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HHS Takes Steps To Increase Access to Opioid Use Disorder Treatment Medication


Overview

Originally Published: 03/29/2016

Post Date: 03/30/2016

by HHS | Tim Cheney


Summary/Abstract

HHS releases bulletin about supporting new opioid addiction treatment action compromising the TREAT Act

Content

 

Editorial Comment: Tim Cheney

"On July 23, 2014 Massachusetts Senator Edward Markey introduced The Recovery Enhancement for Addiction Treatment Act (TREAT Act). This bill, cosponsored by four other Senators, would lift the buprenorphine prescribing limit for addiction physician specialists and non-specialist providers that satisfy additional training requirements and practice in qualified treatment settings. ASAM is joined by a number of organizations, including the AMA, Trust for America’s Health and the National Association of State Alcohol and Drug Abuse Directors, in supporting this bill." ASAM.

So now it is almost one year later and there were over 47,055 lives that were lost in 2015 due to overdose mortality. Treatment capacity for opioid dependence stands at approximately 45%. Suboxone practice caseload caps and inadequate federal funding for methadone treatment have cost society thousands of lives lost to prisons and overdose fatalities. Methadone treatment, long the Gold Standard in treating chronic opioid addiction is severley compromised from delivering quality clinical services as a result of bundled services reimbusement rates forcing providers to deliver services that resemble a gas station. This short sighted economic strategy prohibits clinics from providing services to their comorbid population (85%) ensuring life long clinic attendance or relapse and potential death.

Washington continues to ignore ASAM, the AMA and numerous other Medical Associations impeding potential progess to treat the 55% of opioid dependent individuals in the streets. As we are all aware, all members of Congress and the Senate are physicians. Chances are if any senate or congress member had a non stigmatized life threatening acute or chronic health care problem they would not be educating and dictating treatment protocol nor negotiating legislation that may impact their or their loved ones health and chances of survival.

Well, now it has become just politics as these folks are just addicts. Members of a secondary deviant subculture pagued with immorality and criminality. The TREAT Act calls for no limit after one year on suboxone patient caseload if the physician is board certified in Addiction Treatment (ABAM). The TREAT Act proposes an increase for the initial year caseload from 30 to one hundred and subsequent years their would be no restriction for ABAM Certified Physicians. Now HHS wants to turn this act into a negotiation with a counter proposal of a caseload maximum of two hundred patients after one year. You don't need to be a math major from MIT to realize that if this proposal goes through discounting future onset cohorts of new users that we will still be short in treatment capacity. 

This is critical legislation that needs your support. Some communities have waiting lists for medication assisted treatment of 1 year. People are dying. It seems a bit discriminatory that the Government does not regulate the number of patients a physician may prescribe a Schedule II substance but regulates the number of patients, if they are being treated for addiction, a physician may prescribe a Schedule III substance (Suboxone) especially as it is the Schedule II substance that necessitated the need for the Schedule III substance. Simple logic would lead one to believe that the Government is more interested in escalating the problem rather than addressing the problem. 


Please read the attached and use the link below to contact your legislators in Washington and ask them to sponsor or support this life saving bill.
http://choopersguide.com/content/contact-congress.html

 


Title: Recovery Enhancement for Addiction Treatment Act or the TREAT ACT

A  bill to provide access to medication-assisted therapy, and for other purposes; to the Committee on Energy and Commerce, and in addition to the Committee on the Judiciary, for a period to  be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Summary

Amends the Controlled Substances Act to increase the number of patients that a qualifying practitioner dispensing narcotic drugs for maintenance or detoxification treatment is initially allowed to treat from 30 to 100 patients per year.

Allows a qualifying physician, after one year, to request approval to treat an unlimited number of patients under specified conditions, including that he or she: (1) agrees to fully participate in the Prescription Drug Monitoring Program of the state in which the practitioner is licensed, (2) practices in a qualified practice setting, and (3) has completed at least 24 hours of training regarding treatment and management of opiate-dependent patients for substance use disorders provided by specified organizations.

Revises the definition of a "qualifying practitioner" to include: (1) a physician who holds a board certification from the American Board of Addiction Medicine; and (2) a nurse practitioner or physicians assistant who is licensed under state law to prescribe schedule III, IV, or V medications for pain, who has specified training or experience that demonstrates specialization in the ability to treat opiate-dependent patients, who practices under the supervision of, or prescribes opioid addiction therapy in collaboration with, a licensed physician who holds an active waiver to prescribe schedule III, IV, or V narcotic medications for opioid addiction therapy, and who practices in a qualified practice setting.

