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Results sorted by updated date (newest first)
Posted 5/26/2021 (updated 4/10/2024)
Opioid dependence is a chronic relapsing disorder with considerable individual and global public health burden. The current standard of care for opioid dependence includes treatment with methadone or sublingual (SL) buprenorphine or buprenorphine-naloxone (hereafter, buprenorphine), combined with psychosocial and behavioral support. Both medications are associated with reductions in mortality, illicit opioid use, bloodborne viral infections, and criminal behavior as well as better cost-effectiveness than no treatment or psychosocial treatment alone. Buprenorphine is a partial μ-opioid receptor agonist, enabling office-based treatment for nonsupervised or take-home use of the medication. However, SL formulations of buprenorphine are prone to nonmedical use (eg, injecting, diversion), prompting models of care, particularly in the early phases of treatment, requiring regular attendance at clinics or pharmacies for administration of doses.
Posted 12/21/2022 (updated 3/27/2024)
The Substance Abuse and Mental Health Services Administration released a notice of proposed rulemaking that would allow certified opioid treatment programs to begin prescribing the drug via audio-only or video-enabled telehealth. See additional information under Policy Updates below. The proposed changes come on top of recent findings by HHS of the positive impact of its revised Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder that removed two longstanding requirements for obtaining a waiver to treat up to 30 patients with buprenorphine: 1) the requirement for specific training, and 2) the need for otherwise eligible clinicians to certify their ability to provide or refer patients for counseling and other services. Rural primary care providers have obtained the DEA waiver at a lower rate than urban clinicians; decreased burden and greater flexibility in the guidelines, along with broader use of telehealth could help close that gap.