The law mandates a new type of heroin addiction therapy
The 106th Congress passed The Drug Addiction Treatment Act (S. 2634), a bill supported by the American Psychological Association that allows primary-care providers to prescribe buprenorphine to patients addicted to heroin and other opiates and recognizes that those who receive the drug should receive psychological counseling.
Buprenorphine has been demonstrated to be a safe and effective therapy alternative to clinical methadone. Despite the fact that both medicines are synthetic narcotics that help with withdrawal and cravings, research have indicated that buprenorphine is a better option because it has a lower sedative impact. Furthermore, buprenorphine dosing is simpler for patients: Methadone is taken in liquid form every day, however buprenorphine is only taken three times a week as a tablet.
The law could reduce the mismatch between the estimated 500,000 opiate-dependent individuals in need of treatment and the restricted treatment slots by enabling primary-care practitioners to prescribe the medicine. The FDA is now reviewing buprenorphine's clearance for treating opiate addiction.
The Drug Addiction Treatment Act also broadens the scope of opiate addiction treatment in other ways. "It would provide many who would not seek treatment from methadone clinics for fear of stigmatization—including working people, suburbanites, and teen heroin users—a chance to lead a normal life," says APA Acting Director for Science Policy Geoff Mumford, PhD.
As Congress debated the matter last year, the American Psychological Association (APA) argued that allowing doctors to provide buprenorphine from their offices would yield the best outcomes if the prescription was used in conjunction with psychological counseling. To that purpose, APA lobbied the House Commerce Committee alongside the College on Problems of Drug Dependence, the Academy of Addiction Psychiatry, the American Society of Addiction Medicine, and other organizations. They suggested that:
In addition to receiving competent counseling and psychosocial services, patients treated for opiate addiction in doctors' offices receive the necessary counseling and psychosocial services to complete their recovery.
In the administration of medicines like buprenorphine, primary-care physicians receive more extensive training.
Although those provisions were not included in the final bill, they are consistent with draft guidelines developed by the Advisory Council for the Center for Substance Abuse Treatment within the Substance Abuse and Mental Health Services Administration (SAMHSA), and the American Psychological Association (APA) will continue to advocate for them as the SAMHSA rules are finalized. According to opiate expert Warren Bickel, PhD, vice-chair of the psychiatry department at the University of Vermont and editor of Experimental and Clinical Psychopharmacology, the Drug Addiction Treatment Act ushers in "a new era in the treatment of heroin and opioid dependence."