Biden administration nixes trump plan to waive training for doctors to prescribe buprenorphine

[Purposefull]

The Biden administration is preparing to halt a last-minute plan by the Trump administration to let more physicians prescribe an opioid-treatment drug, said three officials with knowledge of the pending announcement, who spoke on the condition of anonymity because they were not authorized to discuss the plan.


The Trump plan had been hailed by physicians as loosening requirements they said had slowed their response to the nation’s worsening opioid crisis. Then-presidential candidate Joe Biden also criticized the prescribing rules and vowed to lift them if elected president. But some legal experts warned that the Department of Health and Human Services lacked the authority to issue guidelines that allowed physicians to avoid requirements mandated by Congress.


“Unfortunately, the Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder announced by the Trump administration in its last days had significant legal and clinical concerns,” according to a draft announcement obtained by The Washington Post. “The Biden Administration will not issue the Guidelines previously announced.”

Under the Jan. 14 announcement, many physicians would have been exempted from the “X” waiver — a two-decade-old requirement, first mandated by Congress, to undergo a day’s training before they could prescribe buprenorphine for opioid use disorder. The Trump administration sought to go around Congress’s requirements by issuing new “clinical guidelines” that would have enabled doctors with a Drug Enforcement Administration narcotics prescribing license to avoid the training. https://www.msn.com/en-us/news/us/b...on-opioid-treatment-prescriptions/ar-BB1d5ja2

Good move. The plan under the last administration would have allowed in essence any doctor, regardless of training or not to prescribe buprenorphine to anyone. it was a last minute attempt to create a buttload of new buprenorphine addicts all in the name of "fighting the opiate crisis".
I don't know about the rest of you, but it seems this is how we got into the mess in the first place by allowing the pharma companies to peddle potent pain killers to anyone with a medical degree who in turn were handing out pain killers like candy..

 

[Deru]

I couldn't agree with you more. We first need to reassess how we prescribe buprenorphine before we let any random person with the ability to prescribe controlled medications free reign to prescribe bupe, as the ones with training can't even seem to get it right half the time.

 

[DeathIndustrial88]

I feel conflicted about this.

Your guy's worries are definitely legitimate, but Suboxone can and does save lives.

I also have to wonder when we will ever get past the drug war altogether and allow addicts to have access to a clean, safe version of their DOC.

By killing this, people who may have wanted help will have less options. It's also not addressing the underlining issue that a lot of deaths & OD's are attributed to black market narcotics and these deaths and crimes could be reduced significantly if heroin/opioids were made available for addicts to legally use. (And no I don't mean buprenorphine & methadone). Hell even a little lesser restrictions around methadone would be nice.

People who can medicate themselves responsibly (just like an alcoholic, pothead, etc..) does, should not be punished and made into a criminal for using their DOC.

 

[G_Chem]

Yea I’m on the fence too... On one hand this would be huge for many with poor access to doctors able to prescribe buprenorphine. On the other hand, this drug doesn’t play and even doctors trained to prescribe it can mess up. I think the huge unnecessary dosages many get is evidence enough of that.

So ya, hard to say but in the end this probably a good thing.

-Gc

 

[DeathIndustrial88]

While some are saying it's probably a good thing because then everywhere would be flooded with more buprenorphine... I would say if anyone is gonna use opioids, they're probably better off trying/using suboxone than they are a bunch of fent-analogues wrapped up and presented as 'heroin' on the street corner, that might kill them.

I mean think about it.. A doctor doesn't need a DEA license to prescribe any other full agonists... But a shitty, partial agonist with a ceiling limit on respiratory depression, barely any euphoria, and overdose is rare.... needs a doctor with a special license to prescribe it. So why would doctors being able to prescribe buprenorphine be any worse than doctors currently having the ability to prescribe fentanyl or oxymorphone?

 

[Flynnal]

It's interesting that a Democrat would do something like this, but then again it's not surprising. Most of the drug warriors are, in fact, Democrats, and not Republicans.

