Health and Human Services Secretary Sylvia M. Burwell just announced big steps to increase access to the treatment of opioid dependence in the US by expanding access to medication-assisted treatment (MAT). This will be achieved by revising the regulations related to the prescribing of buprenorphine to treat opioid dependence. She also announced $1.8 million in awards to rural communities to expand access to naloxone – a drug that reverses an opioid overdose.
The announcement came during a two-day intensive convening of representatives from all 50 states and Washington, DC focused on preventing opioid overdose and opioid use disorder. The announcement addresses an ever growing problem in the U.S. and around the world and follows a recent controversial FDA approval the narcotic painkiller OxyContin for pediatric use.
In 2013, overdoses from prescription opioid pain relievers claimed more than 16,200 lives, with more than 145,000 people dying from these overdoses over the last ten years. Heroin deaths have also been climbing sharply, more than doubling between 2010 and 2013. The resulting health, social, and economic consequences for communities across the country and the globe are enormous.
“The opioid epidemic knows no boundaries; it touches lives in cities, rural counties and suburban neighborhoods across the country,” said Secretary Burwell. “That’s why it’s so important that we come together – both state and federal leaders – and take a coordinated and comprehensive approach to address this crisis. We all have a role to play and fortunately we share common ground and a common commitment to end this crisis.”
The conference is being held just as Research and Markets put out a report titled, “Global Opioids Overview 2015-2021 – An Assessment of Pain Management and Dependence in the $15 Billion Industry.” The report discusses the use of opioids as potent analgesics for the treatment of cancer and non-cancer pain and examines the management of opioid dependence in the US, the UK, Germany, Spain, Italy, France, Australia, Japan, India and China.
Analysis pertaining to the prescribed opioid users, treatment patterns, and market revenues confirms that the use of weak opioids has fallen dramatically in most markets, while the use of strong opioids has increased. The total market size in the countries covered in this report was $15.7 billion in 2014, of which the US accounted for the highest share, followed by Japan and Germany.
The global prevalence of chronic pain was 20-30% in the same year, although most of the prevalence population received inadequate treatment due to the high potential for opioid abuse or misuse. They found that patient access and cost of treatment remain the key barriers to effectively managing opioid dependence in most countries.
Trying to address these very matters, the HHS Conference will focus specifically on improving opioid prescribing practices, increasing access to naloxone, and expanding the use of medication-assisted treatment (MAT).
Medication-assisted treatment (MAT) is a comprehensive way to address the needs of individuals that combines the use of medication with counseling and behavioral therapies to treat substance use disorders. Nevertheless, existing evidence shows that this lifesaving, evidence-based treatment is under-utilized. A recent HHS report indicates that of the 2.5 million people who currently need treatment for opioid use disorder, fewer than 1 million are receiving it. To help close this gap, the secretary announced today that HHS will move to revise the regulations related to the prescribing of buprenorphine-containing products approved by the FDA for treatment of opioid dependence.
“Updating the current regulation around buprenorphine is an important step to increasing access to evidence-based treatment – helping more people get the treatment necessary for their recovery,” said Burwell.
Under current regulations, physicians that are certified to prescribe buprenorphine for MAT are allowed to prescribe up to 30 patients initially and then after 1 year can request authorization to prescribe up to a maximum of 100 patients. This cap on prescribing limits the ability of some physicians to prescribe to patients with opioid use disorder. The HHS revision to the regulation will be developed to provide a balance between expanding the supply of this important treatment, encouraging use of evidence-based MAT, and minimizing the risk of drug diversion.
The secretary also announced today grant awards of approximately $1.8 million from the Office of Rural Health Policy in HHS’ Health Resources and Services Administration to support rural communities in reducing opioid overdose and death. Recipients, representing 13 states, will use the funding to purchase naloxone, train health care professionals and local emergency responders in the use of naloxone, and facilitate the referral of people with opioid use disorder to substance abuse treatment.
In addition to the secretary, attendees will hear from Office of National Drug Control Policy Director Michael Botticelli, U.S. Surgeon General Dr. Vivek H. Murthy, and Centers for Disease Control and Prevention Director Dr. Tom Frieden, as well as a number of other HHS leaders. The convening is a collaboration between HHS and the National Governors’ Association, the Association of State and Territorial Health Officials, and the National Association of State Alcohol and Drug Abuse Directors. This is the second national meeting that HHS has convened on the opioid epidemic.
Addressing the opioid crisis is a top priority for the administration and the secretary is committed to bipartisan solutions and evidence-informed interventions to turn the tide against opioid drug-related overdose and misuse. This past spring, Secretary Burwell announced a department-wide, evidence-based initiative focused on three promising areas: informing opioid prescribing practices, increasing the use of naloxone, and increasing access to MAT. For more information on the department’s efforts and this initiative, click here. In addition, the President’s Fiscal Year 2016 Budget includes $133 million in new funding to reduce opioid misuse and abuse through prevention and treatment initiatives.
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