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Rule change enables more use of addiction treatment drug

Rule change enables more use of addiction treatment drug
Click here to view original web page at vtdigger.org

Within a few weeks, more Vermont medical practitioners will be eligible to prescribe a medication used in opiate addiction treatment.

A rule approved by a legislative panel Thursday will expand the categories of clinicians eligible to prescribe buprenorphine to include advanced practice registered nurses and physician assistants.

The rule change also will increase the number of patients prescribers can take on. Physicians who have been prescribing buprenorphine for at least two years will have the option of prescribing to up to 275 patients, a significant increase from the previous cap of 100.

Ginny Lyons
Sen. Ginny Lyons, D-Chittenden.

The Legislative Committee on Administrative Rules adopted the rule without any opposition Thursday.

Sen. Ginny Lyons, D-Chittenden, a member of the committee, was a strong supporter of a bill that passed the Legislature last year that began the process of expanding the medical providers who are eligible to prescribe medication-assisted treatment.

Expanding the number of prescribers will help to reduce the time that people sometimes have to wait to get access to treatment for opiate addiction, she said. When addicts decide to seek treatment but are met with waiting lists, they may be discouraged from following through, she said.

“I just do think that having more people on the front lines capable of giving proper medical assessment and treatment will keep people with their families and in their jobs without addiction,” Lyons said.

The changes will take effect in a few weeks, according to Assistant Attorney General Bessie Weiss. The new rule will bring the state in line with federal policies on prescribing medication-assisted treatment, she said.

Tony Folland, of the Department of Health, said that with the changes the department hopes addiction medicine will become a standard part of medical practice.

Already he knows of half a dozen nurse practitioners who have completed the hours of training they need in order to meet the qualifications to prescribe buprenorphine. They are in the process of applying for a change of license with the federal Drug Enforcement Agency, a requirement for prescribing the substance, according to Folland.

Folland said he did not have any estimates for how many medical providers may take advantage of the new prescribing eligibility.

“We are certainly hoping that it’s going to be high,” he said.

Rick DiStefano, who heads Bradford Psychiatric Services and Valley Vista, said he has some concerns about increasing clinicians’ patient load to 275. That is a very high caseload to carry without assistance, he said.

Bradford Psychiatric Services provides outpatient medication-assisted treatment in White River Junction and Rutland. DiStefano said there have not been issues meeting demand for care at those locations.

DiStefano said that buprenorphine is just one part of the treatment for opiate addiction. To be effective, the drug needs to be partnered with other services, such as group therapy and counseling, he said.

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