Problem

The overdose crisis is accelerating: The United States just suffered the deadliest year on record for overdose deaths. More than 107,000 Americans died of an overdose in the twelve months ending in December 2021, the vast majority from opioids.

¹

Centers for Disease Control and Prevention, 12 Month-Ending Provisional Number of Drug Overdose Deaths (Dec. 2021).

Drug overdose is a primary cause of death for new mothers and the leading cause of death for Americans under the age of 50.

²

Drug Policy Alliance, Drug Overdose, https://bit.ly/3riFWcT (“Accidental drug overdose is currently the leading cause of death in the United States for those under 50. Drug overdose deaths now exceed those attributable to firearms, car accidents, homicides, or HIV/AIDS.”).

Veterans, rural Americans, and persons of color all disproportionately suffer from the overdose crisis. Without action, hundreds of thousands more Americans will die from an overdose over the next decade.

³

Max Blau, “Opioids could kill nearly 500,000 Americans in the next decade”, STAT News (Jun. 27, 2017), https://bit.ly/2OVJNzD.

According to public health officials, the gold standard of care for opioid use disorder are medications that prevent painful withdrawal symptoms like buprenorphine.

⁴

U.S. Dept. Health & Human Svcs., Office of the Surgeon General (“U.S. Surgeon General”), Facing Addiction in America: The U.S. Surgeon General’s Spotlight on Opioids (2018), https://bit.ly/3fcP2Ft (“Medication-assisted treatment (MAT) combined with psychosocial therapies and community-based recovery supports is the gold standard for treating opioid addiction.”).

Buprenorphine is a medication, available in generic, that helps people secure long-term recovery and is considered among the most cost-effective treatments for opioid use disorder. Buprenorphine and medications like it cut the risk of overdose death in half.

But, due to current restrictions in federal law, only about 1 in 10 people with opioid use disorder receive medications.

⁵

Substance Abuse and Mental Health Svcs. Admin., National Survey of Drug Use and Health (2020), https://bit.ly/3GuRuCn.

To prescribe buprenorphine for opioid use disorder, medical providers are subject to bureaucratic requirements that impede access to care. Communities who suffer disproportionately from overdose deaths, including new mothers, veterans, rural Americans, and persons of color, have little to no access to this lifesaving medication. In the midst of the overdose crisis, we are in the tragic and self-defeating position of having more federal restrictions on the prescription of effective medical treatments for opioid use disorder than on the prescription of opioids themselves. 

Solution

The Mainstreaming Addiction Treatment Act allows all medical providers with a standard controlled medication license to prescribe buprenorphine for opioid use disorder just as they prescribe medications for other chronic medical conditions. In addition, the bill will expand access to publicly available education for healthcare providers on the best practices for treating opioid use disorder.

By helping to build universal access to buprenorphine for opioid use disorder, the Mainstreaming Addiction Treatment Act will increase participation in treatment and more fully integrate substance use disorder care into the healthcare system. The bill could help save more than 30,000 Americans every year from overdose death and empower them to achieve long-term recovery.

⁶

Kevin Fiscella, MD, MPH, Sarah E. Wakeman, MD, Leo Beletsky, JD, MPH, Buprenorphine Deregulation and Mainstreaming Treatment for Opioid Use Disorder: X the X Waiver, 76(3) JAMA Psychiatry 229-30 (2018), https://bit.ly/3tOlHp2 (“Removing buprenorphine prescribing regulations in France yielded increases in its use by persons with OUD.2 Notably, deaths from opioid overdoses in France declined 79% over the subsequent 3 years. If extrapolated to the United States, this translates to more than 30 000 fewer annual deaths from opioid overdoses.”).