WASHINGTON — Scott Gottlieb, commissioner of the Food and Drug Administration, announced new steps the agency would take to promote the use and development of medication-assisted treatment for substance use disorder at a House hearing on Wednesday.

Gottlieb also rapped the insurance industry for what he called “often inadequate” coverage of existing therapies that combine counseling and medication-assisted treatment.

“To tackle the treatment gap, FDA is planning to convene experts and stakeholders to discuss the evidence of treatment benefits at the population level — such as studies that show community-wide reductions in overdose following expansion of access to therapy,” Gottlieb said.


Widely viewed as one of the Trump administration’s most effective and popular political appointees, Gottlieb has made efforts to address the opioid crisis a signature issue since winning confirmation to lead the FDA in May.

He continued that emphasis during the hearing before the House Committee on Energy and Commerce, outlining a three-pronged approach to encouraging greater MAT use.

The FDA, Gottlieb said, will issue guidance for development of new MAT options, promote efforts to decrease stigma surrounding use of medication in treating substance use disorder, and take further steps to promote use of existing therapies.

“There’s a wealth of information supporting the use of these medications,” Gottlieb said. “We’re focusing on the data in the drug labeling that can help drive broader and appropriate prescribing. So one concept that FDA is actively pursuing is the research necessary to support a label indication for medication-assisted treatment for everyone who presents with an overdose, based on data showing a reduction in death at a broader population-level. Such an effort would be a first for FDA.”

Gottlieb at one point referred to “all three” options for medication-assisted treatment, presumably referring to methadone, buprenorphine, and naltrexone, a newer formulation for a monthly injectable treatment that blocks many of the sedative or euphoric effects of opioid use.

Many addiction treatment experts, however, are not fully convinced by the results of an early study indicating naltrexone is as effective as more traditional, daily administered MAT.

Expanding access to medication-assisted treatment was among the key recommendations of a White House panel when it released its interim report in late July. That commission’s final report is expected next week.

President Trump pledged last week to declare the opioid crisis a national emergency, and an email from the Office of National Drug Control Policy obtained by STAT invited policy stakeholders to “an event on the nationwide opioid crisis” at the White House on Thursday afternoon.

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  • It is interesting that FDA plans to treat one abuse of medication with pushing the use of another medication – which may turn out to be as addictive or may have additional side effects. It almost seems as if Trump waited to declare emergency funds release till a pharma company to profit from opiod crisis could be identified?

    • Sagar, follow the medical evidence instead of your biases. MAT is the most effective treatment for opioid dependence.
      There are multiple companies involved in making these drugs. Methadone has been generic for decades, and the most used formulation of buprenorphine is also generic.
      “Pharma” is not singular or monolithic.

    • Addiction and dependence are two different things. Buprenorphine is fading and changing millions of addicts lives. Although I am still an “addict” according to you, in the past couple years I’ve gone from spending all my time and money on drugs to having an actual career, relationship, and just bought my first home. It’s given me my life back, and no, I don’t get any sort of”buzz” or “high” from it. Your comment is ignorant and dangerous, potentially discouraging people and parents from seeking effective help for themslves and loved ones rather than letting them die slowly in a revolving door of rehab/detox.

  • Amazing. Asking the pharmaceutical industry, that made billions off selling opioids, to now develop new drugs to treat the addictions they created. Not a solution. Not prevention. Just more profits. Clearly the FDA is in the pocket of pharma.

  • Why is the American medical establishment refusing to consider the use of Ibogaine in opioid addiction treatment? This drug is used throughout Europe, Canada and Mexico, but Americans must travel outside the country to use it, and American insurance refuses to cover it.

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