Sessi Kuwabara Blanchard, in last week’s issue of Filter, an online journal emphasizing public policy in the realm of drug use and addiction, describes Congressional initiatives relating to buprenorphine prescribing limits. Before opening the link, please know that while Filter has several intelligently written and apparently well-researched articles displayed, it is of uncertain provenance: no editorial or financial support information, no editorial objectives, no history.  If this was an independent submission for continuing medical education, it would not make the cut. All the same, the linked article provides what may be useful quotations and opinions by legislators who are prominent in the design of prescribing regulations.

ARTICLE HERE

ASAM’s senior policy staffer, Kelly Corredor, has provided the following comment, with which I agree:  “In accordance with ASAM’s Public Policy Statement on the Regulation of Office-Based Opioid Treatment (see link here), ASAM recommends that clinicians obtain training covering buprenorphine, methadone, and naltrexone and any other topics that align with current federal policy. With that said, in light of recent legislative and advocacy-related developments, ASAM leadership has asked its policy committees to review that public policy statement and evaluate ways to improve access to this life-saving treatment while ensuring the delivery of high-quality, evidence-based care.”

Opinions on buprenorphine prescribing limitations have run the range from complete prohibition, to putting the medication in bubblegum dispensing devices available in public places. That should tell us something about the risks associated with being too dogmatic in pressing for the "right" solution to the question of what constitute appropriate revised limits; a compromise solution that is not agreed-to by all parties will likely fail.

- William Haning, MD, DFAPA, DFASAM