WASHINGTON -- A group of 22 senators, including Democratic presidential candidate Bernie Sanders, think the Department of Health and Human Services could do more to increase access to a medication viewed by the medical establishment as the best chance for opioid addicts to make a lasting recovery.
Under current federal regulations, doctors can treat only 30 patients at a time in the first year they’re certified to prescribe buprenorphine (commonly sold in the U.S. as Suboxone), a medication that can reduce opioid cravings and ward off harsh withdrawal symptoms. Doctors can receive authorization to treat as many as 100 patients in subsequent years. Access to the medication can be especially difficult in rural counties. Addicts may have to drive hundreds of miles to find a doctor who can prescribe them the life-saving medication.
In late March, HHS announced a proposed rule change that would allow certified doctors to treat as many as 200 patients at time in their third year of prescribing.
“This is an important step and I think it’s a very public signal of how we think about it and what we believe,” HHS Secretary Sylvia Mathews Burwell told The Huffington Post at the time.
But this week, nearly two dozen senators told Burwell they believe the HHS proposal does not go far enough.
In a letter to Burwell on Wednesday, the lawmakers argued that the opioid crisis has become too widespread to contain merely by doubling the number of doctors who can prescribe buprenorphine. After all, the medication has been shown to help reduce overdose deaths. Why not make sure it's available to anyone who wants to use it for treatment?
The senators, led by Sens. Orrin Hatch (R-Utah) and Ed Markey (D-Mass.), encouraged HHS to raise the number of patients a doctor can treat with buprenorphine to 500.
The letter was signed by a bipartisan group of legislators, including several from states hit hard by the opioid crisis -- Sens. Kelly Ayotte (R-N.H.), Richard Blumenthal (D-Conn.), Sherrod Brown (D-Ohio), Susan Collins (R-Maine), Dick Durbin (D-Ill.), Al Franken (D-Minn.), Kirsten Gillibrand (D-N.Y.), Mazie Hirono (D-Hawaii) and Rand Paul (R-Ky.). Sen. Elizabeth Warren (D-Mass.) also signed the letter.
The senators noted that there are no laws limiting doctors who can prescribe painkillers -- including medications that have helped spur the epidemic.
"The current 100 patient cap is one of several factors that have created a huge disparity between those who can prescribe opioids for treatment of pain and those who can prescribe treatments for opioid use disorder," the senators wrote. "Only 10 percent of the 23 million Americans with addictions and substance use disorders receive any care in a given year."
The senators argue that “raising the cap to only 200 will be unlikely to make the meaningful impact needed in the marketplace to make buprenorphine a viable treatment option for patients.”
In a press release, Markey argued that the cap only perpetuates the stigma of addiction.
“We don’t restrict doctors from prescribing life-saving medication for any other medical condition, so it makes no sense to limit medication-assisted therapies for those suffering from the disease of opioid addiction,” Markey said.
“I thank the Obama administration for responding to my call to act administratively to address limitations on medication-assisted therapies for opioid addiction," he went on. "But we must ensure that the final rule addresses this outdated federal restriction in a manner [that] reflects the immense crisis we are currently facing.”
When HHS announced its own proposed rule change in March, the response was positive, but many doctors thought the department could do more.
“This has been an ongoing issue for years,” Dr. Kelly Clark, the American Society of Addiction Medicine’s president-elect, said at the time. “People are on waiting lists and dying.”