The goal of many substance abuse treatment paths is a drug-free life. The very achievable goal of every treatment path is improved health and function. Medication may be an important tool for reaching or maintaining these recovery goals. The U.S. Department of Health and Human Services made changes to buprenorphine prescribing policies that may help more individuals reach their goals.

Every treatment path is different. Everyone’s recovery goals and needs are unique. No two people want or need the same thing from recovery. This is why no two treatment plans will be identical. As the Surgeon General’s Report on Alcohol, Drugs, and Health[1] shares,

“Ideally, services are not ‘one size fits all’ but are tailored to the unique needs of the individual. Treatment must be provided for an adequate length of time and should address the patient’s substance use as well as related health and social consequences that could contribute to the risk of relapse, including connecting the patient to social support, housing, employment, and other wrap-around services.”

While patients and their loved ones are often ready to end any reliance on substances, their ultimate goals may be best reached by using medications like buprenorphine. Individuals should talk with their addiction treatment provider to determine the best plan for managing recovery and avoiding relapse. This plan should be adjusted regularly to meet changing needs and personal circumstances.

How Buprenorphine May Help

Buprenorphine is one of several medications that may be part of an overall treatment plan. It is an opioid partial agonist. This means use does come with risks of side effects and abuse. However these risks are low when the drug is used as prescribed. As the Substance Abuse and Mental Health Services Administration[2] (SAMHSA) explains, “Like opioids, [buprenorphine] produces effects such as euphoria or respiratory depression. With buprenorphine, however, these effects are weaker than those of full drugs such as heroin and methadone. Buprenorphine’s opioid effects increase with each dose until at moderate doses they level off, even with further dose increases. This ‘ceiling effect’ lowers the risk of misuse, dependency, and side effects.” In exchange for potential side effects, buprenorphine can be a tool in reducing or ending other opioid use. It is not an answer to addiction.

ceiling-effect-of-buprenorphine-chart-opioid-effect-dose-level-methadone-buprenorphineThe Surgeon General’s Report on Alcohol, Drugs, and Health explains, “The available medications do not by themselves restore the addicted brain to health, but they can support an individual’s treatment process and recovery by preventing the substance from having pleasurable effects in the brain, by causing an unpleasant reaction when the substance is used, or by controlling symptoms of withdrawal and craving.” Buprenorphine can help individuals find and maintain freedom from addiction when used as part of an overall treatment program.

When patients and providers determine buprenorphine is the best choice for beginning or maintaining recovery, the next step is getting a prescription. Buprenorphine is already a more accessible medication than others like methadone. SAMHSA explains, “Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine is the first medication to treat opioid dependency that is permitted to be prescribed or dispensed in physician offices, significantly increasing treatment access.” Treatment access is essential. Buprenorphine made recovery reachable to some who otherwise would not have been able to get the treatment they need. Despite easier access, prescribing limitations still made comprehensive, appropriate treatment difficult for some to find. The recent changes made by the U.S. Department of Health and Human Services[3] help ensure individuals who need buprenorphine have access to it. Former laws only allowed physicians to prescribe buprenorphine. Nurse practitioners and physician assistants can now begin training to prescribe the drug. There will soon be more qualified providers as, “Allowing nurse practitioners and physician assistants to prescribe buprenorphine will greatly expand access to quality, evidence-based treatment methods for those most in need of assistance.” Those that complete the training can write prescriptions for up to 30 patients beginning in 2017. This limit on the number of prescriptions may be eligible for change. The U.S. Department of Health and Human Services explains it, “also is announcing its intent to initiate rulemaking to allow [nurse practitioners and physician assistants] who have prescribed at the 30 patient limit for one year, to apply for a waiver to prescribe buprenorphine for up to 100 patients.” Previous rules limited physicians to that 100 patient cap.

More Access to Help

Changes made in July allow up to 275 prescriptions per qualified professional. Previous and recent changes reflect the ever-growing need for effective addiction treatment. Now more individuals can access the tools and care they need for stable, healthy lives.


Sources

[1] https://addiction.surgeongeneral.gov/executive-summary/report/early-intervention-treatment-and-management-substance-use-disorders. Surgeon General’s Report on Alcohol, Drugs, and Health. Surgeongeneral.gov. 18 Nov 2016. Web. 25 Nov 2016.

[2] http://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine. “Buprenorphine.” Substance Abuse and Mental Health Services Administration. 31 May 2016. Web. 25 Nov 2016.

[3] http://www.hhs.gov/about/news/2016/11/16/additional-steps-expand-opioid-treatment.html. “HHS takes additional steps to expand access to opioid treatment.” U.S. Department of Health and Human Services. 16 Nov 2016. Web. 25 Nov 2016.