Doctors Hesitate to Prescribe Life-Saving Opioid Medication Despite Proven Effectiveness

November 14, 2019 - /PressAdvantage/ - There is a widespread agreement within the medical community that buprenorphine works as an effective treatment for opioid addiction. However, at a time when hundreds of people are dying from the opioid epidemic every day, less than 7 percent of doctors are prescribing it.

“When I think of medications I prescribe for chronic illnesses in primary care…buprenorphine is nearly miraculous,” said Laura Kehoe, a primary care physician who runs an addiction treatment clinic at Massachusetts General Hospital.

However, doctors are not prescribing buprenorphine despite the fact that it can help patients stay in long term recovery. Some speculate that it is because doctors lack training and are reluctant to treat people with opioid addiction. Others say it is because prescribing buprenorphine requires extra work.

The federal government classifies buprenorphine as a controlled substance. In order to prescribe it, doctors and other health care providers need a waiver. In order to acquire this waiver, they need to go through eight hours of training.

Kehoe thinks that this training creates a barrier for physicians and other professionals in the health care industry who are already juggling busy schedules.

“I do waiver trainings and I can tell you, eight hours for anybody to sit in one room is a lot,” she said. “When other new medications hit the market, I'm not expected to sit through a waiver.”

Buprenorphine, also known as Suboxone, is a safe medication that helps keep the effects of opioid abuse under control. It can prevent overdose and therefore potentially save a person’s life.

“The waiver in itself just sends the message that this is a difficult illness to treat, difficult medication to prescribe, when, in fact, it’s really quite simple,” Kehoe explained.

There are now bills in the House of Representatives and the Senate that would eliminate the waiver training. 39 attorneys general, including Massachusetts Attorney General Maura Healey, have signed a letter of support.

On the other hand, American Academy of Addiction Psychiatry CEO Kathryn Cates-Wessel said that changing the law around buprenorphine would be a mistake because the training requirement is not what keeps doctors from offering the medication.

“They're not comfortable dealing with someone with a substance abuse disorder, or addiction—it's just not in their comfort zone. They haven't been trained in that area,” she said. “I’ve had doctors and other prescribers say, 'I have the waiver, now what do I do?'”

The CEO added that buprenorphine alone is not the solution because treating opioid addiction is different than other chronic conditions. It frequently requires mental health support as well.

The American Academy of Addiction Psychiatry offers buprenorphine waiver training at no cost to health care providers and students nationwide. Click the link to see some top rehab placement programs.

“If you don’t have access to behavioral health, it can get complicated. How do you handle it? You’ve kind of set yourself up for failure and the patient up for failure,” she said. “I’m afraid if we throw away the waiver, they’re going to miss that very thing they need—education.”

Paul Bowman, a Quincy resident who struggled with opioid addiction himself and recovered through buprenorphine, appreciates both sides of the argument. “I started using because I had surgery and I got hooked on painkillers,” he said. “There’s so much success that I see with Suboxone, that I think they would actually like treating people, because you see people get better.”

If someone in the family is struggling with opioid or alcohol addiction, it is important to seek help. A combination of medical detox and behavioral therapy can go a long way in the fight against drug abuse. But because every individual is affected by addiction differently, a comprehensive program tailored to their specific needs is necessary. Look for a nearby addiction treatment facility today and find out how drug treatment programs work.


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