Treating addiction: Let more doctors prescribe drugs to help addicts

Doctors prescribe medications to treat illness — and addiction is an illness.

Yet federal regulations discourage doctors from prescribing some of the most effective medications to treat addiction — Suboxone and buprenorphine — by requiring a special licensing procedure.

Physicians who obtain the license also subject themselves to audits and reviews of patient records by the U.S. Drug Enforcement Administration. Many doctors and nurse practitioners simply don't want to deal with the hassle.

The federal government should loosen requirements to allow doctors to prescribe these ultimately lifesaving drugs.

It is ironic that doctors can prescribe OxyContin and fentanyl, the very drugs that fueled the national opioid crisis, yet must jump through hoops to prescribe medications that treat addiction.
Buprenorphine is an opioid but does not produce the powerful highs associated with heroin or some painkillers. Suboxone is buprenorphine combined with naloxone, the drug used to reverse overdoses.

Both drugs lighten withdrawal symptoms and cravings for harder drugs, whether they be prescription drugs purchased legally or on the black market, or heroin.

Doctors who obtain the special license can write these prescriptions from the office. Patients who might fear the stigma of going to a methadone clinic or large drug rehab facility might be more likely to get treatment if they can simply go to a doctor's office.

Almost 30% of rural Americans live in counties without a medical professional licensed to prescribe buprenorphine or Suboxone, according to research by the Pew Charitable Trusts. And rural America is where the opioid crisis hit hardest.

While physicians nationwide can prescribe opioids, only 46,500 physicians were licensed to prescribe buprenorphine and Suboxone in 2019. That's about 5% of all practitioners.

In Pennsylvania, only 3% of doctors have the waiver; in Ohio, only 2% of doctors have the waiver, according to the Drug Enforcement Administration.

Not only do the current laws require licensing, they also limit the number of prescriptions for the drugs a doctor can write over the course of a year.

More than 70% of doctors with the license are limited to treating 30 patients a year with the drugs. While that number increases over time, some settings, like jails and prisons, are looking for more doctors to prescribe the drugs. That's because so many inmates coming into the system are addicts and the physicians on staff have reached their annual limit on prescriptions.

Pennsylvania Attorney General Josh Shapiro has encouraged physicians to become certified to prescribe Suboxone. Mr. Shapiro, in fact, helped negotiate a settlement in principle with some opioid-makers that will provide billions of dollars worth of generic Suboxone for opioid addiction treatment.

The federal government should allow physicians to prescribe Suboxone and buprenorphine to Americans struggling with opioid addictions without the special licensing procedure.