Hatch, Levin Hail Success of Drug to Combat Heroin Addiction, But Say Certifying More Doctors to Dispense and Prescribe the Medication Could Treat More Addicts and Save More Lives

Senators hold Senate symposium to review data on the first three years of availability of buprenorphine

WASHINGTON – At a Senate symposium on Thursday, Sens. Carl Levin, D-Mich., and Orrin Hatch, R-Utah, will hail the success of buprenorphine, a medication that helps to block the craving for heroin. They will stress that increasing the number of physicians who are certified to dispense and prescribe the medication could help substantially in reaching more heroin addicts. A 2000 law sponsored by Hatch and Levin, the Drug Addiction Treatment Act, made it legal for physicians to distribute the medication in their offices, and the FDA approved its use in 2002, a revolutionary breakthrough. But since its legalization, less than two percent of primary care physicians have applied for certification to treat patients in their private offices with buprenorphine.

Hatch and Levin are hosting the symposium and have invited officials from the Department of Health and Human Services (HHS) who will highlight the findings of a three-year study that has tracked the availability and use of buprenorphine. At the symposium, physicians, patients, and health policy experts will provide first-hand accounts of office-based buprenorphine treatment.

“In the past three years, we have seen the dramatic life-saving impact that buprenorphine can make in the lives of heroin addicts. We have seen hopefulness in situations where hope had seemed lost,” Levin said. “Buprenorphine can only be effective, however, if patients have access to it and an adequate number of physicians are prescribing it. This study by HHS confirms our hopes about the effectiveness of buprenorphine and also helps to illuminate things that need to be done to help more patients reach this powerful medicine.”

“We need to break the pernicious cycle between heroin addiction and crime,” said Hatch. “If we can encourage thousands of addicts into rehabilitation today, they and their families will be able to live more productive lives tomorrow. We can make major gains in our nation’s crime problem and improve the social structure and stability of many families who today live under the scourge of drug abuse.”

Under the law, physicians must obtain a certification to disperse buprenorphine, but only 7,518 total physicians have done so. Among general practitioners, including internal medicine and family medicine practices, only 2,910 physicians have been certified out of 242,924 potential doctors in these practice areas, or less than two percent.

In addition to establishing a process through which trained physicians can dispense or prescribe buprenorphine, the Drug Addiction Treatment Act required the Secretary of HHS to evaluate the impact of office-based buprenorphine treatment. In compliance with this requirement, the Secretary directed the Substance Abuse and Mental Health Services Administration to conduct a survey to determine 1) the availability of the office-based treatment, 2) the effectiveness of the office-based treatment, and 3) the potential adverse public health consequences.

The HHS survey found that buprenorphine treatment is clinically effective and well-accepted by patients; the program has increased the availability of medication-assisted treatment; adverse effects have been minimal; the 30-patient limit established in DATA and cost reimbursement issues may decrease potential access to treatment; and longer term studies are necessary to determine the relative cost-effectiveness of buprenorphine treatment under this program.

Participants in the symposium, in addition to Hatch and Levin, include Nora Volkow, MD, Director, National Institute on Drug Abuse, National Institutes of Health, U.S. Department of Health and Human Service; H. Westley Clark, MD, JD, MPH, Director, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services; Herbert Kleber, MD, Professor of Psychiatry and Director, Division on Substance Abuse, College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute; Charles R. Schuster, PhD, Distinguished Professor of Psychiatry and Behavioral Neuroscience, Wayne State University School of Medicine; David Fiellin, MD, ASAM, Associate Professor of Medicine, Yale University School of Medicine; Jim Finch, MD, a Family Practice physician from Durham, NC; and two patients successfully treated with buprenorphine, Korean War veteran Odis Rivers, who is now drug free and no longer taking buprenorphine, and Tess Walker, a college student who has been in treatment for several years and remains free of her addiction to heroine.

The Hatch-Levin Drug Addiction Treatment Act of 2000 (DATA 2000) established that certified physicians may prescribe certain medications to treat heroin addiction in an office-based setting and with take-home maintenance prescriptions. This groundbreaking law created an entirely new treatment modality for millions of Americans who suffer from dependence on opioids, which include heroin, morphine, and some prescription painkillers. Prior to passage of this law, medical treatment for opioid addiction and dependence was restricted to designated drug abuse treatment centers.