Biden relaxes rules on opioid treatment

May 5—BOSTON — Opioid addicts seeking treatment will have more choices following a decision by the Biden administration to relax rules on a popular drug therapy.

The government issued new guidelines last week allowing more practitioners to prescribe buprenorphine.

Currently physicians and nurses authorized to administer the drug, used as therapy for opioid addiction, must undergo training and apply for a federal waiver before they're allowed to write prescriptions.

The new rules ease requirements for treating patients. Addiction recovery experts say that will save lives by allowing more people struggling with addiction to get treatment.

"Medication-based treatments save lives, whether it's heart disease, diabetes or substance abuse," said John Rosenthal, co-founder and chairman of the Police Assisted Addiction and Recovery Initiative, a group that works with law enforcement. "These barriers to treatment have never made sense, and lifting them means more people can get access to treatment."

President Joe Biden was criticized for postponing a similar rule written under former President Donald Trump. But the Biden administration's rule goes further, officials said.

Under the changes, nurse practitioners, physician assistants and certified nurse midwives will be allowed to administer the drugs. Health care workers will still need training and waivers if they treat more than 30 patients with the medication-assisted treatment.

Buprenorphine, also known by the brand name Suboxone, can help curb withdrawal symptoms and cravings.

Opioids killed more than 1,500 people in Massachusetts during the first nine months of 2020, a 2% increase from the same period a year earlier, according to the state Department of Public Health.

Many of those deaths involved fentanyl, a powerful synthetic opioid that's 50 times more potent than heroin.

More than 10,000 people have died from opioid-related overdoses in the state in the past five years.

Nationally, more than 90,000 Americans died during the 12-month period ending in September 2020, according to data from the U.S. Centers for Disease Control and Prevention.

The rise in opioid deaths has come as the nation battles the coronavirus pandemic.

But even before that, in 2019, a state commission found numerous barriers to medication-based treatment in Massachusetts, such as a lack of providers, onerous regulations, local opposition to treatment facilities and a reluctance among physicians to treat addicts.

There is limited access to methadone, another treatment for opioid addiction, in part because of strict federal regulations for dispensing the controlled substance, the report noted.

Cost is another issue. While methadone treatments can cost up to $3,500 a year per patient, even the generic form of Suboxone costs two to three times as much.

Naltrexone, a non-narcotic treatment known by its brand name Vivitrol, also comes with a hefty price — about $1,300 per shot.

Rosenthal said stigma has been another barrier for those looking for treatment. Studies showing that many physicians are reluctant to treat opioid addicts.

"This is a chronic illness, not a moral failing, and it needs to be treated as such," he said.

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group's newspapers and websites. Email him at cwade@cnhinews.com