In a news release posted yesterday, The US Department of Health and Human Services (HHS) proposed a doubling of the number of patients that a physician can simultaneously treat with buprenorphine. The proposal is in response to escalating rates of opioid addiction, and is intended to reduce lengthy waiting lists for treatment caused by the current regulation under which doctors can treat up to 30 patients at a time during their first year of prescribing certification for buprenorphine. At present, prescribers can get authorization to treat up to 100 patients in subsequent years; the new proposed regulation would permit a doubling of this certification, to 200 patients at a time in year 3 of prescribing. The HHS proposal is one of a number of initiatives announced by the Executive Branch as part of the overall effort to address the opioid addiction crisis.
The proposed modification to the patient limit rule is a step that has been long advocated by public health and addiction medicine specialists. Since FDA approval of buprenorphine in 2002, the number of clinicians who have chosen to prescribe as a component of treatment for opioid addiction has been lower than anticipated. Among those who do, many have maxed out the number of patients they can treat, resulting in deferred treatment access and increased death rates from opioid overdose. HHS describes the change as one designed to balance the multiple goals of expanding access to buprenorphine, promote its use as an element of evidence-based medication-assisted treatment, and minimizing the risk of drug diversion. HHS Secretary Sylvia Burwell commented “This proposal is an important step to increasing access to evidence-based treatment to help more people get the treatment necessary for their recovery and is critical in our comprehensive approach to addressing the serious opioid epidemic facing our nation.” A story about the HHS initiative may be read here. Yesterday’s news release from HHS may be read here.