Directs the Comptroller General to initiate an evaluation of the effectiveness of this Act, including an evaluation of: (1) changes in the availability and use of medication-assisted treatment for opioid addiction, (2) the quality of medication-assisted treatment programs, (3) diversion of opioid addiction treatment medication, and (4) changes in state or local policies and legislation relating to opioid addiction treatment.

Bill introduced to House on May 22, 2015

Sponsor: Sen. Markey, Edward J. [D-MA]

Bill Text

Actions

06/16/2015 Referred to the Subcommittee on Crime, Terrorism, Homeland Security, and Investigations. 
Type of Action: Committee Consideration
Action By: House Judiciary
05/22/2015 Referred to the Subcommittee on Health. 
Type of Action: Committee Consideration
Action By: House Energy and Commerce
05/21/2015 Referred to House Judiciary 
Type of Action: Introduction and Referral
Action By: House of Representatives
05/21/2015 Referred to House Energy and Commerce 
Type of Action: Introduction and Referral
Action By: House of Representatives
05/21/2015 Referred to the Committee on Energy and Commerce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. 
Type of Action: Introduction and Referral
Action By: House of Representatives
05/21/2015 Introduced in House 
Type of Action: Introduction and Referral
Action By: House of Representatives


S-1455

Title: Recovery Enhancement for Addiction Treatment Act or the TREAT ACT

A bill to provide access to medication-assisted therapy, and for other purposes; to the Committee on Health, Education, Labor, and Pensions.

Summary:

 

Recovery Enhancement for Addiction Treatment Act or the TREAT Act

 

Amends the Controlled Substances Act to increase the number of patients that a qualifying practitioner dispensing narcotic drugs for maintenance or detoxification treatment is initially allowed to treat from 30 to 100 patients per year.

Allows a qualifying physician, after one year, to request approval to treat an unlimited number of patients under specified conditions, including that he or she: (1) agrees to fully participate in the Prescription Drug Monitoring Program of the state in which the practitioner is licensed, (2) practices in a qualified practice setting, and (3) has completed at least 24 hours of training regarding treatment and management of opiate-dependent patients for substance use disorders provided by specified organizations.

Revises the definition of a "qualifying practitioner" to include: (1) a physician who holds a board certification from the American Board of Addiction Medicine; and (2) a nurse practitioner or physicians assistant who is licensed under state law to prescribe schedule III, IV, or V medications for pain, who has specified training or experience that demonstrates specialization in the ability to treat opiate-dependent patients, who practices under the supervision of, or prescribes opioid addiction therapy in collaboration with, a licensed physician who holds an active waiver to prescribe schedule III, IV, or V narcotic medications for opioid addiction therapy, and who practices in a qualified practice setting.

Directs the Comptroller General to initiate an evaluation of the effectiveness of this Act, including an evaluation of: (1) changes in the availability and use of medication-assisted treatment for opioid addiction, (2) the quality of medication-assisted treatment programs, (3) diversion of opioid addiction treatment medication, and (4) changes in state or local policies and legislation relating to opioid addiction treatment.

 

Bill introduced to Senate on May 22, 2015

SponsorSen. Markey, Edward J. [D-MA]

Bill Text - Read Entire bill here

Actions 

03/16/2016 Committee on Health, Education, Labor, and Pensions. Ordered to be reported with an amendment in the nature of a substitute favorably. 
Type of Action: Committee Consideration
Action By: Senate Health, Education, Labor, and Pensions
05/22/2015 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. 
Type of Action: Introduction and Referral
Action By: Senate

 

 

HHS Takes Steps To Increase Access to Opioid Use Disorder Treatment Medication

Proposed change would allow physicians to prescribe buprenorphine to more patients.

HHS is proposing a new rule to allow physicians to prescribe the opioid use disorder treatment medication buprenorphine to an increased number of patients. The proposed change is designed to strike a balance between expanding access to this important treatment, encouraging use of evidence-based medication-assisted treatment (MAT), and minimizing the risk of drug diversion.

If adopted, the proposal would allow for a qualified and currently waivered physician to prescribe buprenorphine for up to 200 patients. Buprenorphine is a U.S. Food and Drug Administration-approved drug used as part of MAT, a comprehensive way to address the recovery needs of individuals that combines the use of medication with counseling and behavioral therapies to treat substance use disorders. Buprenorphine—because of its lower potential for abuse—is permitted to be prescribed or dispensed in physician offices, significantly increasing its availability to many patients. When taken as prescribed, buprenorphine is safe and effective.

HHS welcomes public comment on this proposed rule, which will be open for 60 days starting Wednesday, March 30, 2016.

Review and Comment on the Proposed Rule

Comments