A MAT Act to Eliminate the Drug Enforcement Administration Waiver for Opioid Use Disorder: The Case for a Better Treatment of Addiction

The MAT Act would eliminate the special Drug Enforcement Administration waiver that doctors must apply for in order to prescribe buprenorphine (a medication that helps reduce the craving for opioids). It would enable community health aides to dispense this medication as long as it’s prescribed by a doctor through telemedicine. And it would give the Substance Abuse and Mental Health Services Administration responsibility to start a national campaign to educate health care practitioners about medications for opioid use disorder. According to addiction specialists, these drugs are some of the best options for helping people into recovery from opiate overdoses. Only a tiny percentage of people who could benefit from them have access, according to the National Academies of Sciences, Engineering and Medicine.

There are several reasons for that, including stigma, a lack of understanding about how medications work and so on. Few doctors are willing to treat addiction in the first place. Dropping the D.E.A. waiver will not be enough to alleviate that shortage; lawmakers will also have to find ways to ensure that addiction treatment enjoys the same robust reimbursement rates as other chronic conditions. Eliminating the Waiver would be a major step in the right direction. The prescription drugs that caused the current epidemic should be more difficult to access than the drugs that could have alleviated it.

Source: https://www.nytimes.com/2022/12/12/opinion/drug-crisis-addiction.html

Rarely Get Life Saving Medicines That May Change People’s Lives: A Report on “People addicted to opioids rarely get life saving medicine” by Tonko

The House has already passed a mental health package which was written by Representative Paul Tonko of New York.

“If somebody has access to these life-saving medications, it cuts their mortality risk by 50 percent,” says Dr. Linda Wang, a researcher who treats patients with addiction at Mount Sinai Hospital in New York City.

As a result, public health officials say only one in 10 Americans struggling with addiction ever receive treatment. Studies show access to treatment is especially difficult for people of color.

Those policies left millions of people vulnerable as the powerful, toxic synthetic opioid fentanyl spread in the U.S., making addiction even more dangerous.

“There were significant barriers that were quite stigmatizing for patients as they enter treatment,” says Dr. Neeraj Gandotra, chief medical officer for the Substance Abuse and Mental Health Services Administration (SAMHSA), the federal agency that oversees addiction.

Gandotra points out even people who do manage to get methadone are often forced to visit a government-approved clinic multiple times a week to get doses.

The idea that they have to go to the clinic daily is a significant barrier.

“There was no evidence that diversion increased or risk increased, but there was evidence that people who gained access to treatment did better,” he said.

Source: https://www.npr.org/2022/12/17/1143053704/people-addicted-to-opioids-rarely-get-life-saving-medications-that-may-change

Step Towards Regulation of Opioid Treatment Medicines in the Light of the Biden-Biden Regulatory Reforms

The rule change proposed by the Biden administration would make those reforms permanent. Waiting periods for access to methadone would also be eliminated.

Gandotra says SAMHSA also plans to eliminate stigmatizing language from federal rules for opioid treatment programs, including the term “detoxification.”

She credits methadone for allowing her to stabilize her life and go back to school, where she’s about to get her PhD in justice studies at Arizona State University.

But she also says she’s faced years of stigma and surveillance within the opioid treatment system, where she often felt less like a patient and more like a criminal.

Russell says she was able to take home a month’s supply of her medication at a time. She used to travel a long way from her home in Phoenix to the nearest clinic.

For now, methadone in particular will remain heavily regulated and will still only be available through a limited number of certified opioid-treatment programs.

Some addiction experts and government officials say the ultimate goal is for opioid recovery medicines to be regulated like medications for other chronic diseases.

I don’t think it’s a good idea to say if this rule change is a step towards that. We believe it is, but I have to say I’m not sure how far along we still have to go,” Gandotra said.