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Regulation Change Could Help Addiction Treatment In The West

Jessica Hatchell

The U.S. Department of Health and Human Services is easing restrictions on one of the most effective treatments for opioid addiction.

That medication is buprenorphine, and the change makes it so healthcare professionals don’t have to get extra training to offer the medication to as many as 30 patients with opioid addiction.

Addiction specialists hailed the move, including Dr. Donald E. Nease, Jr. with the University of Colorado Anschutz Medical Campus. He thinks this is a great step toward acceptance of medications that help in addiction treatment.

“Reminds me a lot of early in my career,” Nease said, “when the same thing happened with the routine treatment and primary care of depression.”

The Mountain West hasn’t seen the worst of the opioid crisis, but use has been increasing in the region and overdose deaths have risen nationwide during the pandemic.

And there are plenty of other challenges within doctors' offices to overcome, like more frequent reimbursement.

“I think making this available to folks whether they’re on public assistance insurance or private insurance, that’s really important,” said Dr. Nease.

Another hurdle is physicians themselves.

“This change in (HHS) guidance is a great step, but unfortunately doesn’t guarantee that all these prescribers are automatically going to start prescribing buprenorphine,” said Elizabeth Stone, a PhD student at the Johns Hopkins Bloomberg School of Public Health.

A recent survey Stone conducted showed that stigma against addiction affects whether doctors will prescribe medication for it.

“Less than 30% of (primary care physicians) reported that they were willing to have a person taking medication for (opioid use disorder) as a neighbor or marry into their family,” the survey found.

That stigma led to 11% less likelihood that a physician would prescribe medications for someone with opioid use disorder.

Another surveyshowed that only 38% of physicians wanted the federal government to remove a waiver system that would allow them to prescribe buprenorphine without extra hurdles.

Even pharmacies play a role. A study published this week shows that one in five U.S. pharmacies block access to buprenorphine.

Dr. Yngvild Olsen is an addiction medicine specialist who works with the American Society of Addiction Medicine. She believes one of the biggest hurdles addiction treatment faces is continued stigma around the disease. That includes how addiction medications have been regulated.

“Having a separate registration, having a separate training requirement that’s focused on this one particular medication, that has unfortunately continued to perpetuate some of that stigma,” she said.

Olsen hopes that this HHS change is just the first of many, including getting rid of more barriers to treatment and encouraging more education about addiction treatment in medical schools.

For some researchers, like Dr. Like Linda Zittleman, there’s a hope for community education, too. Zittleman works with the High Plains Research Network and IT MATTTRs program.

“...we found that when patients, community members, and practice care teams learned about what’s called the cycle of addiction – what actually happens in the brain when someone has a use disorder – many of their assumptions and views on treatment shifted,” she wrote.

“When addicted to opioids, a person gets to a point of using not to get high but to avoid withdrawal, avoid feeling awful. When people understand that, their perspective on opioid use disorder and its treatment can shift.”

This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Boise State Public Radio in Idaho, KUNR in Nevada, the O'Connor Center for the Rocky Mountain West in Montana, KUNC in Colorado, KUNM in New Mexico, with support from affiliate stations across the region. Funding for the Mountain West News Bureau is provided in part by the Corporation for Public Broadcasting.

Copyright 2021 Boise State Public Radio News. To see more, visit Boise State Public Radio News.

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