Changing Guidelines for Doctors Who Prescribe Suboxone

The opioid crisis has left many in need of effective, accessible treatment. Suboxone treatment and other buprenorphine-based medications have proven to be effective in treating opioid addictions.

Despite its efficacy, Suboxone remains tightly regulated. These governmental regulations limit which doctors can prescribe Suboxone and can make it difficult for individuals to receive the treatment they need.

To learn about the regulations surrounding doctors who prescribe Suboxone and how to find a certified Suboxone doctor near you, read on.

Which Doctors Can Prescribe Suboxone?  

Even after being available in the U.S for more than a dozen years, fewer than 4% of all American physicians are licensed 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 providers who might have occasional needs to prescribe are prohibited from doing so.

Can Primary Care Doctors Prescribe Suboxone?

While the amount of physicians that can prescribe Suboxone is growing, more are needed as the opioid epidemic continues. In fact, a recent study from the Annals of Internal Medicine found that fewer than 10% of primary care doctors are approved to prescribe buprenorphine.

The small number of doctors that can prescribe Suboxone is just one facet of the problem. Of those who do prescribe it, adequate training is often lacking. Most doctors (and/or their staff) are not prepared to treat patients suffering from substance use disorders (SUD). At times, this patient population can consume outsized resources. As a result, there is a need for providers to specialize in the treatment of SUD. At MATClinics, our staff, from top to bottom, are trained to assist the range of patients suffering from SUD.

Three-Day Rule

In January of 2017, a primary care resident wrote an op-ed piece in the Washington Post decrying his inability to prescribe Suboxone to a critically ill  SUD patient who refused to stay in the hospital for proper treatment. The patient, without access to heroin, was going through excruciating withdrawal, and the doctor believed 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. This is known as the "Three Day Rule.”

The Suboxone three-day rule allows physicians (even those without a waiver or treatment center registration) to administer the medication to a patient suffering from severe withdrawal symptoms. The doctor’s ignorance (as well as that of his superiors) led to the dismissal of a patient with a dangerous bacterial infection in his blood caused by his substance use disorder.

Addiction Medication Policy: Is Suboxone Accessible to Patients?

As administrations change, the laws regulating doctors who prescribe Suboxone also shift. Explore the rules that regulate the life-saving medication.

In the summer of 2016, the US Congress passed, and the president signed, two important new laws that aimed 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 Recovery Act (CARA) which allowed physician’s assistants (PAs) and nurse practitioners (NPs) to prescribe Suboxone.  

The required training for PAs and NPs is 24 hours instead of eight hours for physicians and is available online for free by the American Society of Addiction Medicine. These medical professionals must then submit the waiver form to the Drug Enforcement Administration (DEA) to become buprenorphine-waivered practitioners.

MATClinics has several prescribing providers on staff certified to prescribe Suboxone to those battling opioid addiction. We are excited to do our part in opening up the pipeline of Suboxone providers.

In 2021, the Trump administration repealed the DEA waiver requirement, opening the door for physicians to prescribe this highly-effective medication to patients. This move enhanced the accessibility of treatment in light of the surging opioid crisis.

However, the Biden administration reversed this action shortly after. This means that the addiction medication policy is now in a similar place as it was in 2016, with rules that make it harder for those in need of Suboxone to get it.

Find a Certified Suboxone Doctor in Maryland

Suboxone regulations change, but MATClinics remains committed to providing effective and individualized treatment for those suffering from opioid addiction. Our certified Suboxone providers work with you to ensure you receive the best treatment possible. Learn more about how medication assisted treatment works and how you or your loved one can find healing at MATClinics today!

Contact MATClinics for more information.

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