner “get a taste of doing this kind of work,” by requesting a waiver without taking the time for training. Still, she said, requiring specific federal authorization to prescribe the treatment has a chilling effect. “This will not be the solution we are looking for,” she said, “to overcome the epidemic of opioid overdose”.
The opioid crisis – which federal experts have estimated 500,000 dead between 1999 and 2019 – persists as a major public health threat, The Washington Post reported:
“Preliminary federal figures suggest that 90,000 people in the United States have died of drug overdoses in the 12 months ending in September, a record number. Almost 67,000 of them were fatal opioid overdoses. “
In my practice, I see not only harm suffered by patients when seeking medical services, but also the harm that can be done to them by dangerous drugs. Over the years, Big Pharma, doctors, hospitals, insurers and other healthcare players – fueled by a relentless and excessive surge in profits – created the opioid overdose crisis. The abuse of strong painkillers, especially synthetic varieties, has also opened the door to nightmares with overdoses, especially illicit drugs.
So far, it has taken Herculean efforts to deal with the mess, including dragging drugmakers into long and costly court battles, and with expensive interventions from federal, state and local governments to help far too many people. addicted, debilitated and overdosed. This is a good step in carefully authorizing drug treatment for people with opioid abuse problems. But we still have a lot of work to do to address this deadly public health challenge.