Even after being available in the US for more than a dozen years, fewer than 4 percent of all American physicians have gone through the training required to prescribe Suboxone (we use "Suboxone" to represent all buprenorphine based medications in the same way people use Kleenex to describe facial tissues).
There is frustration in every corner of addiction treatment. Patients have a hard time finding prescribing providers and the vast majority of doctors who might have occasional needs to prescribe are prohibited from doing so. Last month (January, 2017), a primary care resident wrote an op-ed piece in the Washington Post decrying his inability to prescribe Suboxone to a critically ill addict who refused to stay in the hospital for proper treatment. The patient, without his heroin, was going through excruciating withdrawal and the doctor was prohibited from prescribing him Suboxone.
But maybe the worst part of the story is that the doctor was not even aware that any physician can administer Suboxone for three days. Its called the "Three Day Rule", and his ignorance (as well as that of his superiors) led to the dismissal of a patient with a dangerous bacterial infection in his blood.
This summer, the US congress passed and the President signed two important new laws that aim to unclog the pipeline for Suboxone treatment. First was the modification to the Controlled Substances Act that increased the Suboxone patient limit of physicians to 275 from 100. The second law was the Comprehensive Addiction Recover Act (CARA) which allows physicians assistants (PAs) and nurse practitioners (NPs) to prescribe Suboxone.
The required training for PAs and NPs is 24 hours instead of the 8 hours for physicians and is available online for free by the American Society of Addiction Medicine. Unfortunately, the waiver form that that NPs and PAs have to submit to the DEA is still not available, but people can at least begin taking the course.
MATClinics has already agreed to hire its first prescribing NP and she will start with us as soon as she receives her DEA waiver. We are excited to do our part in opening up the pipeline of Suboxone providers. If you or someone you know is qualified and interested in working for MATClinics, please click here for more information.