Should the United States Government Repeal Restrictions on Buprenorphine/Naloxone Treatment?

Kenneth Blum, Mark Gold, H. Westley Clark, Kristina Dushaj, Rajendra D. Badgaiyan

Research output: Contribution to journalComment/debatepeer-review

6 Scopus citations

Abstract

Attention must be focused on needed changes to the current United States law that restricts physicians who prescribe buprenorphine for the detoxification or treatment of Opioid Use Disorder, to accepting no more than 100 patients. The current system does not provide comprehensive treatment as defined by the American Society of Addiction Medicine (ASAM) criteria. In addition, it suffers from both fragmentation and stigma and will require a significant change to comply with ASAM's call for integrated delivery of comprehensive addiction treatment. This commentary calls for the development and implementation of “best practice,” by recommending caution in lifting the 100 patient limit until substantial achievement of this goal occurs. The authors call for an increase to 200 in the patient limit to be restricted to those physicians who are Board Certified in Addiction Medicine by the American Board of Addiction Medicine (ABAM) or in Addiction Psychiatry by the American Board of Psychiatry and Neurology (ABPN), or other responsible medical organizations. Any additional restriction lifting should follow a systemic evolution that rewards and documents competency. Such a system would involve the integration of treatment, treatment systems, and recovery with prescription medication. In addition, it should monitor emotional blunting, treatment progress and initiation of genetic addiction risk testing.

Original languageEnglish (US)
Pages (from-to)1674-1679
Number of pages6
JournalSubstance Use and Misuse
Volume51
Issue number12
DOIs
StatePublished - Oct 14 2016
Externally publishedYes

Keywords

  • Buprenorphine
  • competency
  • drug urine testing
  • genetic risk
  • naloxone
  • restriction cap
  • United States law

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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