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Expert calls for reforms to address the overdose crisis

addiction
Credit: Pixabay/CC0 Public Domain

At the end of 2022, the federal government eliminated the "X waiver," a major hurdle to providing addiction treatment, but progress needs to be continued, according to the authors of a new Perspective piece published in the New England Journal of Medicine.

The X waiver required a special license and uncompensated training for physicians and other prescribers, creating a regulatory barrier to offering lifesaving buprenorphine treatment for opioid use disorder. Ending the X, the authors write, is necessary but not sufficient to achieve overdose-prevention goals.

Sarah Wakeman, MD, Medical Director for Substance Use Disorder at Mass General Brigham, and her co-author Leo Beletsky, JD, MPH, University of California, San Diego School of Medicine, call for several additional measures to expand access. These include:

  • Mainstreaming addiction education: Rather than the 8-hour training the Drug Enforcement Administration is now requiring of all clinicians who prescribe controlled substances, incorporate education about addiction during medical school, residency, and other .
  • Expanding methadone access: Rethinking methadone regulations, including transitioning stable patients to office-based care with general practitioners.
  • Investing in the workforce: Federally fund training programs, including addiction medicine fellowship programs for physicians and training in addiction programs for nurse practitioners, social workers, and mental health counselors.

"The X waiver was one example of an onerous and unnecessary barrier to a lifesaving intervention, but there are many others, including methadone regulations and policies obstructing access to harm-reduction services," said Wakeman. "We believe the should continue its important progress in expanding access to medication for by rethinking methadone regulations."

More information: Sarah E. Wakeman et al, Beyond the X—Next Steps in Policy Reforms to Address the Overdose Crisis, New England Journal of Medicine (2023). DOI: 10.1056/NEJMp2301479

Journal information: New England Journal of Medicine
Citation: Expert calls for reforms to address the overdose crisis (2023, May 1) retrieved 15 July 2024 from https://medicalxpress.com/news/2023-05-expert-reforms-overdose-crisis.html
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