ASRA Pain Medicine Update

The 12-months predicted drug overdose deaths have increased at an astonishing pace. The latest CDC reports predicted over 90,000 deaths by October 2020. In 2019, the number of reported deaths averaged 68,000 in the year. Increasing trends started in the winter of 2019 and have escalated consistently in 2020. The current percent change in the number of deaths within the US is close to 30%.^[1] This alarming pace of increase is impacted by the immense gap in treatment availability.^[2] In addition to the numerous resources that are needed to address this, what cannot be understated is the importance of having more providers that can provide evidence-based treatment, including medication for opioid use disorder in the form of buprenorphine, to prevent overdose deaths. The DEA X-waiver, while well-intentioned, can at times present a barrier for several providers to provide patient care. The legislative push to eliminate this requirement is essential. On April 27th, 2021, the Department of Health and Human Services (HHS) released new practice guidelines.^[3] Under these guidelines, providers will not require the additional 8 hours of training. Eligible providers are physicians, physician assistants, clinical nurse specialists, certified nurse specialists, certified registered nurse anesthetists, and certified midwives. They can provide treatment to up to 30 patients at a time after applying for a “Notice of Intent” with the Substance Abuse and Mental Health Services Administration to prescribe buprenorphine. In addition, the previous legal requirement to provide ancillary psychosocial treatment has also been eliminated, with the goal of providing more life-saving treatment to patients who desperately need it. With this, we encourage all pain providers to join in providing safe patient care and save lives as this treatment becomes more widespread. 

References

1. Ahmad FB, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics.  https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm. Updated May 12, 2021. Accessed June 7, 2021. 
2. HHS releases new buprenorphine practice guidelines, expanding access to treatment for opioid use disorder. The Substance Abuse and Mental Health Services Administration (SAMHSA).  https://www.samhsa.gov/newsroom/press-announcements/202104270930. Published April 27, 2021. Accessed June 7, 2021. 
3. HHS releases new buprenorphine practice guidelines, expanding access to treatment for opioid use disorder. US Department of Health & Human Services. https://www.hhs.gov/about/news/2021/04/27/hhs-releases-new-buprenorphine-practice-guidelines-expanding-access-to-treatment-for-opioid-use-disorder.html. Published April 27, 2021. Accessed June 7, 2021.