HHS Unveils New Rules for Doctors Treating Opiate Drug Abuse

With the U.S. in the thick of what’s been called a pre­scrip­tion-paink­iller epi­dem­ic, the Health and Hu­man Ser­vices De­part­ment an­nounced plans to change a rule re­strict­ing doc­tors from pre­scrib­ing med­ic­a­tion to treat opioid ab­use.

Coup­ling medi­cine with coun­sel­ing and be­ha­vi­or­al ther­apy is a com­pre­hens­ive path to re­cov­ery, ac­cord­ing to HHS, but of the 2.5 mil­lion people who need treat­ment for an opioid use dis­order, less than 1 mil­lion people are re­ceiv­ing it. The Thursday an­nounce­ment—aimed at in­creas­ing ac­cess to treat­ment—fo­cuses on a reg­u­la­tion lim­it­ing the num­ber of pre­scrip­tions doc­tors can write for bupren­orphine, a medi­cine used to com­bat paink­iller and heroin de­pend­ence.  

The cur­rent rule: Phys­i­cians cer­ti­fied to pre­scribe the med­ic­a­tion, at first, can only do so for 30 pa­tients. After a year, they can be al­lowed to write pre­scrip­tions for up to 100 pa­tients. The de­part­ment an­nounced this would change, but fell short of say­ing ex­actly what the new reg­u­la­tion would be.

“This epi­dem­ic is mul­ti­fa­ceted, and we need to re­spond with the best solu­tions that medi­cine and be­ha­vi­or­al ther­apy can provide to­geth­er,” HHS Sec­ret­ary Sylvia Bur­well said Thursday at a two-day, 50-state meet­ing aimed at find­ing solu­tions to the rise in opioid use. “So we need to in­crease the use of bupren­orphine, which can help us treat opioid use dis­order when com­bined with psy­cho-so­cial sup­port.”

Ad­di­tion­ally, the de­part­ment’s Of­fice of Rur­al Health Policy will dole out about $1.8 mil­lion in grants to com­munity part­ners in 13 states. This comes on the heels of a White House an­nounce­ment last week that the ad­min­is­tra­tion is us­ing $500 mil­lion au­thor­ized by the Af­ford­able Care Act in part to give com­munity health cen­ters more re­sources to treat pa­tients with al­co­hol and drug ad­dic­tion.

That’s be­cause pre­scrip­tion drugs and their cheap­er al­tern­at­ive—heroin—have hit com­munit­ies hard in re­cent years. From 2002 to 2013, the num­ber of heroin-re­lated deaths nearly quad­rupled to 8,200, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion. And from 1999 to 2013, paink­iller-re­lated deaths nearly quad­rupled to 16,000, the CDC re­ports.

Cap­it­ol Hill, the White House, and pres­id­en­tial can­did­ates are tak­ing no­tice. In May, Sens. Rand Paul and Ed­ward Mar­key in­tro­duced a bill that would, like the ad­min­is­tra­tion’s Thursday an­nounce­ment, in­crease ac­cess to bupren­orphine. In Au­gust, the ad­min­is­tra­tion an­nounced it would fun­nel $5 mil­lion in­to re­du­cing the traf­fick­ing, dis­tri­bu­tion, and use of heroin. This month, Demo­crat­ic front-run­ner Hil­lary Clin­ton un­veiled a $10 bil­lion plan to treat drug and al­co­hol ad­dic­tion and fo­cus on treat­ment rather than jail time.

Dur­ing Bur­well’s an­nounce­ment to ex­pand ac­cess to med­ic­a­tion-as­sisted treat­ment, she in­voked the story of a young wo­man from Den­ver, named Blair Hub­bard. Hub­bard was a “good kid,” Bur­well said, who be­came ad­dicted to paink­illers after her wis­dom teeth were re­moved and then turned to heroin. After a near death ex­per­i­ence, Hub­bard got help—and it was a com­bin­a­tion of med­ic­a­tion and ther­apy that helped kick-start her sobri­ety.

“The solu­tion to this prob­lem is not go­ing to be easy, but Blair’s fight wasn’t easy either,” Bur­well said. “For her and for all of our neigh­bors up against opioid ab­use, we have to fight just as hard. Good in­ten­tions are not enough. We must act today.”

(Image via Mukhina Viktoriia/Shutterstock.com)