Leading medical professionals in the United States have called for a review of treatment methods available to doctors regarding opiate addiction. Removing current restrictions on the prescription of the drug Suboxone are highlighted as an important alteration required for the effective treatment of those who suffer from opiate abuse.
Treatment options for people addicted to substances are constantly under scrutiny by experts. In the United States much like here in the UK it appears most experts are in agreement that there is a need for the number of patients being treated by the drug Suboxone (Buprenorphine and Naltrexone) to increase. Currently doctors who are able to provide treatment including Suboxone therapy are limited to 100 prescribed patients at any given time. This is due to a number of reasons the first being historical laws regarding the prescribing of opiate medications.
Opiate addiction was previously viewed as prescription induced, that is, dependence developed after opiates were prescribed by doctors. As a result laws were enacted to prevent doctors prescribing opiate based medicines to more than 30 patients at any given time. This number was later increased to 100 if they had formerly kept the cap of 30 and applied for a special waiver. The reasoning for this was due to the belief that people receiving opiate treatment were more needy of the doctor’s time than other patients, they require not only prescriptions refilling but help with co-existing disorders such as mental health problems or behavioural disorders. Given the high demands, an individual Doctor’s ability to give a quality service to more than 100 patients was questioned.
Dr Elinor McCance-Katz, Professor of Psychiatry at the University of California believes all doctors now need to be trained in how to appropriately assess and treat opiate addiction. Dr. McCance-Katz said, "We need more doctors who feel comfortable and competent in providing Suboxone treatment. The Government has developed a training program to allow doctors to receive a waiver for Suboxone treatment, but we don’t have nearly enough doctors participating. I am the Medical Director of the program, called the Physicians' Clinical Support System for Buprenorphine (PCSS-B). The program provides training and clinical mentorship to practicing physicians and physicians-in-training who want to include office-based treatment of opioid use disorders in their practice. This program, sponsored by the Centre for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA), includes training at no charge to physicians. The peer mentoring program allows doctors to ask questions on setting up a practice, and to discuss treatment issues as they arise"
She goes on to explain that the reason there is poor take up of the programme by doctors is because there is little emphasis put on substance abuse disorders in medical school, Doctors are leaving medical school with a limited knowledge and often a distorted view of the client base which, in turn, makes them unwilling and uncomfortable treating them.
Here in the UK Suboxone is a Schedule 3, class C drug. It requires a licence or prescription to possess it legally. Its common use is as treatment for severe opiate addiction.