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There have been huge changes at the federal level regarding the prescribing of medications for opioid use disorder, particularly regarding buprenorphine. For two decades since the DATA 2000 law, addiction clinicians had to get a specialized waiver through the DEA to prescribe buprenorphine, and many states passed laws with practice guidelines and limits on the numbers of patients they could see. There were other stipulations and regulations, and while well intentioned, there were quite a few negative consequences. Most of all, access to treatment was significantly limited for most people with an opioid use disorder.
Recent legislation, namely the Mainstreaming Addiction Treatment or MAT Act, got rid of the X waiver altogether. This immediately granted every prescribing physician in the country with an active DEA license the ability to prescribe buprenorphine. This bill passed with bipartisan support and was hailed as the right call from just about everyone across the board.
But in the year since, we haven’t seen much of an uptake in access. And many states – including Tennessee – still have restrictions in place for nurse practitioners and physician assistants.
My guest this month is Dr. Stephen Loyd, chief medical officer of Cedar Recovery and Chair of the Tennessee Opioid Abatement Council. In this conversation, we discuss what policy gaps remain, especially surrounding the issue of dose limits for buprenorphine, and the difficulties of treatment in the age of fentanyl.
Hosted and produced by Jeremy Kourvelas. Original music by Blind House.
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