Most drug warriors are actually left-wing. Most people really can't seem to get it.

I've always presumed that controlling and ruining lives was the wet dream of any powerful politician. Let's face it, as much as I hate to say it, the vast majority of them are either narcissists or psychopaths anyway.

So we get what we had here last week. Which is the way he wants. Well, he gets!

 

[Nightraver]

Heck you guys are divided about the prescribing of a powerful opioid and in formerly Great Britain we can’t even get access to medical weed which has been made legal but only for people rich enough to see a private doctor
Even then it’s a mine field of red tape
If we could get access to medical weed our opioid problem would actually start reversing
Most people I know on heroine over here were given it by scum they had to deal with trying to get weed
I know you can lead a horse to water but can’t make him drink it but if they hadn’t been exposed to it in the first place they might be alive now

 

[burn out]

I couldn't agree with you more. We first need to reassess how we prescribe buprenorphine before we let any random person with the ability to prescribe controlled medications free reign to prescribe bupe, as the ones with training can't even seem to get it right half the time.

Any random person? As has been pointed out, these people can prescribe morphine, benzos, amphetamines, antipsychotics, etc. There is no reason they should need a special license to prescribe suboxone. What this does is it makes very hard for some people to get suboxone. When I needed it, iI had trouble finding it because suboxone doctors can only have a certain number of patients and many of them are full and not accepting new patients so that can delay your ability to get what is a potentially life saving medication. Then, in my experience a lot of the suboxone doctors are actually kind of shady doctors whose whole practice sometimes consists of prescribing suboxone and they prescribe huge amounts and keep people on it for years. I think you acknowledge that last part since you said we need to reassess how we prescribe suboxone, which I agree with, but rather than supporting the idea of needing a special license I would argue it illustrates the fact that requiring a special license has not accomplished anything. Despite the extra training, doctors still have no idea what they're doing. Maybe there is a better approach?

 

[cosmic charlie]

All drugs should be legal period and people should be educated about them in classes at school from an early age. We could create distribution centers with further education and warning pamphlets being given regarding the said drugs you are buying. Human beings should be allowed to ingest whatever we choose to especially in "the land of the free". Sure I take Bupe now illegally cuz it's very hard to find doctor in my area right now and I love to get it prescribed again I finally have insurance.

But what id rather be doing is using the pharmaceutical Heroin that truly calms my troubled soul and treats my pain. For being members of a drug forum alot of people around here drug prohibitionist attitude and i cant fault you because of how we all have been brought up. But the real change that needs to happen is legalization of everything and sure maybe an age restriction of 18 years old for non supervised medical use of narcotics would make sense but to say it's a bad thing for everyone to have access to a pretty damn safe medication for an opioid like Bupe with a lower overdose risk than most of them, well that's just silly.

Especially when I still watching my friends overdose on Fentadope around here every week and in had to get hit with Narcan less than a week ago cuz I cant find one of these doctors and half on google in my area have closed up shop cuz of Covid19 maybe unofficially but it had never been this hard for me to find one in the past. If it was up to me the country would be flooded with drugs, pure and clean ones and in time we would all adapt and LESS people will die period and spend half their life suffering like i have done to the war on drugs it makes me so angry, and I begin to question anyone else that agrees with it at this stage in the game.

~Shadow Cat

 

[Deru]

Despite the extra training, doctors still have no idea what they're doing. Maybe there is a better approach?

I sure hope so. It would probably have to start with doctors not feeling pressured to pump people full of 720+ MME to prioritize protecting their license versus their patient's health. I cringe every single time I hear someone go into rehab or to a doctor for an opioid addiction to 100 to 200 MME/day and come out a bigger opioid addict than they went in on, prescribed 480 to 720 MME of buprenorphine (16 to 24 mg).

 

[DeathIndustrial88]

All drugs should be legal period and people should be educated about them I'm classes at school from an early age. We could create distribution centers with further education and warning pamphlets being given regarding the said drugs you are buying. Human beings should be allowed to invest whatever we choose to especially in "the land of the free". Sure I take Bupe now illegally cuz it's very hard to find doctor in my area right now and I love to get it prescribed again I finally have insurance.

