Recovery Roundtable: Should Doctors Be Allowed to Prescribe More Suboxone?

Newly proposed legislation would increase the number of Suboxone patients doctors see.

Suboxone is a medication approved by the FDA for the treatment of heroin and prescription pill addiction. It’s widely used as a replacement for methadone and can be prescribed in the comfort of a doctor’s office, whereas methadone can only be provided at a limited number of specialized addiction centers.

Jumping Through Suboxone Hoops

Despite its benefits, Suboxone remains largely underused a decade after it was approved. The is due, in large part, to the legal hoops all prescribing physicians must jump through. Some of those include:

  • Completion of mandatory training
  • Limitation of their patient roster to 30 patients in the first year and 100 patients in the following years
  • Strict monitoring requirements by the DEA

A Call for Change

Suboxone is now one of the most frequently prescribed drugs for a combination of behavioral therapy and medications known as Medication Assisted Treatment (MAT) to treat substance abuse. That popularity, coupled with the fact that our nation is in the middle of an opioid addiction crisis of epic proportions, finally prompted the federal government to bring in new legislation – a proposal that allows practitioners to obtain a waiver for prescribing Suboxone to a lot more of their patients.

According to a press release issued by the Substance Abuse and Mental Health Services Administration (SAMHSA), practitioners can now obtain a waiver to prescribe Suboxone to up to 275 patients, an increase from 100 patients. To be eligible to treat up to 200 patients, practitioners must have “held a waiver to treat 100 patients for at least one year without interruption and possess a subspecialty board certification in addiction psychiatry or addiction medicine or practice in a qualified practice setting.”

SAMHSA will approve or deny the practitioner’s request within 45 days of receipt and hopes the proposed rule “will stimulate broader availability of high-quality MAT both in specialized addiction treatment settings and throughout more mainstream health care delivery systems.”

Others believe the number of prescribers should be increased, but with the same limit on the number of patients. This could be accomplished by allowing nurse practitioners or physician assistants in multispecialty groups to become prescribers. Opening the door to multispecialty group practices not only increases the network of available Suboxone prescribers, it also provides the opportunity for the patient to treat other health issues, as well as address emotional problems associated with their drug use.

Image Source: iStock