With concerns that a looming economic crisis linked to the COVID-19 pandemic could send rates of substance use disorder in the U.S. soaring in the coming months, national not-for-profit addiction treatment advocacy group Shatterproof is hoping that federal legislators will revisit a pair of bills that could expand access to medication-assisted treatment.
Currently, according to Shatterproof research, just 3.4% of medical professionals who can prescribe opioids in the U.S. publicly disclose that they can also prescribe buprenorphine to treat opioid addiction. (An additional 2.3% are waivered to prescribe buprenorphine, but do not appear to publicly disclose this, according to Shatterproof’s findings.) As a result, 39% of U.S. counties do not have a publicly listed waivered buprenorphine prescriber.
Two pieces of previously proposed legislation could address this:
Mainstreaming Addiction Treatment Act. Introduced by Rep. Paul Tonko of New York in May 2019, the bill would remove the separate waiver, called a DATA 2000 X-waiver, required for buprenorphine prescribing. In a recent news release, Shatterproof noted that overdose-related deaths in France dropped 79% within three years of similar legislation being enacted.
Shatterproof chief public policy officer Kevin Roy tells BHE that the additional waiver currently required is a barrier in itself.
“There are so few waivered prescribers to begin with,” Roy says. “We have reason to believe the waiver itself is the barrier. We need to remove that barrier and remove the stigma that is associated with it. If there is a separate training to prescribe treatment than there is to prescribe the addictive substances themselves, we think that is a contributing factor to the stigma around treating people with addiction and for those seeking treatment.”
Medication Access and Training Expansion (MATE) Act. Introduced by Rep. Lori Trahan of Massachusetts in November 2019, this legislation aims to ensure opioid prescribers have a baseline knowledge of how to prevent addiction, and how to identify, treat and manage patients with OUD. A separate study Shatterproof conducted in Massachusetts along with RIZE Massachusetts and the GE Foundation illustrated the current gap: 1 in 4 providers said they had received addiction training during their medical education.
The MATE Act is a logical complement to the MAT Act in that it would be a significant step toward normalizing addiction treatment education for medical professionals as the barrier for prescribing medications for OUD would be lowered.
“If you are going to be allowed by federal regulations and DEA policy to prescribe controlled substances, you should also have an accompanying understanding of the risks of addiction and the basics of treatment for it,” Roy says. “We think these pieces of legislation go hand-in-hand.”
Roy adds that Shatterproof leaders would like to see federal lawmakers consider including the MAT and MATE Acts in future COVID-19 legislative packages.
“We certainly think Congress should take a close look at including them in one of the COVID response packages they’re considering right now or into the fall,” he says. “Addiction and the impacts of addiction are regrettably strongly linked with the economic crisis that is probably just developing right now. It’s only logical you do the things that are necessary before the problem becomes worse.”