New Guidelines for Opioid Treatment Offer Hope

Pill Bottle Spilled Out

As deaths from dug overdose continue to increase, the Biden Administration has announced a key change affecting the prescription of buprenorphine.

The policy, first proposed in January during the Trump Administration, eliminates training requirements for the prescription of buprenorphine and expands eligibility to nurse practitioners, physicians assistants, and certified nurse midwives.

Before the change, healthcare workers were forced to take an 8-hour course before they could prescribe buprenorphine. This requirement caused many healthcare workers to avoid the drug entirely.

Buprenorphine is a partial opioid agonist that eases the withdrawal symptoms of opioid use disorder (OUD) by producing effects similar to, but much weaker than, opioids including pain relief, euphoria, and respiratory depression.

When taken as prescribed, the FDA considers buprenorphine a safe and effective treatment. In most cases, it is prescribed in conjunction with counseling and behavioral therapy. Buprenorphine can be addictive, but not to someone suffering from OUD. To decrease the likelihood of diversion (sharing or selling a prescribed drug) and misuse, manufacturers add naloxone to the drug.

“Buprenorphine is probably one of the most effective ways that we have for preventing people from overdosing from all of the opioids that are out there in the black market,” explains Dr. Nora Volkow, director of the National Institute on Drug Abuse.

“I would like to call it a big deal becuase it is, again, bringing forwards the treatment of opioid use disorder as for other diseases,” says Volkow. “We don’t have any other medical conditions where you as a doctor are told, ‘By the way, you can only prescribe these medications if you go through this special training and you get a waiver.’”

The deregulation of buprenorphine marks President Biden’s first major action on drug overdose – a threat to public health many have described as an “epidemic.”

“Many people will say this has gone too far, but I believe more people will say this has not gone far enough,” says Brett Giroir, who served as assistant secretary for health during the Trump Administration. “This is a measured, logical, appropriate, evidence-based, and patient-centered intervention that may save tens of thousands of lives.”

More than 90,000 Americans died as a result of drug overdose last year, roughly 20,000 more than the year previous. It is unknown but likely that COVID-19 and the difficulties associated with it contributed to the increase.

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