DEA updates regulation, allowing more clinicians to prescribe opioid addiction treatment

Hydrocodone opioid pills
The DEA has updated regulations to allow more clinicians to prescribe medication-assisted treatment for addiction. (Getty/smartstock)

In a step aimed at combating the nation’s opioid epidemic, the Drug Enforcement Administration will allow more midlevel practitioners to prescribe buprenorphine, a medication used to treat opioid addiction.

A final rule, published in the Federal Register, will allow nurse practitioners and physician assistants to prescribe and dispense the drug. The rule brings DEA regulations into conformity with the Comprehensive Addiction and Recovery Act (CARA), which was passed by Congress and signed into law in 2016.

The DEA said in an announcement that it took the step to make it easier for people living in rural and underserved areas of the country to receive opioid addiction treatment. Both nurse practitioners and physician assistants can now become DATA-waived qualifying practitioners with the authority to prescribe and dispense buprenorphine from their offices. 

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Currently there are 43,000 practitioners in the U.S. authorized to prescribe buprenorphine, the DEA said. But given the country’s ongoing opioid epidemic, which kills an estimated 175 people every day, many people struggling with addiction cannot find treatment.

"This action reflects this work and the ongoing need to further expand access to the most effective treatment for opioid use disorder," David Fiellin, M.D., professor of medicine, emergency medicine and public health at Yale School of Medicine, told Reuters.

Prior to the passage of CARA, the vast majority of physicians authorized to prescribe buprenorphine were in urban areas. The 2016 law added to the categories of practitioners who may prescribe the drug for maintenance or detoxification treatment.

When CARA was enacted, the DEA began the process of waiving the Drug Addiction Treatment Act for midlevel practitioners. Nearly 5,000 of them are already able to treat and prescribe patients with addictions.

According to a 2017 report by the National Rural Health Association, 53% of rural counties did not have a doctor who could prescribe buprenorphine, leaving 30 million people in counties where treatment was not available, the DEA said.

As a result, rural patients seeking outpatient buprenorphine treatment must often travel long distances to access care.

Rural providers of buprenorphine report a demand far beyond their capacity and say they lack the resources to adequately support patients in treatment, the DEA said. The NRHA report also found that, with 92% of substance use treatment facilities located in urban areas, rural areas offer fewer inpatient and day treatment options.

The Trump administration this week renewed the declaration that officially categorized the opioid epidemic as a public health emergency shortly before it was set to expire. President Donald Trump declared the opioid crisis an emergency back in October, a move recommended by the commission he convened to study the epidemic, but critics say neither the president nor Congress has put any funding into solving the problem. 

Although the administration has pledged to make combating the opioid crisis a priority and despite calls for additional funding, the White House wants to cut the budget for its drug policy office by 95%, FierceHealthcare reported last week. 

Former Democratic Rep. Patrick Kennedy, one of six members appointed to the bipartisan commission, told CNN this week that the task force work was a “sham” and a “charade.”

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