Federal regulations restrict doctors from prescribing addiction medications

Federal regulations restrict doctors from prescribing addiction medications

March 11, 2019

Federal regulations restrict doctors from prescribing addiction medications

Addiction Substance Abuse

Opioid-based medications, like buprenorphine, are quite useful to help prevent overdoses, curb cravings, and allow patients dealing with drug abuse issues to get through the day without any fear of painful withdrawal symptoms. Such prescription drug addiction treatment drugs help people achieve long-lasting recovery from addiction and are far more reliable than quitting drug abuse without any medical help.

However, according to doctors, the stringent federal regulations surrounding prescription of these treatment medications, the special physician training required, and the monitoring needed to prescribe them have dissuaded a lot of their colleagues from procuring the license needed to prescribe these drugs.

Federal regulations pertaining to prescription drugs

According to the U.S. Drug Enforcement Administration (DEA), in Pennsylvania, only 3 percent doctors have the waiver needed to prescribe buprenorphine, whereas in Philadelphia, the number is 4 percent. The problem is graver in rural areas. According to a new research from the Pew Charitable Trusts, around 30 percent of rural Americans live in a county that does not have a buprenorphine provider.

Also, the most heavily regulated opioid-based treatment drug, methadone, can only be sold at specially licensed clinics. It also often requires users to visit the licensed clinics daily, just to get the drug and for counseling.

A particular type of license, commonly known as the x-waiver, is needed to be procured from the DEA and the Substance Abuse and Mental Health Services Administration (SAMHSA), by physicians wanting to prescribe buprenorphine. This license is received after the doctors take an eight-hour training course conducted by the American Society of Addiction Medicine (ASAM). The course teaches doctors how to apply for the x-waiver, identify patients likely to benefit from buprenorphine, and to ascertain the presence of any other illnesses associated with opioid addiction.

All about x-waiver

A doctor who has procured the x-waiver license can treat up to 30 patients in the first year of getting the license. They can then treat 100 patients in the second year and in the third year, not more than 275 patients. Ironically, these restrictions are only applicable to physicians prescribing these medications for a substance use disorder (SUD). In fact, no special license is needed by doctors to prescribe methadone for pain. Although buprenorphine is not approved by the Food and Drug Administration (FDA) for pain, some providers are still prescribing the same, off-label without any x-waiver license.

Pat Trainor, the local spokesperson for the DEA said that the x-waiver license facilitates doctors to help people get medication-assisted treatment (MAT) in their communities. They do not have to go to an opioid treatment program to avoid the stigma associated with drug abuse. He also added that primary care physicians not accustomed to treat addiction, need training to do so, hence the need for the x-waiver.

Doctors feel that it is quite likely that a lot of physicians who have obtained the x-waiver license will not hit their prescribing cap. According to Leo Beletsky, an associate professor of law and health sciences at Northeastern University’s law school, a lot of doctors with the x-waiver do not even use it, fearing the discrimination their well-set practice would face. Therefore, it is not just enough to get people waivered, as there would still be issues around the stigma with doctors unwilling to submit themselves to the periodic DEA audits.

Seeking help for prescription drug abuse

Prescription drugs are ideally safe if they are taken as per the doctor’s directives. But, some people grow psychologically accustomed to using them, believing that if they do not take these, they would experience extreme physical discomfort. This attitude fuels a tolerance, which gradually moves to dependence and then addiction to prescription drugs. Prescription drug abuse is a dangerous practice. When an individual injects, snorts, or consumes more than the prescribed limit, the medicines are forced to release their active ingredients at one go thereby posing the risk of an overdose.

If you or a loved one is battling with prescription drug addiction and is looking for reliable drug rehabilitation centers, get in touch with the Invictus Health Group. Call our 24/7 drug addiction treatment helpline 866-548-0190 and help yourself or a loved one lead an addiction free life. Our specialized prescription drug addiction treatment centers offer comprehensive treatment programs coupled with other evidence-based procedures and experiential therapies to treat prescription drug abuse. You can also chat online to a member from our Admissions Team for further information.

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