In 2021, nearly 107,000 people died of a drug overdose, with 75% of those deaths involving an opioid. Fentanyl was found to be the most common of these opioid-related deaths. However, buprenorphine was among the drugs used to reduce opioid drug abuse and fatalities associated with drug abuse. Due to its uses in reducing opioid misuse, and recent studies on the safety of buprenorphine in Medication Assisted Treatment of opioid abuse, the Drug Enforcement Administration (DEA) has now allowed practitioners to prescribe buprenorphine without prior notification via Notice of Intent. All practitioners who have a current DEA registration that includes Schedule III authority may now prescribe buprenorphine for Opioid Use Disorder in their practice.
Changes in MAT for Opiate Abuse Over the Years
The regulations for Medication-Assisted Treatment (MAT) for opiate abuse have undergone several changes in recent years. Here are some of the fundamental changes:
- Increased Access: In 2016, the federal government changed regulations to allow qualified physicians to prescribe buprenorphine, a medication used to treat opioid addiction, without additional training or certification. This was intended to increase access to MAT for people struggling with opioid addiction.
- Increased Patient Limits: In 2018, the Department of Health and Human Services (HHS) increased the patient limit for physicians who prescribe buprenorphine from 100 to 275 patients, again intending to expand access to MAT.
- Telemedicine: In response to the COVID-19 pandemic, the federal government temporarily relaxed restrictions on the use of telemedicine to prescribe buprenorphine. This allowed people to access MAT from home without risking exposure to the virus in a healthcare setting.
- Now in Jan 2023, according to the Substance Abuse and Mental Health Administration Section 1262 of the Consolidated Appropriations Act, 2023, prescribers are no longer required to notify for prescribing prescription opioid buprenorphine, and the same is expected for methadone in the near future.
Reasons Behind Relaxing Buprenorphine Prescribing
According to a recent study published in JAMA and also quoted by the National Institute of Health, researchers discovered that between July 2019 and June 2021, buprenorphine was only a factor in a very small number of drug overdose deaths. 1955 overdose deaths involving buprenorphine occurred during the research period, accounting for 2.2% of the overall drug overdose deaths and 2.6% of the opioid-related overdose deaths noted in the State Unintentional Drug Overdose Reporting System (SUDORS) dataset. The scientists found that although monthly opioid-related overdose deaths generally increased between April 2020 and June 2021 when DEA eased buprenorphine prescribing regulations in response to the COVID-19 pandemic, the proportion of those deaths involving buprenorphine did not increase.
The study also discovered that, in contrast to 67.2% of deaths using an opioid other than buprenorphine, 92.7% of overdose deaths involving buprenorphine also involved at least one other substance. Specifically, benzodiazepines, antidepressants, and anticonvulsants were more likely to be involved in buprenorphine-involved overdose deaths than other opioid-involved overdose deaths.
“Research has shown beyond a doubt that medications for opioid use disorder are overwhelmingly beneficial and can be lifesaving, yet they continue to be vastly underused,” said NIDA Director and senior author, Nora Volkow, M.D. “Expanding more equitable access to these medications for people with substance use disorders is a critical part of our nation’s response to the overdose crisis. The findings from this study strengthen existing evidence suggesting that greater flexibility in prescribing may be one safe method for working toward this goal.” quoted from the National Institute of Health
Impact of This Recent Policy Change
Here are some key points to consider regarding the recent change in policy around buprenorphine prescribing:
- The policy change may increase access to buprenorphine, which is positive for individuals with opioid use disorder.
- More people struggling with opioid abuse can have access to MAT.
- There is the possibility of increased buprenorphine abuse
- Healthcare providers may need to adjust their practices to ensure safe and appropriate prescribing.
Impact of Expanding Buprenorphine Prescription
The recent removal of the federal requirement for practitioners to submit a Notice of Intent to prescribe medications like buprenorphine for treating Opioid Use Disorder is undoubtedly a positive step in expanding access to life-saving medications. However, this also raises some concerns about the potential for increased abuse of buprenorphine.
Buprenorphine is a partial opioid agonist that binds to the same receptors in the brain as opioids. It thereby reduces cravings and withdrawal symptoms. While it is an effective medication for treating OUD, it can also be used illicitly. Most illegal use of this drug, however, is for reducing withdrawal symptoms, decreasing amount of heroin or opiate use, and in some cases the financial cost of drug use.
The Utility of Expanded Drug Test Panels Including Buprenorphine
As buprenorphine prescribed use, and in some cases, illicit use increases, the addition of buprenorphine to drug panels is beneficial. Buprenorphine drug tests are often used to ensure that the patient is taking their prescribed buprenorphine dose for treatment of opiate addiction. In the limited cases where it is being abused, buprenorphine can also be detected by a drug test.
DrugTestKitUSA offers a range of high-quality drug testing kits that are easy to use, accurate, and affordable. These drug testing kits can be an excellent tool for identifying potential substance use disorders. Many expanded panels are also capable of identifying buprenorphine in the system. Take advantage of the filtering feature to select from a variety of drug test attributes, including a filter for buprenorphine.