On December 8, Congress moved for the second time to increase the number of patients to whom a doctor can prescribe buprenorphine [7], an opiate agonist used to treat heroin dependence. Under an amendment to the Controlled Substances Act, certified physicians will be able to prescribe for up to 100 patients.
When Congress passed the Drug Addiction Treatment Act of 2000 allowing for the first time medical office-based opiate addiction treatment, it limited the number of patients who could be treated in any one practice to 30. Last year, Congress changed the cap to 30 patients per physician. To qualify for the new, 100-patient prescribing limit, doctors must have been certified to prescribe buprenorphine for at least one year.
"Of the estimated six million people in the United States who are dependent on opioids, many of them have been forced to wait for the medical treatment they so desperately need simply because of a mandated 30-patient 'cap' on how many people a doctor may treat," said Edwin A. Salsitz, MD, of Beth Israel Medical Center in New York City. "Enactment of the legislation will begin to address this inequity."
Salsitz was quoted in a press release from Reckitt Benckiser Pharmaceuticals, the company that manufactures Suboxone and Subutex, the formulations of buprenorphine approved for opiate dependency treatment by the Food and Drug Administration.
"This is the best-kept secret in opioid addiction and it shouldn't be," said Timothy Lepak, president of the Connecticut-based National Alliance of Advocates for Buprenorphine Treatment. "I'm puzzled that there's any limit whatsoever."
The amendment passed as part of the bill reauthorizing the Office of National Drug Control Policy (ONDCP), the drug czar's office.