Tuesday, March 29, 2016

White House Announces Proposal to Raise Cap on Buprenorphine Prescribing

Today, President Obama is announcing a host of public and private sector initiatives addressing the nation’s opioid epidemic, including a proposal to increase the current patient limit for qualified physicians who prescribe buprenorphine to treat opioid use disorders from 100 to 200 patients.

Additionally, more than 60 medical schools are announcing that, beginning in fall 2016, they will require their students to take some form of prescriber education, in line with the newly released Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain, to graduate.

The proposals met with preliminary approval from APA leaders. “These are very important steps to improve the accessibility of buprenorphine,” Frances Levin, M.D. (pictured above), chair of the APA Council on Addiction Psychiatry, told Psychiatric News. “The problem, however, is getting physicians more comfortable prescribing [buprenorphine], since there are already many physicians who are certified but don’t prescribe or underprescribe.

“Training physicians while they are residents is a very good strategy,” she said. “We need a grassroots approach.”

Her comments were echoed by John Renner, M.D., vice chair of the council. “Our survey of addiction clinicians indicates that the majority are not comfortable treating numbers of patients in [the 150-200 patient] range,” he told Psychiatric News. “It is possible that this change will create a number of large buprenorphine practices, but it will not generate the numbers needed to impact the current epidemic. We remain committed to our proposal to expand treatment services by also encouraging a larger number of small buprenorphine practices by expanding clinician training, permitting prescribing by physician assistants and nurse practitioners, and addressing clinicians’ concerns about the system of DEA inspections.”

The president’s remarks were made at the National Rx Drug and Heroin Abuse Summit in Atlanta. Also speaking at the summit was psychiatrist Patrice Harris, M.D., who is chair of the American Medical Association's Task Force to Reduce Opioid Abuse. As part of her remarks, she encouraged physicians to use state Prescription Drug Monitoring Programs.

“We urge physicians to register and use the state prescription drug monitoring program to check a patient's prescription history; educate yourself on managing pain and promoting safe, responsible opioid prescribing; support overdose prevention measures, such as increased access to naloxone; reduce the stigma of substance use disorders and enhance access to treatment; and ensure patients in pain aren't stigmatized and can receive comprehensive treatment.”

For more information, see the Psychiatric News article “Why Aren’t More Physicians Prescribing Buprenorphine?”


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