DEA Increases Access to Medication-Assisted Treatment

By Paul Gaita 01/25/18

More qualified medical professionals are now allowed to prescribe buprenorphine, an opioid dependency medication. 

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A new deregulatory measure will allow nurse practitioners and physician assistants to prescribe and dispense the opioid dependency drug buprenorphine, which will grant increased access to medication-assisted treatment (MAT) in areas of the country where qualified doctors may be in short supply.

The U.S. Department of Justice made the announcement on January 23, which reverses previous regulations that allowed only qualified physicians who had registered with the Drug Enforcement Administration (DEA) to administer the drug. The measure waives that requirement in the hopes of increasing treatment options in rural areas, where 53% of counties had no medical professionals qualified to treat opioid dependency with medication.

Prior to the enactment of the Drug Addiction Treatment Act (DATA) in 2000, only medical professionals who had registered with the DEA as both physicians and operators of a Narcotic Treatment Program (NTP) could administer, dispense and prescribe controlled substances approved by Food and Drug Administration (FDA). DATA waived the NTP registration requirement, but mid-level practitioners, such as nurse practitioners, clinical nurse specialists and physician assistants, remained prohibited from qualification.

But according to findings by the National Rural Health Association (NRHA), 90% of DATA-waived physicians practice in urban areas, while more than half of rural counties and some 30 million individuals live in areas where no prescribing physician is available.

The Justice Department press release cites buprenorphine providers in such areas, who say that they lack adequate supplies to meet the demands of patients in this area, many of whom are required to travel long distances to gain access to such treatment. The NRHA report also found that 92% of such areas have fewer options for inpatient and day treatment facilities, while 2017 data from the Centers for Disease Control and Prevention (CDC) noted that overdose death rates in rural regions have surpassed drug overdose deaths in metropolitan areas for several years.

The deregulation by the DEA brings the agency into conformity with the passage of the Comprehensive Addiction and Recovery Act in 2016, which allowed some mid-level practitioners to obtain the DATA waiver to prescribe medication-assisted treatment who were licensed under state law to prescribed Schedule III, IV or V medications and who had completed training and other qualifications. Some 5,000 nurse practitioners and physicians' assistants were approved by the DEA, and the agency noted that nearly 43,000 mid-level practitioners nationwide may now qualify for approval.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.