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Feds Lift Waiver Requirement for Doctors Prescribing Buprenorphine: What Does This Mean for Medication-Assisted Treatment?

The Federal Department of Health and Human Services has significantly relaxed regulations governing prescribing practices of buprenorphine; a move that can have significant implications for expanding access to medication-assisted treatment. Before leaving office, the outgoing Trump Administration announced that nearly all doctors would be able to prescribe buprenorphine (also referred to as Suboxone® because it’s the active ingredient in the drug).

The move was made, in part, due to the soaring number of overdoses during the COVID-19 pandemic. The Centers for Disease Control and Prevention (CDC) reports that over 81,000 drug overdose deaths occurred in the United States in the 12 months ending in May 2020, the highest number of overdose deaths ever recorded in a 12-month period.

Will It Be Easier to Access Buprenorphine for Medication-Assisted Treatment?

The short answer is yes. Prior to the policy shift, doctors who wished to obtain a buprenorphine waiver, pursuant to requirements from the Substance Abuse and Mental Health Services Administration (SAMHSA), had to complete an eight-hour training program to receive the proper licensure. Under the new policy, any physician with a Drug Enforcement Administration (DEA) prescriber license will be able to treat up to 30 in-state patients with buprenorphine. If they complete the previously required waiver training, they will be able to treat up to 275 in-state patients. Hospital-based physicians will be exempt from the patient cap altogether. Nurse practitioners and physician assistants will still need to apply for the waiver from SAMHSA.

Currently, less than 100,000 care providers (including physicians, nurse practitioners and physician assistants) are licensed to prescribe the drug. The move has faced some backlash from prevention advocates who are concerned about such widespread deregulation of a controlled substance; but it is met with considerable support from many on the front lines of the opioid crisis. Many stakeholders have long been calling for the deregulation of the drug, claiming it will save lives and increase accessibility to medication-assisted treatment.

Does This Deregulation Make Medication-Assisted Treatment Less Safe?

Although this move will undoubtedly increase access to MAT, which many have dubbed the “gold standard of addiction treatment”, it’s still important to seek medication-assisted treatment from a trusted and reputable provider who is familiar with the risks and procedures associated with the use of buprenorphine, as well as what to expect during the treatment process. The reality is that buprenorphine administration, as well as other types of MAT, like methadone and Vivitrol®, is a complex medical procedure that should be handled by a qualified and experienced professional.

It’s also important to realize the MAT is not meant to replace any other aspect of care and should occur as part of a comprehensive opioid addiction treatment program alongside acute withdrawal management and comprehensive behavioral rehab.

Questions to Ask Your Provider

When you’re getting ready to start buprenorphine treatment, it’s natural to have certain questions. Talk to your provider about any and all concerns. Here are some answers to common questions:

How Long Will Treatment Last?

There are three main phases of MAT: Induction (first one to two days), stabilization (several weeks), and maintenance, which varies depending upon patients’ progress and ongoing withdrawal symptoms.

Should I Start Treatment at Home or in the Doctor’s Office?

Generally speaking, it’s better to receive buprenorphine treatment in the office. While you may be marginally less comfortable and have to secure a ride to treatment (driving is not advisable during and after care), your care team is there to check on you and answer questions.

Do I Need to Stop Taking Opioids before Starting Buprenorphine Treatment?

Yes. Before taking your first buprenorphine dose, stop taking all opioids for 12-36 hours. While this may lead to mild to moderate withdrawal symptoms, it’s imperative for maximum efficacy of treatment.

What Symptoms Should I Expect?

While each person’s withdrawal symptoms will vary before starting treatment, some of the more common include restlessness, tremors and shaking, enlarged pupils, joint and muscle pain, goose bumps, anxiety or irritability, chills or sweating, tearing or runny nose and more. It’s recommended that you experience three of these symptoms simultaneously prior to starting your treatment. Your Subjective Opiate Withdrawal Scale (SOWS) should be greater than 17 prior to taking your first dose of buprenorphine.

How Much Should I Take?

The American Society of Addiction Medicine offers comprehensive insights on dosage and scheduling, based on your symptoms and ongoing needs. When taking buprenorphine under the tongue, do not swallow, as swallowing will mitigate its effects.

Finding A Trusted and Reputable Medication-Assisted Treatment Provider

When you or loved one are getting ready to explore any type of medication-assisted treatment as part of an opioid treatment program (OTP), there are several factors to determine in your search, including:

  • Do they take my insurance?
  • How much experience do they have?
  • Do they offer rehab services, too?
  • Is a doctor prescribing the drug?
  • Can they offer additional help with withdrawal?

Recovery Unplugged has been offering medication-assisted treatment to our clients for years and is a trusted and experienced source for your continuum of opioid addiction care. We are an established Florida Vivitrol provider, and have helped thousands of clients just like you or your loved one leverage medication-assisted treatment toward their recovery. Recovery Unplugged accepts most major insurances and is in network with some of the leading providers in the industry, including Aetna, Cigna, Blue Cross Blue Shield of Texas and more.

Don’t Let Just Any Provider Handle Your Buprenorphine Treatment

While the latest regulations allow for increased access to buprenorphine, it’s very important which provider you choose. MAT is just the beginning of your opioid recovery journey. Once your withdrawal symptoms are under control, you can start receiving behavioral rehab to address the root causes and sustaining factors associated with your opioid abuse. Recovery Unplugged is here to help you safely, confidently and successfully take the first step toward MAT, behavioral rehab and lasting recovery. Call us now to start your treatment and take your life back. Our staff is standing by 24-7to conduct a full insurance verification and guide you toward care that best suits your care needs and lifestyle.

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