WASHINGTON — Eighteen state public health directors, a growing group of physicians, and a prominent member of Congress are pushing a dramatic expansion of substance use treatment by posing a simple question: Why can’t doctors who prescribe opioids also prescribe drugs to treat opioid addiction?

Their push to deregulate use of buprenorphine, which is used to lessen opioid cravings and withdrawal symptoms, would represent a fundamental shift in U.S. addiction treatment. The medication — and addiction medicine in general — are highly regulated, largely due to fears that opioid-based treatment drugs like buprenorphine and methadone could be misused.

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  • I used suboxone to get off opioids.Took it for 4 months,never more than two mg at a time,once a day.I tapered off the suboxone over a 45 day period.I was sick for almost 4 months with suboxone withdrawal and would tell anyone that thinks that this will help them get off opioids to just face the withdrawal and get through it.Suboxone is just substituting one opioid addiction for another that is worse than heroin withdrawal

  • Luke: Thank you for the response. I see you are in the NYC area.
    You mention my son’s to cooperation a treatment option. I agree.
    He is in self denial and has detoxed several times always referring to his conception drugs are not the problem; an underlying undiagnosed stomach ailment is to blame. UCLA Reagan center and several gastroenterologists will disagree in the fact nothing has been found for years except a common use of prescribed opioids and little coordination and follow up since 12 years of age.
    I look forward to a talk with you.

  • The two statements concerning the existing methadone cartel’s lobbyist efforts and the French efforts bring up two points.
    One effort is to protect marketing territory, financial interest, and a growing industry of remedial expensive treatment. The French model seems to strive to solve a problem of addiction.
    As a father with a son in prison awaiting a treatment avenue to return him to society in a progressive capacity and investigating the treatment scene; I can only come to the conclusion the social support system of a healthy America is not the priority.
    Financial gain is the instituted program.
    Let’s be honest here.

  • There is a need for for prescribers however the fact that medical professionals with typically no formal education in addiction during medical school and only an 8 hour on line course is greatly concerning. Lack of knowledge about addiction has the potential to make the issues worse. There are individuals who are opiate dependent and those who meet criteria for opiate use disorder. Very different needs. The system wants to treat them the same. Individuals with OUD are often very complex with many other issues and treatment needs that may go undiagnosed. Prescribers need more than an 8 hour on line course.

  • Buprenorphine daily has great data, big difference in relapse rates in 6 wk or 12 wk, but, most of it is industry sponsored and short term. Often, the control group has 100% relapse in a couple weeks, which suggests that it isn’t a fully committed control group (not even 1 in 100 or 1 in 250 is abstinent in 4 weeks?? Really?) There isn’t such great data known yet for 2- or 5-year outcomes with Rx assisted management.

  • Yes, we need to open up access. I took the Nurse Practitioner training and worked in a Methadone clinic where I had to confront my own ignorance.
    I had had no REAL understanding of how addiction destroyed peoples lives and ripped their families apart. I have come to acknowledging my negative prejudices and am learning all that I can from colleagues who have open and accepting attitudes. It is not easy to change beliefs about others is it? Thank you for the article. Melanie ARNP

    • Yes. It seems to be a good, common sensical approach they are taking now. The right people are taking command. Dr. Kolodny! I wish you would please step back and stop meddling in this process! I will never come to grips with why he always seemed to want to make trouble for others.

  • Allowing Buprenorphine to become more widely and more easily available is probably the stupidest thing I ever heard! Firstly, having a patient get off of Suboxone is almost as difficult as Opioids . Secondly, what these people will do is take Suboxone until they can get more opioids so they don’t go into withdrawal. Therefore allowing these
    patients to stay addicted to opioids for ever !

  • This policy proposal may have terrible unintended consequences. Physicians and even nonphysicians may be allowed to write scrips for opioids (suboxone) to people who are either not addicted (but then soon will be) or who need more than just pills to stay off illegal drugs. Opioid agonist drugs do not cure addiction – just the symptoms. Stop medicating and patients go into opioid withdrawal just like with heroin or other opioids.

    The relapse rate for suboxone and methadone is not much different from abstinence treatments – very very high. So, relaxing who can prescribe opioid agonist meds, and to how many patients, might make the public feel good, but it definitely risks kicking the epidemic can down the road to an even worse epidemic in the near future. If I was Big Pharma, I would be doing a happy dance about now.

  • I would just like to thank the pharmaceutical companies for developing opioids for the many of us who suffer in pain. We realize that there may be some greed in your business, but the benefits of your pain medications far outweighs the detriment for us.

  • Follow the money. More medications for a problem worsened by medications in this “new epidemic”. What is your answer doctors for the rapidly growing methamphetamine “problem”? Whatever happened to sobriety and recovery

    • I have the benefit of over half a century of experience in the treatment of opioid addiction. When private medical practitioners were permitted to treat the addicted the result was widespread diversion of methadone, overdose deaths, and the creation of experimenters who often became full-blown dependents. Subsequently, methadone clinics were born and doctors were no longer able to prescribe legally. My question is ,”What has changed that assures this policy will not have the same devastating outcomes?” People dependent on drug misuse LOVE doctors. They are easily manipulated and do not have the time necessary to adequately provide comprehensive treatment for each patient. Substitution drug treatment MUST have an intensive counseling component for the masses to be stabilized and hope for a full recovery. This policy will fail on a grand scale miserably.

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