Nurse Practitioners and Physician Assistants Now Eligible to Prescribe Buprenorphine

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Nurse practitioners and physician assistants will now be eligible to prescribe and dispense the opioid addiction treatment buprenorphine from their office, Reuters reports. The Drug Enforcement Administration said the change will make it easier for residents of underserved areas to receive treatment for opioid addiction. The new rule is a result of the Comprehensive Addiction and Recovery Act (CARA), passed in 2016. The law expanded access to substance use treatment services and overdose reversal medications by extending the privilege of prescribing buprenorphine in office-based settings to qualifying nurse practitioners and physician assistants. CARA requires that nurse practitioners and physician assistants complete 24 hours of training to be eligible to prescribe buprenorphine. “This action reflects this work and the ongoing need to further expand access to the most effective treatment for opioid use disorder,” David Fiellin, Professor of Medicine, Emergency Medicine and Public Health at Yale School of Medicine, told Reuters....
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Increasing Availability of Medication-Assisted Treatment Using Buprenorphine

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Many people who need treatment for substance use disorders are not receiving it. Though there are many physicians with waivers to provide buprenorphine for medication-assisted treatment, they tend to be clustered in and around urban centers,leaving many rural counties without access to treatment. In fact, 60.1 percent of rural counties in the United States lack a physician with a DATA 2000 waiver to prescribe buprenorphine. To widen the availability of medication-assisted treatment using buprenorphine, the 2016 Comprehensive Addiction and Recovery Act authorized SAMHSA to allow nurse practitioners (NPs) and physician assistants (PAs) to apply for waivers to prescribe buprenorphine to treat opioid addiction. To receive the DATA 2000 waiver, NPs and PAs must complete 24 hours of training (triple the 8 hours required of physicians). To make training more accessible to NPs and PAs, including those in remote areas, SAMHSA offers the training free through the Providers' Clinical Support System...
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Many Doctors Who Prescribe Buprenorphine Could Be Treating More Patients

Many Doctors Who Prescribe Buprenorphine Could Be Treating More Patients
Many doctors who are allowed to prescribe buprenorphine to treat opioid addiction are treating many fewer patients than they could be, a new study finds. More than 20 percent of doctors who have government waivers to prescribe buprenorphine treated three or fewer patients, and fewer than 10 percent treated more than 75 patients, NPR reports. The study, published in the Journal of the American Medical Association , was conducted when doctors were allowed to treat up to 30 patients at a time for the first year, and then up to 100 patients after that. This summer, Secretary of Health and Human Services (HHS) Secretary Sylvia Burwell announced doctors will now be able to treat up to 275 patients if they have additional credentialing in addiction medicine or addiction psychiatry from a specialty medical board and/or professional society, or practice in what the HHS deems a qualified setting.
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New Technology Aims to Improve Buprenorphine Treatment in Young Adults

New Technology Aims to Improve Buprenorphine Treatment in Young Adults
When addiction treatment specialist Zev Schuman-Olivier, MD, found that young adults taking buprenorphine to treat their opioid addiction often stopped using the medication, he began looking for a novel way to address the problem. He is now testing an integrated mobile system that incorporates smartphone videoconferencing and a secure electronic medicine dispenser to allow young adults to take their daily buprenorphine at home, under remote supervision of a recovery coach. The system, called “ MySafeRx ,” allows a person taking buprenorphine at home to have a daily videoconference with a mobile recovery coach. After a recovery check-in, the coach uses the MySafeRx Android smartphone app, which has been designed to interface with the Medicasafe pill dispenser, to request a unique access code, which the coach releases through the app to the participant’s smartphone. The participant enters the code into the medicine dispenser, which then releases that day’s buprenorphine dose. By...
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Veterans With Pain, PTSD and Substance Use Disorders May Benefit from Buprenorphine

Veterans With Pain, PTSD and Substance Use Disorders May Benefit from Buprenorphine
Buprenorphine may be more effective than opioid therapy in treating symptoms of post-traumatic stress disorder (PTSD) in veterans struggling with chronic pain, PTSD and substance use disorders, a new study suggests. Researchers found twice as many veterans treated with buprenorphine experienced improvement in PTSD symptoms, beginning at eight months and improving up to 24 months. In contrast, symptoms worsened for veterans treated with opioids, Medscape reports. The study included 382 veterans of the Iraq and Afghanistan wars who were diagnosed with chronic pain, PTSD and substance use disorders. The researchers found 23.7 percent of veterans in the buprenorphine group experienced significant improvement in PTSD symptoms, compared with 11.7 percent of those treated with moderately high doses of opioids. “We rarely see patients who have isolated, chronic pain; and, for that matter we rarely see patients who have isolated PTSD or isolated opioid use disorder,” said lead author Karen Seal, MD,...
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Shortage of Opioid Treatment in Vermont Mirrors National Problem

Shortage of Opioid Treatment in Vermont Mirrors National Problem
Almost 500 people in Vermont are on waiting lists to receive medication to treat their opioid dependence, Stateline reports. More than half will wait almost a full year. Vermont has 248 doctors licensed to prescribe buprenorphine, the article notes. Most treat only their existing patients who have opioid dependence. Last month, Stateline reported that despite the rising rate of addiction to opioids, a relatively small number of doctors nationwide are authorized and willing to prescribe buprenorphine to treat opioid addiction. Fewer than 32,000 doctors are authorized to prescribe the treatment, and most doctors with a license to prescribe buprenorphine seldom, if ever, use it. In contrast, more than 900,000 U.S. doctors can write prescriptions for painkillers such as OxyContin, Vicodin and Percocet. Studies have found that opioid addiction medicines like buprenorphine, which is approved by the Food and Drug Administration, offer a much higher chance of recovery than treatments not...
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Small Number of Doctors Prescribing Buprenorphine

Small Number of Doctors Prescribing Buprenorphine
Despite the rising rate of addiction to opioids, a relatively small number of doctors are authorized and willing to prescribe buprenorphine to treat opioid addiction, according to Stateline . Fewer than 32,000 doctors are authorized to prescribe the treatment, and most doctors with a license to prescribe buprenorphine seldom if ever use it, the article notes. In contrast, more than 900,000 U.S. doctors can write prescriptions for painkillers such as OxyContin, Vicodin and Percocet. Studies have found that opioid addiction medicines like buprenorphine, which is approved by the Food and Drug Administration, offers a much higher chance of recovery than treatments not involving medication, according to Stateline. Under an agreement with the federal government, California’s county-run Medicaid programs are scheduled to begin covering a full set of addiction treatment options recommended by the American Society of Addiction Medicine, including opioid addiction treatments. Unlike methadone, which is dispensed at clinics under...
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