Obama seeks to loosen restrictions on opioid abuse medication

President Obama announced several new administration actions aimed at combating the country’s deadly opioid epidemic at the National Rx Abuse and Heroin Summit in Atlanta on Tuesday.

Ahead of the annual event, where Obama was slated to speak to law enforcement and medical professionals as well as recovering addicts and their families, the White House released a detailed outline of the president’s new plan.

Perhaps most significant among the actions announced were those related to expanding access to Medication Assisted Treatments, specifically buprenorphine.  Despite its proven success in treating opioid abuse, buprenorphine has been subjected to tight restrictions ever since it was first approved to treat opioid addiction in 2000. Doctors must undergo a special eight-hour training in order to prescribe buprenorphine and, once qualified, they are limited to prescribing the medication to no more than 100 patients at a time. Because buprenorphine is often used as a long-term maintenance medication, these restrictions have resulted in long waiting lists for the small number of qualified physicians, leaving a large percentage of people with opioid addiction without access to treatment. 

U.S. President Obama participates in a National Rx Drug Abuse and Heroin Summit in Atlanta, Georgia, on March 29, 2016. (Photo: Kevin Lamarque/Reuters)

Over the past year, the Obama administration has made made a number of funding-related moves to increase access to Medication Assisted Treatments for opioid abuse, including a $1.1 billion proposal from the president in February. But Tuesday’s announcement included the first specific action to increase the patient limit for qualified buprenorphine prescribers, with the Department of Health and Human Services issuing a proposed rule to lift the cap from 100 patients to 200.

Additionally, this new set of initiatives seeks to further expand access to such medication by increasing the number of physicians who are qualified to prescribe it. The Substance Abuse Mental Health Services Administration, or SAMSHA, plans to organize buprenorphine prescriber training for physicians in states with the greatest need.

The Centers for Disease Control and Prevention has linked the 200 percent increase in fatal opioid overdoses since 2000 to the somewhat simultaneous increase in opioid painkiller prescriptions. However, in February, President Obama rejected a bipartisan proposal from the National Governors Association to combat the country’s opioid epidemic by restricting access to prescription pain medication. 

“If we go to doctors right now and say, ‘Don’t overprescribe’ without providing some mechanisms for people in these communities to deal with the pain that they have or the issues that they have, then we’re not going to solve the problem, because the pain is real, the mental illness is real,” Obama said at the time.

In March, the CDC released a new guideline for physicians prescribing opioids for chronic pain, and Tuesday President Obama announced that, as of fall 2016, 60 different medical schools will now include some sort of prescriber training based on the new CDC guideline as a requirement for graduation.

Among the other actions Obama outlined Tuesday were increases in federal funding for law enforcement programs that aim to crack down on the trafficking of heroin and black-market prescription pills; to equip and train more first responders to administer naloxone, the opioid antidote proven to prevent fatal overdoses; and to ensure that Medicaid and private insurance plans offer affordable coverage for mental health and substance use disorder treatments.

While much of the current opioid epidemic has been tied to an increased access to prescription painkillers, the unsustainable cost of abusing such drugs has inevitably lead to an increase in heroin use and, as a result, a rise in hepatitis C cases in several parts of the country

In an effort to stop the spread of hepatitis C and other bloodborne illnesses, like HIV, that are associated with intravenous drug use, the Obama administration is allowing communities in need to use federal funds to operate clean-syringe service programs.

Finally, the Department of Agriculture will expand its Rural Health and Safety Education Grant Program to tackle specific challenges related to substance abuse in rural communities—which have been among the hardest hit by the opioid epidemic. 

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