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ABSTRACT
Attention must be focused on needed changes to the current United States law that restricts physicians who prescribe buprenorphine for the detoxification or treatment of Opioid Use Disorder, to accepting no more than 100 patients. The current system does not provide comprehensive treatment as defined by the American Society of Addiction Medicine (ASAM) criteria. In addition, it suffers from both fragmentation and stigma and will require a significant change to comply with ASAM's call for integrated delivery of comprehensive addiction treatment. This commentary calls for the development and implementation of “best practice,” by recommending caution in lifting the 100 patient limit until substantial achievement of this goal occurs. The authors call for an increase to 200 in the patient limit to be restricted to those physicians who are Board Certified in Addiction Medicine by the American Board of Addiction Medicine (ABAM) or in Addiction Psychiatry by the American Board of Psychiatry and Neurology (ABPN), or other responsible medical organizations. Any additional restriction lifting should follow a systemic evolution that rewards and documents competency. Such a system would involve the integration of treatment, treatment systems, and recovery with prescription medication. In addition, it should monitor emotional blunting, treatment progress and initiation of genetic addiction risk testing.
Acknowledgments
Many thanks go to the following: David Baron, DO, of the Departments of Psychiatry & Behavioral Sciences at the Keck School of Medicine of USC; John Femino, MD, North Kingstown, RI; Charles Moehs, MD, at Occupational Medicine Associates in Watertown, NY; A. Kenison Roy III, MD, at Addiction Recovery Resources, Inc., in Metairie, LA; William Jacobs, MD, at the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Georgia Regents University; Daniel Anges, MD, at the Northwestern Feinberg School of Medicine; David E. Smith, MD, at the Institute of Health and Aging, University of California at San Francisco; Eric R. Braverman, MD, and Mona Li, BA, at the Department of Clinical Neurology at PATH Foundation NY in New York, NY; Gregory Bunt, MD, at Daytop, Inc., in New York, NY. The authors appreciate the important contributions of Mona Li and Margaret A. Madigan. The authors also want to thank Mary Hauser of Dominion Diagnostics, LLC for her support.
Declaration of interest
Kenneth Blum owns stock in LaVita RDS and is owner of Synaptamine, which holds patents on KB220Z. Dr. Blum is the holder of a number of US and Foreign issued and pending patents related to Nutrigenomics and Nutraceuticals. Through IGENE LLC., Dr. Blum exclusively licensed the Genetic Addiction Risk Score (GARS)™ to Dominion Diagnostics, LLC, as a sales organization. He is a paid consultant of Dominion Diagnostics, LLC, IGENE. Dr. Blum is a member of the scientific advisory board of Dominion Diagnostics, LLC and is Chief Scientific Advisor of Dominion Diagnostics, LLC; LaVitaRDS; Shores Treatment and Recovery center and Summit Estates Recovery Center. Rajendra D. Badgaiyan is on the Scientific Advisory Board of LaVita RDS.
Funding
This work was supported by the National Institutes of Health grants, 1R01NS073884 and 1R21MH073624, awarded to Dr. Rajendra D. Badgaiyan.
Funding
This work was supported by the National Institutes of Health grants, 1R01NS073884 and 1R21MH073624, awarded to Dr. Rajendra D. Badgaiyan.