Sunday, December 30, 2012

Dear Colleague Letter 12-6-2012 Final Rule Modifying Buprenorphine Dispensing Restrictions in OTPs

National Alliance for Medication Assisted Recovery

Press Release

Contact Persons:
Joycelyn Woods, Executive Director,
Roxanne Baker, President,
Phone/Fax: 212-595-NAMA

The National Alliance for Medication Assisted Recovery ‘s (NAMA Recovery) purpose is to represent the interests and rights of patients receiving Medication Assisted Treatment (MAT). While NAMA Recovery commends the Center for Substance Abuse Treatment for attempting to equalize Buprenorphine in Opioid Treatment Programs (OTPs) with Office-Based Opioid Treatment (OBOT) prescribing physicians our concern is it will have a negative effect on OTP patients creating a two tier system. We suggest that this is an opportunity to normalize medications within the OTP.

Both methadone and buprenorphine should have an induction period so that dose adjustments can be made and to insure that patients are taking their medication daily. At the end of thirty (30) days if patients have negative toxicology and are showing progress that take home medication be started for responsible patients prescribed methadone and buprenorphine. Without these adjustments patients prescribed methadone will be impelled to switch to buprenorphine with often disastrous results (i.e. inadequate dosing, opioid pain medications are difficult to prescribe).

Including buprenorphine as a medication prescribed in OTPs will most certainly increase diversion of buprenorphine and this in turn results in increased stigma which is already occurring and more restrictive policy.

Unfortunately it is very probable that those receiving methadone at OTPs will pay the price for any diversion from OTPs whether buprenorphine or methadone.

We recognize that the services offered in OTPs make them uniquely qualified to treat addictive disorders. NAMA Recovery urges caution to insure that the goals of this Dear Colleague letter are met in making MAT more available and to adjust the policy to make a fairer OTP system.

Since its beginning methadone treatment has been demonstrated to be the most effective treatment for opioid addiction, resulting in the termination of opioid use and of criminal behavior. In spite of this success, methadone treatment is often disparaged as a “substitute drug” by those who ignore the positive benefits that it has clearly brought to society. These attitudes negatively impact on opiate treatment programs in a variety of ways, but it is the methadone patients themselves who are particularly stigmatized and harmed. With the advances of science and introduction of buprenorphine it was hoped that the stigma and prejudice directed at patients and programs would change. As the premier international advocacy organization for Medication Assisted Treatment (MAT) the National Alliance for Medication Assisted Recovery* (NAMA Recovery) will actively respond to the issues that affect the daily lives of MAT patients and work towards the day when they can take pride in their accomplishments.

Download Dear Colleague Letter

Download NAMAR Press Release

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