Emergency department (ED) physicians need to play a bigger role in propagating evidence-based opioid addiction treatments, including harm reduction, said U.S. Surgeon General Dr. Jerome Adams while speaking at the American College of Emergency Physicians forum in Washington, D.C. on May 25, 2018.
Dr Jerome highlighted the effectiveness of harm reduction tactics, such as needle exchange programs and safe injection sites, in tackling the consequences of drug abuse. He further emphasized the need to involve community stakeholders in understanding the benefits of harm reduction strategy. According to him, seeking community resources and engaging the stakeholders to offer long-term recovery programs and support harm reduction strategy can help in shattering the cycle of patients overdosing, stabilizing at EDs, undergoing detox and getting discharged without recovery support.
Besides, he also stressed on allowing ED doctors to widely prescribe medication-assisted treatment (MAT) like buprenorphine, similar to what France did to deal with its heroin epidemic. Notably, the country recorded a 79 percent reduction in overdose deaths over four years in the 1990s after it allowed its ED doctors to prescribe buprenorphine without any training requirements or limiting the number of patients they could treat.
In spite of implementing an array of measures to combat the opioid epidemic in the United States, reports identified an almost 30 percent increase in emergency department (ED) visits due to suspected opioid overdoses between July 2016 and September 2017 across the U.S.
Seeking inspiration from France
Hit hard by the heroin epidemic, France recorded a 10 percent annual rise in overdose deaths in the 1980s. Surprisingly, instead of implementing any revolutionary reform, the country changed its regulations around buprenorphine, setting an example for peers like the U.S., which is currently in the midst of an opioid epidemic. France allowed its doctors to prescribe MAT to patients struggling with opioid addiction, without them applying for either a license or getting trained. As a result, almost 10 times more people struggling with opioid addiction were able to access MAT, considerably reducing the overdose death rates.
However, in the U.S., the laws involving the use and prescription of buprenorphine continue to remain strict. They mandate any doctor to apply for a waiver and take an eight-hour medical course before he/she can be allowed to prescribe buprenorphine for opioid addiction treatment. Meanwhile, there is no requirement to seek training or certification to prescribe opioids or painkillers.
As a result, only around 50,000 of the more than 950,000 active physicians in the U.S. can currently prescribe buprenorphine. Even these physicians can prescribe buprenorphine to a maximum of 30 patients. In order to be able to prescribe MAT to more people, they need to apply for further certification.
While scrapping the law completely could result in total devastation as buprenorphine abuse is also fairly common among the population, easing the regulation as per the requirement of every state and city can “minimize the downside,” said Dr. Jerome.
Medical intervention needed to overcome opioid addiction
Treating opioid addiction without medical help can be challenging considering the severe opioid withdrawal symptoms. However, timely professional support can help one recover completely. A treatment program comprising MAT, which includes prescribing naltrexone, buprenorphine or methadone, counselling sessions and alternative therapies can be an effective opioid addiction treatment, available at most opioids addiction treatment centers.
If you or a loved one is grappling with opioid addiction, contact Sovereign Health, a leading behavioral and addiction treatment center in the U.S. We offer evidence-based MAT and other cutting-edge therapies to patients of addiction to help them achieve long-lasting recovery. Call our 24/7 helpline or chat online for more information about our opioids addiction rehabs, spread across the country.