As the United States government searches for leverage in the battle against the opioid epidemic, several recent developments have altered the way medication for opioid use disorder (MOUD), such as buprenorphine, can be prescribed. While some of these changes have increased accessibility to buprenorphine, others threaten to hinder access. With opioid overdoses continuing at a harrowing rate, it’s hoped that more emphasis will be made on truly broadening access to this potentially life-saving medication.
Addiction Treatment During the COVID-19 Pandemic
To help prevent the spread of COVID-19 in 2020, the Drug Enforcement Agency (DEA) paired with Substance Abuse and Mental Health Services (SAMHSA) to roll out relaxed prescribing guidelines for addiction treatment medication. This allowed physicians to write buprenorphine prescriptions via telehealth.
With this change, people with opioid use disorders could receive MOUD treatment without meeting with their physician in the office. Since some people must travel outside their area of residence to access buprenorphine, the change was embraced by many. The new telehealth rule was only expected to be temporary, but because it removed barriers to care it went on to gain widespread support in the addiction treatment field.
The Biden administration took further measures to broaden MOUD access in the spring of 2021 by announcing the elimination of the “X waiver.” Having been in effect since the passage of the Drug Addiction Treatment Act of 2000, the X waiver required physicians to complete a course before prescribing MOUD treatment. Without the X waiver requirement, any physician with the power to prescribe scheduled substances can prescribe buprenorphine.
According to the White House Office of National Drug Control Policy, about 130,000 providers had an X waiver. Now that the requirement is gone, two million prescribers can give buprenorphine to people with opioid use disorders.
Ongoing Developments in the Regulation of Controlled Substances
Some of the momentum gained in the last few years appears to be slowing now. While buprenorphine remains more accessible than methadone, another common medication used to treat opioid use disorders, the latest proposed regulations will push back its accessibility to a degree.
After the Biden administration proposed in 2022 that MOUD’s availability via telehealth should be a permanent option, the DEA released a proposal in early March that would restrict buprenorphine access through virtual means. The proposal, which applies to all controlled substances, specifies that buprenorphine may be prescribed in a 30-day supply by telemedicine. Before that 30-day period ends, the patient will be required to meet in-person with their physician if they wish to continue their treatment.
To some, this is a necessary regulation that will help prevent the unethical prescribing of dangerous drugs, but to others its overreaching, ultimately making it more difficult for patients to maintain their recovery plan. There has also been criticism of buprenorphine’s status as a Schedule III substance, as some feel that it shouldn’t be so strictly regulated. But unless the DEA decides to amend the drug’s status, its availability will remain the same.
While the final ruling on buprenorphine’s availability through telehealth remains undetermined, it’s important that those struggling from opioid use disorders are aware that there are telemedicine options available to them. MOUD treatment can provide much needed stability to those in recovery. By curbing cravings, lessening withdrawal symptoms, and lowering the chances of relapse, this medication can play a significant role in helping people attain long-term recovery.
If you or a loved one is struggling with alcohol addiction or a substance use disorder, call Spectrum Health Systems today at 1-877-MyRehab.