Dismantling Buprenorphine Policy Can Provide More Comprehensive Addiction Treatment

Woodruff, Alex; Tomanovich, Mary; Beletsky, Leo; Salisbury-Afshar, Elizabeth; Wakeman, Sarah E.; Ostrovsky, Andrey

doi:10.31478/201909a

Cited by 8 publications

(10 citation statements)

References 15 publications

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“…The Substance Abuse and Mental Health Services Administration (SAMHSA) certifies opioid treatment centers (OTCs) and approves them to dispense controlled opioid treatment medications such as methadone and buprenorphine [31,32,33]. Under the provisions of the Drug Addiction Treatment Act of 2000 (DATA), buprenorphine can also be prescribed outside of an OTC, in a doctor's office setting, so long as the physician has received a waiver from SAMHSA (buprenorphine can be prescribed for pain without a waiver) [34]. The DATA Act also reduced record keeping requirements for physicians who prescribe buprenorphine, and recent additional legislative changes raise the number of patients a physician can treat at any one time [34].…”

Section: Opioid-related Death Rates and Change In Death Rates By Counmentioning

confidence: 99%

“…Under the provisions of the Drug Addiction Treatment Act of 2000 (DATA), buprenorphine can also be prescribed outside of an OTC, in a doctor's office setting, so long as the physician has received a waiver from SAMHSA (buprenorphine can be prescribed for pain without a waiver) [34]. The DATA Act also reduced record keeping requirements for physicians who prescribe buprenorphine, and recent additional legislative changes raise the number of patients a physician can treat at any one time [34]. Provider training for MAT has also become more available, and the number of newly certified practitioners who can prescribe the medication has increased every year since 2002 in North Carolina [35].…”

Section: Opioid-related Death Rates and Change In Death Rates By Counmentioning

confidence: 99%

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Tracking Trends in the Opioid Epidemic in North Carolina : Early Results from the Opioid Action Plan Metrics

Jones

Luo

Mansfield

et al. 2020

North Carolina Medical Journal

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background Deaths from unintentional opioid overdose have increased markedly over the last decade in North Carolina. In 2017 the state created a North Carolina Opioid Action Plan, which laid out a multisectoral response to the crisis that included the medical community, law enforcement, emergency medical services, and treatment professionals. It also created a website providing county-level data associated with the crisis. Using this publicly available data, we examine trends and associations between opioid-related mortality and strategies to reduce opioid prescriptions, reduce fatality of overdose, and improve treatment and recovery. method We examine yearly trends from 2010-2017 for statewide unintentional opioid-related death rates, prescription of opioid pills, buprenorphine prescription rates, naloxone administrations, and number of Certified Peer Support Specialists. We compare recent opioidrelated death rates for 2015-2017 with an earlier period (2010-2012) at the county level, and examine the association between death rates and rates of the supply, treatment, and recovery metrics. results Trends for all metrics increased from 2010-2017, although the number of opioid pills per capita has declined since 2015. Between 2010 and 2017, 84 of the state's 100 counties experienced an increase in opioid-related mortality. County-level mortality was positively associated with opioid prescription rate (r = +0.12, P = 0.24) and with naloxone administrations (r = +0.20, P = 0.05). Prescription of buprenorphine was associated with a reduction in opioid mortality (r =-0.27, P = 0.01). The effect of Certified Peer Support Specialists was not discernable. limitations Data are available for only eight years and aggregated at the county level. Mortality data are based on death certificates using ICD-10 codes from the North Carolina State Center for Health Statistics, Vital Statistics, which may not capture all opioid-related fatalities. Drug-related deaths may involve multiple non-opioid substances; in addition, determining the intent of the deceased individual may be difficult (suicide versus unintentional). Naloxone administration data only includes data from emergency medical services, not communityadministered naloxone, because that data was only available for 2013 and later and is based only on self-reports. conclusions The potential efficacy of buprenorphine is promising and should be further explored. All interventions should be monitored.

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Section: Opioid-related Death Rates and Change In Death Rates By Counmentioning

confidence: 99%

Section: Opioid-related Death Rates and Change In Death Rates By Counmentioning

confidence: 99%

Tracking Trends in the Opioid Epidemic in North Carolina : Early Results from the Opioid Action Plan Metrics

Jones

Luo

Mansfield

et al. 2020

North Carolina Medical Journal

View full text Add to dashboard Cite

show abstract

“…A lack of adequate baseline education on opioid use disorder, associated stigma, and financial concerns are all reasons physicians report for not receiving a DATA waiver. 64 Another major concern physicians express is the increased regulatory scrutiny from both DEA and local law enforcement. The administrative burdens and ongoing anxiety of inspections from a legal body intimidate some physicians and act as a deterrent to going through the DATA waiver process.…”

Section: Increasing Access To Buprenorphinementioning

confidence: 99%

“…The administrative burdens and ongoing anxiety of inspections from a legal body intimidate some physicians and act as a deterrent to going through the DATA waiver process. 64 Among physicians who do have a DATA waiver, many do not see the max allotment of patients per year. 64 Recently, physician assistants and nurse practitioners were permitted to receive a DATA waiver to prescribe buprenorphine as pharmacotherapy for opioid use disorder.…”

Section: Increasing Access To Buprenorphinementioning

confidence: 99%

“…64 Among physicians who do have a DATA waiver, many do not see the max allotment of patients per year. 64 Recently, physician assistants and nurse practitioners were permitted to receive a DATA waiver to prescribe buprenorphine as pharmacotherapy for opioid use disorder. While this marginally increases the number of providers capable of managing buprenorphine, a large treatment gap still remains.…”

Section: Increasing Access To Buprenorphinementioning

confidence: 99%

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