But what id rather be doing is using the pharmaceutical Heroin that truly calms my troubled soul and treats my pain. For being members of a drug forum alot of people around here drug prohibitionist attitude and i cant fault you because of how we all have been brought up. But the real change that needs to happen is legalization of everything and sure maybe an age restriction of 18 years old for non supervised medical use of narcotics would make sense but to say it's a bad thing for everyone to have access to a pretty damn safe medication for an opioid like Bupe with a lower overdose risk than most of them, well that's just silly.

Especially when I still watching my friends overdose on Fentadope around here every week and in had to get hit with Narcan less than a week ago cuz I cant find one of these doctors and half on google in my area have closed up shop cuz of Covid19 maybe unofficially but it had never been this hard for me to find one in the past. If it was up to me the country would be flooded with drugs, pure and clean ones and in time we would all adapt and LESS people will die period and spend half their life suffering like i have done to the war on drugs it makes me so angry, and I begin to question anyone else that agrees with it at this stage in the game.

~Shadow Cat

I couldn't agree with you MORE!!!!!! My EXACT feelings and thoughts for the longest time!

I have been an opioid/heroin addict for 12 years and never ONCE overdosed. The only time I even came close is when I was given FENTANYL. Not REAL DIACETYLMORPHINE. But I was smart about it and only did a little tester bump! I immediately knew it wasn't heroin but some kind of fent and was incredibly careful with the rest of the batch. I'm living proof that heroin CAN be used safely, long term, and even responsibly!

Nothing truly helps heroin cravings better than actual heroin. And some countries do this! Like Switzerland!

There is so much misinformation and misunderstandings around heroin & opioids.
People have been conditioned to believe if you use heroin, you WILL die. And it's just not true.
Most overdoses are from people combining an opiate with several other downers. They OD and then the autopsy shows they had an opiate in their system
and it gets labeled an "opioid overdose". Or someone gets a bag of "heroin" and it's actually fent or some other potent analogue and they stop breathing and it will
get labeled a "heroin overdose". When in reality, it's not THAT easy to overdose on opiates (including heroin) when used ALONE. Especially if you have a tolerance.

Not to mention all the dangers of the black market and the issues that come with all that.
I've been on bupe for 5 years and it has stopped working for cravings for me. The only thing keeping me from going back to heroin is the fact that my dealer is in prison for murder and I wouldn't have the money to keep a habit on it anyway. But it truly is what treats what ails me.

People can come home from work or go to a bar and get so black out drunk shit faced and potentially hurt everyone else around them and this is LEGAL and OK and even advertised in our faces on TV. But I'm a bad person/junkie/etc.. if I would rather come home and take some heroin and chill? Really?

The war on drugs boils my blood!!!!!! I'm so glad to see some one else who can see it like it is!!! I really hope to see heroin-legalization in my life time. And no I don't mean "oregon decriminalized drugs!" type legal, but actually access for addicts to get safe daily doses.

If anyone truly wanted to stop the "opioid epidemic" they would allow people to use safe, clean, heroin. Other countries have proven this, why is the US so far behind? You have to wonder why they wouldn't want to try something new to stop, but I bet we all already know why they don't.

 

[neversickanymore]

Anybody check on the massive past requirements needed to prescribe this.. lol look into it. I think its around a 40 hour course taken by a licensed physician, Probably at Club Med. (I love that company) Don't fully quote me on that as much of the current data has been temporarily taken down. But to look at its history, in the future, look under HHS Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder. I voted for Joe, but this is a bone head move. Good lord with 40 hours of education they are supposed to learn addiction, while trying to scuba dive the Caribbean. That's if your not just whisked in by your peers. That's much faster then the most prone addict does. Sorry for the interruption, continue the gov shit show!!

End game right now are many physicians are pretty clueless about addiction and politicians are clueless in general. Where is the lobby to clue them in? Not from the DEA sanctioned drug dealers. Oxy Family gets prosecuted and the US gov just confiscates its own paper money.. big win there.

