Rule on Dispensing Buprenorphine Eased

A new federal rule has been issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) concerning the dispensing of buprenorphine in opioid-abuse treatment programs.

The rule, which took effect January 7, allows these addiction-treatment programs more flexibility in dispensing take-home supplies of buprenorphine, removing restrictions on the length of time a patient needs to be in treatment to receive take-home supplies of the medication.

“This is a very positive development and should lead to increased access to treatment,” John Renner, M.D., associate chief of psychiatry at the VA Boston Healthcare System and chair of the APA Council on Addiction Psychiatry, said in an interview with Psychiatric News. “It gives opioid treatment program clinicians the full range of treatment options now available to physicians in office-based practice. Treatment decisions will now be more flexible and patient-centered rather than constrained by programmatic regulations. It should also make it easier to shift patients between methadone and buprenorphine, depending on their treatment needs. I think most clinicians and patients will see this as a very welcome change,” Renner stated.

The change in the federal buprenorphine rule will not affect requirements for dispensing methadone—the other opioid-agonist treatment medication used by programs that treat opioid addiction.

SAMHSA officials based the change in the restrictions for dispensing buprenorphine on several factors. These include differences in the abuse potential between methadone and buprenorphine, as well as actual abuse and death rates in treated opioid addicts. Buprenorphine is lower in both of these categories than is methadone. ■