Nurse Practitioners and Physician Assistants Now Eligible to Prescribe Buprenorphine

Nurse practitioners and physician assistants will now be eligible to prescribe and dispense the opioid addiction treatment buprenorphine from their office, Reutersreports.

The Drug Enforcement Administration said the change will make it easier for residents of underserved areas to receive treatment for opioid addiction.

The new rule is a result of the Comprehensive Addiction and Recovery Act(CARA), passed in 2016. The law expanded access to substance use treatment services and overdose reversal medications by extending the privilege of prescribing buprenorphine in office-based settings to qualifying nurse practitioners and physician assistants. CARA requires that nurse practitioners and physician assistants complete 24 hours of training to be eligible to prescribe buprenorphine.

Full story at drugfree.org

Although their introductions as treatment are different, two top medications for opioid addiction are equally effective

With opioid addiction officially declared a public health emergency in the U.S., medical intervention to treat the illness is increasingly important in responding to the epidemic. Now, a new study concludes that two of the top medications available for outpatient, office-based treatment, once initiated, are equally safe and effective in curtailing opioid use, relapse, treatment drop-out and overdose.

Researchers in the Departments of Psychiatry and Population Health at NYU School of Medicine, who led the study sponsored by the National Institute on Drug Abuse (NIDA) and published online November 14, 2017 in The Lancet, conclude that extended-release naltrexone (an opioid antagonist marketed as Vivitrol) demonstrated similar safety and clinical effectiveness to more commonly prescribed buprenorphine-naloxone (an opioid agonist marketed both generically and as Suboxone).

However, the study also points out differences that have previously been known: Patients being treated with naltrexone must detoxify before it can be administered. (This is commonly referred to as the “detox hurdle.”) On the other hand, buprenorphine allows individuals to transition relatively seamlessly from opioid use to medication maintenance without needing to detoxify.

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Starting opioid addiction treatment in the ED is cost-effective

The most cost-effective treatment for people with untreated opioid addiction who visit the emergency department (ED) is buprenorphine, a medication to reduce drug cravings and withdrawal, say Yale researchers. Their study found that among patients who came to the ED, the ED-initiated medication strategy was most likely to be cost-effective compared to referral alone or a brief intervention with facilitated referral, the researchers said.

The study was published in the journal Addiction.

Nationally, only about one in five individuals who needed treatment for opioid addiction received treatment in the past year, and fewer received the most effective treatments, such as buprenorphine. Yet studies have shown that treating individuals with such medications is effective. In an earlier analysis of this study, Yale researchers found that when patients are screened for opioid addiction, receive ED-initiated buprenorphine, and a referral for ongoing treatment, the treatment was more effective than a standard referral or brief intervention with referral.

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Survey Finds Many Doctors Underprescribing Buprenorphine

Doctors are underprescribing the opioid addiction medicine buprenorphine, according to a new survey of addiction specialists.

Buprenorphine can be used to treat opioid addiction in the privacy of a doctor’s office. Doctors who prescribe the medication must have a waiver allowing them to do so. Until recently, doctors with waivers could prescribe buprenorphine to 100 patients. This year, the cap was raised to 275, HealthDay reports. More than half of the doctors with a waiver said they were not currently prescribing the buprenorphine to capacity, according to the survey, which was presented at the American Psychological Association annual meeting.

Full story at drugfree.org

Why are doctors underusing a drug to treat opioid addiction?

A drug approved for private physicians to treat opioid addiction is being underprescribed, and a survey of addiction specialists suggests that many of them are not willing to increase their use of it, despite an expanding opioid addiction epidemic in the United States, according to research presented at the 125th Annual Convention of the American Psychological Association.

Two opioid replacement medications are currently approved for opioid use disorder: methadone, which under federal law must be dispensed from authorized clinics, and buprenorphine, which can be used to treat opioid addiction in the privacy of a physician’s office, so long as the physician has the proper waivers.

Full story at Science Daily