The Obama administration on Wednesday announced a change that will allow doctors who prescribe medication that helps opioid addicts the leeway to treat more patients.
Under current regulations, doctors who write prescriptions for buprenorphine, known by the trade name Suboxone, are limited to 100 patients in their caseload. The change set to take effect later this year will increase that number to 275 under certain conditions.
“We have to turn the tide of this epidemic,” said U.S. Health and Human Services Secretary Sylvia Mathews Burwell. “The opioid epidemic is one of the most pressing public health issues in the United States.”
For some larger clinics in New Mexico that specialize in addiction treatment, the change might help more patients because doctors who meet the requirements for certification and training will be able to serve them.
New Mexico has one of the highest overdose death rates in the United States, and many of those fatalities are in rural counties — such as Rio Arriba, San Miguel and Taos — that might not have adequate treatment centers. The real challenge for a rural, geographically large state such as New Mexico is to get more primary care doctors certified to treat addiction in their own practices, said Dr. Wendy Johnson, clinical director for La Familia Medical Center in Santa Fe.
“The biggest barrier in this state to Suboxone is the initial barrier to treating the first 30 [patients],” Johnson said. “If we can get every doctor to see 10 or 20 so it’s a normal part of primary care, that would be great.” La Familia has seven certified Suboxone prescribers who serve some 170 patients, including pregnant women, she said.
She said credentialing is part of the obstacle for many doctors, as is the need for case-management services and counseling that addicts often need along with Suboxone.
Johnson also said most primary care providers want a varied patient load, so treating the maximum 275 addiction patients under the new guidelines is not something they would particularly want. “We want varied patients and patients of all ages. That’s why we became general practice doctors,” she said.
Unlike methadone, which has to be administered in a clinic, Suboxone can be taken anywhere. It has some ingredients that help addicts experience a high, but it is more limited and without overdose risks. Critics of the drug say it can easily be sold or exchanged for heroin or opioids and is more easily smuggled into jails.
President Barack Obama also is asking Congress to pass the Opioid and Heroin Abuse Crisis Investment Act, which calls for $1.16 billion in support of expanded treatment, drug monitoring programs, safe prescribing programs as well as funding for residential substance abuse treatment.
The measure is being considered in the U.S. House of Representatives, which has scaled back some of the provisions.
Contact Bruce Krasnow at email@example.com.