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Opioid Drugs

Biden Relaxes Buprenorphine Prescribing but Pharmacies Aren’t Biting

— May 5, 2021

Although physicians are more readily able to prescribe buprenorphine, pharmacies are still refusing to dispense it.

The Biden administration has eased guidelines for prescribing the addiction treatment drug buprenorphine (marketed as Subutex or Suboxone) is and, yet a new study found one in five U.S. pharmacies still refuse to dispense it.  Under the new White House policy, health workers won’t need extra training to prescribe the drug and will no longer be required to refer patients to counseling services.

“The medical evidence is clear: access to medication-assisted treatment, including buprenorphine that can be prescribed in office-based settings, is the gold standard for treating individuals suffering from opioid use disorder,” Adm. Brett P. Giroir, assistant secretary for health, said at the time. “Removing some of the certification requirements for an X-waiver for physicians is a step toward providing more people struggling with this chronic disease access to medication-assisted treatment.”

“Buprenorphine is a vital, lifesaving medication for people with opioid use disorder, but improving access has been a problem for a variety of reasons,” agreed the study’s senior author, Daniel Hartung, a professor at Oregon Health & Science University/Oregon State University College of Pharmacy, in Corvallis.  The study was published online in the Drug and Alcohol Dependence journal.

Biden Relaxes Buprenorphine Prescribing but Pharmacies Aren't Biting
Photo by Alexandr Podvalny from Pexels

Hartung and his colleagues contacted 900 U.S. pharmacies, focusing on 473 counties with the highest rates of opioid overdose fatalities.  The team found “20% of the pharmacies” would not dispense buprenorphine.  “Independent pharmacies and those in southern states were much more likely to restrict buprenorphine,” according to the report.

Only buprenorphine, methadone and naltrexone are approved by the Food and Drug Administration (FDA) to treat opioid use disorder (OUD).  Buprenorphine is used to ease withdrawal symptoms and pain, balancing brain function.  “Any disruption in access to buprenorphine can seriously harm a patient’s addiction recovery,” the study authors noted.

Study co-author Dr. Ximena Levander, a clinical instructor in the OHSU School of Medicine added of the need for buprenorphine prescribing, “If I see a patient and they want to get started on buprenorphine, they’ve already gone through a lot of processing to make that behavior change.  Any barrier can be very disruptive, especially when initiating treatment because they’re at high risk to return to use.”

The Biden Administration’s move comes amid an even higher overdose crisis due to COVID-19.  Current Centers for Disease Control and Prevention (CDC) data reveals that 87,000 Americans died of overdoses during the 12-month period that ended in September 2020.

Dr. Michelle Lofwall, an addiction specialist and researcher at the University of Kentucky, said a black market for buprenorphine has been an issue over the years because patients cannot get into centers, and until the medication is more commonly prescribed, this will continue to happen.   “These people want help, and they tried, and they didn’t succeed.  So now they’re going to go get it if it’s available,” she explained. “They’ve had it and they know it works for them and they want to get it legally.  They want to get their life back.”


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