PROPOSED RULE AMENDS FEDERAL OPIOID TREATMENT PROGRAM REGULATIONS REGARDING DISPENSING OF BUPRENORPHINE
The Substance Abuse and Mental Health Services Administration (SAMHSA) requested comments on the proposed rule ammendment regarding the Federal OTPs dispensing requirements for buprenorphine and combination products. My comments are outlined below.
“Opioid Drugs in Maintenance and Detoxification Treatment of Opiate Addiction; Buprenorphine and Buprenorphine Combination; Approved Opioid Treatment Medications Use”
Current regulations demand of all patients receiving buprenorphine in OTPs (Outpatient Treatment Program) daily attendance for several months followed by rigidly defined criteria for less frequent visits thereafter. In marked contrast, patients receiving buprenorphine outside an OTP setting can receive at the first physician visit a prescription to be filled at any pharmacy for a month’s supply of the medication. The proposed rule-making change eliminates this arbitrary and unwarranted disparity by providing that precisely the same flexibility will apply to OTPs as has governed “waivered” physicians for several years; it is to be welcomed!
The proposed regulatory change, however, is exceedingly narrow in scope, focusing exclusively on the administration, dispensing and prescribing of buprenorphine. In stressing that buprenorphine providers and patients in OTPs shall be obliged to “adhere to all other Federal treatment standards established for methadone” the proposed rule-making notice calls attention to these “other standards,” and they demand comment. To say they are extraordinary would be an understatement; they would appear to be unique in American medicine.
For complete comments click here .