DEA Relaxes Buprenorphine Prescribing Rules  to Boost Rural Opioid Addiction Treatment

DEA Relaxes Buprenorphine Prescribing Rules to Boost Rural Opioid Addiction Treatment

The U.S. Drug Enforcement Administration (DEA) has "deregulated" some restrictions on who is allowed to prescribe buprenorphine, to help expand the availability of treatment for opioid use disorder in underserved rural areas where there are few doctors.

Under the new rules, mid-level Nurse Practitioners and Physician Assistants now can register with the DEA to prescribe and dispense buprenorphine, along with physicians.

Before the enactment of the Drug Abuse Treatment Act (DATA) in 2000, only physicians could treat opioid addicts, and they had to register with the DEA both as physicians and also as operators of Narcotic Treatment Programs.

DATA waived the second requirement of an operator of a Narcotic Treatment Program. This new category, called "DATA-Waived," meant that many more physicians were able to sign up and offer treatment services. Unfortunately, not many have done so - at least not as many as was hoped.

With the DEA's latest ruling, which conforms with the historic Comprehensive Addiction and Recovery Act (CARA) signed into law in 2016, it's hoped many more people can be served. Be sure to read more about the landmark CARA legislation, which we explain here.

"Because the vast majority of DATA-Waived physicians prior to CARA served urban areas, rural parts of the United States were underserved," the DEA said. "This action provides more treatment options for addicts in rural parts of the country."

If practitioners respond as hoped and many more become DATA-Waived prescribers, it could have a big impact on treatment in rural America. And rural America needs all the help it can get.

Urban vs rural

Everyone knows that prescription and illicit drug abuse is a leading cause of accidental death in America - more than 64,000 deaths in 2016 from drug overdoses.

The news, movies and TV suggest it's a big city problem.

Not so.

A new study by the CDC shows that rural America leads the nation in per-capita drug overdose deaths -well ahead of urban America.

"In 1999, drug overdose death rates for urban areas were higher than in rural areas (6.4 per 100,000 population versus 4.0 per 100,000)," the CDC says. "The rates converged in 2004, and in 2006 the rural rate began trending higher than the urban rate. In 2015, the most recent year in this analysis, the rural rate of 17.0 per 100,000 remained slightly higher than the urban rate of 16.2 per 100,000."

The need for more help with opioid use disorder in rural America was made abundantly clear in a recent report from the National Rural Health Association (NRHA):

  • 90 percent of treatment-registered physicians practice in urban counties
  • 53 percent of rural counties have no physician able to prescribe medication to help treat opioid use disorder
  • 30 million Americans live in rural counties where no treatment is available
  • 92 percent of substance use treatment facilities are located in urban areas.

As a result, said the NRHA, rural patients seeking outpatient buprenorphine treatment frequently have to travel long distances to access care. Meanwhile, the few rural providers say demand exceeds their capacity to help, because they "lack the resources to adequately support themselves and patients in treatment."

Using buprenorphine

At Novus, we consider the use of buprenorphine a useful medication as a component of medication assisted treatment.

Over the years, and for many reasons, the idea has grown that medications such as buprenorphine (Subutex), buprenorphine plus naloxone (Suboxone), and even methadone, are treatments for opioid use disorder by themselves.

Please understand that medication alone is not treatment. As described by government and public health agencies at all levels, MAT means using an approved medication while concurrently offering meaningful counseling to an individual with a substance use disorder.

At Novus, we are focused on providing the most effective medical detox available, using all the tools available to help someone achieve their first step on the way to a sustainable sobriety.

If you or someone you care for has a problem with opioids, don't hesitate to call Novus.

Start Your New Path to Sobriety Today!

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