DELEGATION URGES DEPARTMENT OF HEALTH AND HUMAN SERVICES TO WAIVE PATIENT CAP FOR MAINE DOCTORS WHO TREAT OPIATE ADDICTIONS
WASHINGTON, D.C.—Maine Senators Susan Collins and Olympia J. Snowe and Congressmen Tom Allen and Mike Michaud have written a letter to Charles G. Curie, Administrator of the Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. In it, they urge Mr. Curie to exercise the Department’s authority to exempt Maine ’s buprenorphine-waivered physicians from the 30-patient cap imposed under current law on individuals who prescribe these drugs in their offices to treat opiate addictions.
Maine has one of the highest rates of opioid addiction in the nation and among the highest number of physicians per capita approved for prescribing buprenorphine. However, Maine ’s methadone treatment programs are at capacity, as are the buprenorphine-waivered physicians.
Following is text of the letter:
We are writing to request that the Department of Health and Human Services (DHHS) exercise its authority to exempt Maine ’s buprenorphine-waivered physicians from the 30-patient cap imposed under current law on individual physicians who prescribe Subutex (buprenorphine) and Suboxone (buprenorphine/naloxone) in their offices to treat opiate addictions. While the Congress recently enacted Public Law 109-56 to expand access to treatment options for patients addicted to opiates, the measure does not reach far enough to alleviate the ongoing crisis in our state.
Current law allows certified physicians to prescribe buprenorphine and buprenorphine/naloxone, but limits the number of patients treated to 30 per individual physician. While the new Public Law 109-56 eliminated a provision which applied the 30-patient limitation to group practices, it preserved the 30-patient limitation on individual physicians. It is our understanding that no other medication is so limited. In fact, we understand that the Food and Drug Administration (FDA) continues to approve potent new opioid analgesics without placing any limits on prescribers.
Research and considerable clinical experience throughout the U.S. and the world have proven that buprenorphine is a uniquely safe and effective treatment for opiate addiction. It is our understanding that there has not been a single documented overdose death in the U.S. since the drug’s introduction. It can be prescribed by office-based physicians, and we are told that it is perfectly suited to expanding access to addiction care, particularly in large rural states, like Maine .
Maine has one of the highest rates of opioid addiction in the nation. Our State’s methadone treatment programs are at capacity, as are the buprenorphine-waivered physicians. The Director of Maine’s Office of Substance Abuse estimates that there are over 20,000 untreated opiate addicts in Maine . Residents in large areas of our state, including most of the Mid Coast and Downeast regions, are without access to care. Only one hospital program in the Southern Maine region – the Mercy Recovery Center – provides comprehensive inpatient and outpatient treatment of opioid dependence.
Unfortunately, the Mercy Recovery Center is forced to turn away at least 10 patients a week who call seeking help for their addiction. While Mercy Hospital has attempted to increase access to care by sponsoring buprenorphine training programs for community physicians, there is an urgent need to increase access to this very effective and life-saving treatment now. If an exemption is not provided, under current law Maine would have to import 667 new certified/licensed/trained physicians to be able to prescribe enough Suboxone to meet the existing need of untreated addicts in our State.
The Drug Addiction Treatment Act of 2000 gave the Secretary of HHS the authority to grant exemptions to the 30-patient limit to waivered physicians. We urge you to consider lifting the 30-patient cap for certified addiction medicine specialists in Maine . By so doing, HHS will expand access to needed care for a very desperate population.
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For more information, contact:
Antonia Ferrier (Snowe) 202/224-1304
Jen Burita (Collins) 202/224-2523
Mark Sullivan (Allen) 207/774-5019
Monica Castellanos (Michaud) 207/782-3704