Senate Amendment Would Dramatically Improve How Doctors Treat Heroin Addiction

The legislation would expand access to evidence-based treatment for opioid addicts.

WASHINGTON -- The Senate health committee on Wednesday passed a measure that would dramatically expand access to a key treatment in the effort to slow the heroin epidemic.

The amendment, pushed by Sens. Edward Markey (D-Mass.) and Rand Paul (R-Ky.) and passed unanimously, would increase access to buprenorphine (commonly sold as Suboxone) for opioid addicts. When included with counseling, known as medication-assisted treatment, buprenorphine can provide addicts with one of the best chances at a recovery, public health experts say.

But under current federal regulations, a doctor must first take a daylong course before being certified to prescribe the medication. In their first year of prescribing, they are only permitted to treat 30 patients with the medication at any one time. For the following years, the patient limit can move up to 100. The upshot: Long waiting lists and long drives stand between addicts and evidence-based, effective treatment. The Huffington Post highlighted the issue last year in an investigative piece on the opioid epidemic and the U.S. drug treatment system. 

Although the chances of the amendment becoming law this year might not be optimal, its bipartisan support sends a signal to the Obama administration that if it wants to unilaterally reform the regulations on buprenorphine, it would be welcomed by Congress.  

Last fall, the Department of Health and Human Services announced that it would increase access to buprenorphine by lifting the cap. A draft of the new rules has yet to be made public.

“We need to remove the barriers to effective treatment for opioid addiction, including outdated federal restrictions on medication-assisted therapies like buprenorphine,” Markey said in a press release. “This treatment decreases overdose deaths, reduces transmission of HIV and Hepatitis C and saves lives.”

The amendment would increase patient limits to as many as 500 patients and permit nurse practitioners and physician assistants to prescribe the medication to opioid addicts. The idea is not a new one. Last year, Markey and Paul introduced a bill that the amendment uses as source material. Experts ranging from the American Society of Addiction Medicine to the National Governors Association have urged easing restrictions or eliminating them altogether.

Dr. Kelly Clark, ASAM’s president elect, praised the amendment’s passage and is hopeful that it will become law. “We are in the middle of an epidemic that is taking the lives of two Americans every hour,” she told HuffPost. “We cannot move quickly enough to address this situation."