The Obama administration is taking steps to increase the ability of patients suffering from opioid abuse or overdose to receive buprenorphine and naloxone.

The increased access is among several actions President Obama is announcing March 29 to deal with the opioid abuse and heroin epidemic. The announcement coincides with his attendance at the National Rx Drug Abuse and Heroin Summit in Atlanta.

Specifically, HHS is issuing a proposed rule to increase the current patient limit for qualified physicians who prescribe buprenorphine, used to treat opioid dependency, from 100 to 200 patients. The department's Substance Abuse and Mental Health Services Administration is also releasing a new $11m funding opportunity for states to purchase and distribute the opioid overdose reversal drug naloxone and to train first responders and others on the use of the drug and other overdose prevention strategies.

During a press call announcing the actions, Michael Botticelli, director of National Drug Control Policy, said that although buprenorphine has been available for some time – it was approved for clinical use in 2002 – very few physicians have gone through training to prescribe it. He noted that the treatment also has been underutilized in the primary care setting.

Botticelli also pointed out that under current law only physicians are allowed to prescribe buprenorphine. He said the President's fiscal year 2017 budget proposal includes a demonstration project to allow nurse practitioners and physician assistants to prescribe the drug.

Richard Frank, HHS Assistant Secretary for Planning and Evaluation, added that insurance coverage for substance use disorder treatment has been lagging and that there is stigma and "professional discomfort in some quarters" about prescribing the drug. He said HHS has been working with professional societies to get them to commit to doing more education among their members so they will be more active in prescribing and in medication-assisted treatment practices.

Medical Schools Adopt Prescriber Education

Among other actions, HHS is finalizing a rule to strengthen access to mental health and substance use services for people enrolled in Medicaid and Children's Health Insurance Program plans by requiring that the benefits be offered at parity to medical and surgical benefits.

The President is also signing a memorandum directing the creation of an interagency task force to advance access to mental health and substance use disorder treatment and to promote parity.

The White House said that in connection with these actions, more than 60 medical schools are announcing that, beginning in the fall of 2016, they will require their students to take some form of prescriber education in line with the Centers for Disease Control and Prevention's recently released guidelines for prescribing opioids for chronic pain ([A#14160315007]).

Drug sponsors are required to provide education programs for prescribers under the Risk Evaluation and Mitigation Strategy (REMS) for extended-release and long-acting (ER/LA) opioids.

The President's proposed budget for fiscal year 2017, announced in February, proposes $1.1bn in new mandatory funding over two years to expand access to treatment for prescription opioid drug abuse and heroin use.

The announcement of new actions follows a flurry of government activity directed to the epidemic. On Feb. 4, FDA announced an action plan rebooting its policies to deal with the crisis ([A#14160204003]).

Last week, the agency added boxed warnings to the labeling of immediate-release opioid products to make them more closely aligned with labeling for ER/LA opioids ([A#14160322005]). The agency also issued draft guidance for generic drug manufacturers to test generic abuse-deterrent solid oral opioid products ([A#14160324002]).

Opioid Abuse: White House Expanding Access To Buprenorphine, Naloxone

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