HHS Issues New Buprenorphine Guidelines
On January 12, 2021, the U.S. Department of Health and Human Services (HHS) released new relaxed guidelines for the distribution of buprenorphine a common treatment for Opioid Use Disorder (OUD).
The new guidelines eliminate the requirement for physicians to take training and obtain a special federal waiver to prescribe buprenorphine to their patients, thus allowing for greater access to buprenorphine that was designed to reduce withdrawal symptoms and cravings opioids such as hydrocodone, oxycodone, morphine, and codeine. Previously, doctors were required to take an eight-hour training course to receive the waiver.
Under the new guidelines, doctors registered with the U.S. Drug Enforcement Administration (DEA) will still be limited to prescribing buprenorphine to no more than 30 in-state patients at any one time. Hospital-based physicians, such as ER doctors, will be exempt to this because they are usually no longer treating a patient after they leave their care.
The HHS announcement cited increasing rates of opiate overdoses and deaths resulting from overdoses as the basis for the new guidelines and stated that Medicine Assisted Treatment – recovery treatment that also includes counseling, behavioral therapy and treatment of comorbidities – is “the gold standard” for treatment of OUD.
According to the CDC, more than 83,000 people died of drug overdoses in the 12 months ending in June 2020, the highest number ever recorded in a one-year period.
The exemption applies only to physicians and only for the prescribing of drugs such as buprenorphine. It does not apply to prescribing of methadone. Physicians and other medical professionals, such as nurse practitioners and physician assistants, can still apply for waivers to prescribe buprenorphine described under the previous policy.
The American Medical Association (AMA), which has been lobbying for this change in regulations for the last year, emphatically endorsed the new policy.
In a January 14 statement, the AMA stated that this change allowed physicians can now manage their patients’ other medical conditions while also being able to treat them for their opioid use disorder. “Ensuring physician-led teams for treating patients with opioid use disorder is critical to ending the opioid epidemic. Removing the waiver requirement can also help lessen the stigma associated with this treatment and the persistent health disparities in treating substance use disorders.”
If you think you or a loved one are suffering from substance use or OUD, seek treatment by contacting a medical professional.