Turns out that lifting restrictions on doctors prescribing buprenorphine, a controlled drug used to treat opioid use disorder, is only the first step to expanding access to addiction treatment. A 2022 law removed a requirement that practitioners undergo special training to prescribe the drug. But the measure hasn’t been the game-changer lawmakers and federal agencies had hoped it would be, according to Thomas Prevoznik, deputy assistant administrator for the Drug Enforcement Administration. Speaking Monday at the Rx and Illicit Drug Summit in Atlanta, Georgia, Prevoznik said the total volume of buprenorphine prescriptions dispensed since the law entered into force has remained around 1.4 million and hasn’t spiked up as expected, Carmen reports. Here are the reasons he attributes to the low uptick: — Stigma “The biggest thing I heard and continue to hear from prescribers and pharmacists … is they continue to call those who suffer from opioid use disorder ‘them,’ like they don't want ‘them,’ they don’t want to treat ‘them’ in their practice,” Prevoznik said. That attitude was an eye-opener for the DEA, he said, noting that people with opioid use disorder are “our family members, our neighbors, our friends. … They’re dying. This has to become part of mainstream health care,” he said. — Low drug-reimbursement rates Prevoznik said pharmacists have complained about losing money when they prescribe buprenorphine because of low reimbursement rates. “That has to change,” he said. — Fear of the DEA The DEA controls access to buprenorphine because it’s an opioid. The drug helps people wean off more dangerous and usually illicit drugs, such as fentanyl and heroin. But drug distributors and pharmacists fear running afoul of DEA thresholds on the amount of buprenorphine that can be bought. Prevoznik said he’s made it clear that the federal agency does not have such thresholds; however, states imposed levels as the prescription opioid crisis persisted. The DEA and HHS and its Substance Abuse and Mental Health Services Administration sent a letter last month to health care practitioners and distributors clarifying some of those issues, he said.
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