 

[G_Chem]

It's interesting that a Democrat would do something like this, but then again it's not surprising. Most of the drug warriors are, in fact, Democrats, and not Republicans.

Most drug warriors are actually left-wing. Most people really can't seem to get it.

I've always presumed that controlling and ruining lives was the wet dream of any powerful politician. Let's face it, as much as I hate to say it, the vast majority of them are either narcissists or psychopaths anyway.

So we get what we had here last week. Which is the way he wants. Well, he gets!

While I’m not a fan of Biden, saying most drug warriors are left is plain false. All the states with the most backwards drug laws are very red.

In Oregon, the west half is left and the eastern right half is right (works well I suppose) ask the west liberal half about the new drug laws and they love em, ask the right East half and it’s bullshit druggies should be locked up.

Idaho and Florida two of the reddest states I’ve visited are both the scariest places to be with drugs.

From the time Trump came in there was a noticeable increase border drug patrol. In fact the only time I’ve ever had a package opened was during his time in office with many years before having no issue.

-GC

 

[Flynnal]

While I’m not a fan of Biden, saying most drug warriors are left is plain false. All the states with the most backwards drug laws are very red.

I was really referring to Britain and Australia. But in the USA this is also partially true - at least for the Democrats that actually matter - the Presidents and State Governors. None of the Democrat presidents have ever entertained the idea of decriminalizing drugs let alone ever passed a motion or a referendum on it. The left-wing here in Australia are very much against drugs...even cannabis! The same goes for New Zealand and they actually voted against recreational cannabis...but they at least got one thing right - they officially voted on dying-with-dignity legislation that would ensure patients were given the choice of a more peaceful end should they fall victim to a painful and lethal illness.

 

[thegreenhand]

Yeah considering that these doctors still have the narcotics training I see no reason they can’t prescribe buprenorphine as well. More people with access to MAT = less people dead. Will some people be wrongly prescribed it? Sure, but that already happens and someone on pharmaceutical drugs is a hell of lot less likely to die than someone using street drugs

Oh and drugs warriors are not a right or left issue. Both sides use it to profit when in office.

when the drug czar was created Reagan said"This bill is the product of a bipartisan effort."

http://www.reagan.utexas.edu/archives/speeches/1988/111888c.htm

 

[Flynnal]

"This bill is the product of a bipartisan effort."

Which is why neither party should ever be trusted on drug reform. This sort of reform must come from grassroots. No one at the top gives two fucks about us guys, or at least 99% of anyone at the top, being more truthful I guess.

This is the fight for the common man, no one is going to do this for you - it's on you to protest these stupid and nonsense policies that continue to ruin lives. The government isn't here to FIX your problems, it's here to CREATE them for you.

 

[cosmic charlie]

Im about to jump on Methadone Maintenance im giving up on the Bupe doctors for now, the done holds me better anyways and since its Covid you only go once a week at this place no matter what and that's pretty Dope I can live with that probably try and get my dose around 100mgs when im able who knows where they will start me tho probably 40mgs than generally the introduction at most places I've been at so I will have to talk to the doctor and have him push me up, my cravings get fierce and I just don't wanna deal with that shit anymore honestly. So I surrender to my liquid handcuffs to set me free...

 

[neversickanymore]

Im about to jump on Methadone Maintenance im giving up on the Bupe doctors for now, the done holds me better anyways and since its Covid you only go once a week at this place no matter what and that's pretty Dope I can live with that probably try and get my dose around 100mgs when im able who knows where they will start me tho probably 40mgs than generally the introduction at most places I've been at so I will have to talk to the doctor and have him push me up, my cravings get fierce and I just don't wanna deal with that shit anymore honestly. So I surrender to my liquid handcuffs to set me free...

You obviously have been around the block, but switching from bupe to methadone I'm thinking 40 to start will be more than enough. Are you on subs or bupe? What's your dose? Post back your experience as I like to hear about it.