White House unveils national anti-opioid addiction push

The Obama administration is relaxing the rules for doctors who are approved to prescribe a powerful anti-opioid medication, in its latest push to halt the dramatic rise of drug overdoses in the U.S.

Federal health officials on Wednesday announced a new plan to raise the much-maligned patient cap for doctors who have earned permission from the federal government to treat patients with an anti-addiction drug called buprenorphine.

The new policy will help “tens of thousands” of people gain access to treatment, Health and Human Services (HHS) Secretary Sylvia Mathews Burwell told reporters.

Burwell unveiled the new buprenorphine rule – which had been in the works since last fall – along with a spate of other initiatives to halt the nation’s worsening opioid epidemic with just about six months left in her term. 

“Like too many Americans, I’ve seen the cost of this epidemic up close,” Burwell said. “We have to turn the tide of this epidemic.”

Burwell said she has heard from some physicians who “feel pressured” to prescribe opioids because their patients are asked about their pain levels on surveys that help determine their federal reimbursement payments.

To prevent that in the future, HHS is proposing a rule to divide a patient’s pain assessment from the Medicare reimbursement process.

HHS is also upping its outreach to doctors about safe prescribing and its own researchers are launching more than a dozen new studies on opioid misuse and pain treatment “to help fill knowledge gaps.”

Drug overdose deaths have been climbing to record highs, including an alarming 14-percent increase in just one year, according to federal health data.

The administration’s new initiatives show a focus on treatment, which White House drug czar Michael Botticelli hailed as a shift from just a few years ago, when addiction was not considered a disease.

The Obama administration has underscored the role of medication-assisted treatment, which uses drugs like buprenorphine to help individuals manage the side effects of fighting their addictions. The treatments are controversial, however, in part because the drugs are themselves opioids.

As a result, the federal government has enacted strict rules on doctors who can prescribe the drugs.

Anti-addiction advocacy groups have said those strict limits have made visits to doctors more expensive and harder to come by. Federal health officials at agencies like the National Institutes of Health have called the medication an “underused” form of addiction therapy.

Under current rules, doctors can prescribe up to 100 patients for buprenorphine – but only if they have been authorized to do so. Without special approval, doctors can only prescribe up to 30 patients at a time.

Nationally, about 33,000 physicians have been approved to prescribe buprenorphine, as of government data from June 2016.

But starting in August, pre-approved doctors can prescribe buprenorphine to up to 275 patients – nearly three times above the current cap.

The Department of Health and Human Services (HHS) released its final regulation on buprenorphine amid a heated debate in Congress over opioid policy.

Legislators in Congress initially hoped to raise the cap to 500 patients – and planned to include it in the major opioids legislation currently under negotiations between the House and Senate.

Those hopes mostly collapsed last week, however, after a steep cost estimate of that bill from the Congressional Budget Office. About 350,000 more people would be expected to receive treatment under the bill, which would result in an increase of $2.3 billion by 2026.

Patient caps were not included in a draft of the House and Senate’s opioid conference released late Monday. Lawmakers will hold a hearing on that draft Wednesday.