Congress’ latest opioid law isn’t enough
A new law that makes it easier for physicians to prescribe a life-saving drug to treat opioid addiction faces implementation problems.
The law, enacted in December, removed the requirement for practitioners to attend an educational course to prescribe buprenorphine, which helps patients wean from opioids such as fentanyl or heroin. The law also lifted restrictions on the number of patients doctors can treat.
Even so: The new law doesn’t mean doctors will benefit or pharmacies will stock buprenorphine, although studies have found it reduces the risk of death from an opioid overdose by about 40 percent.
The Drug Enforcement Administration subjects the drug to such strict regulation that many are reluctant to give it away.
While one government arm tries to expand access, another creates a bottleneck, said Michael Lynch, a physician who specializes in addiction medicine, “Only a limited number of these prescriptions can actually be fulfilled.”
Why it matters: Doctors told POLITICO they are having trouble filling patients’ prescriptions as pharmacies and drug distributors try not to get in trouble with the DEA.
Practitioners experienced in treating opioid addiction told POLITICO that there are other obstacles:
— Many doctors are unaware that the educational requirements for prescribing buprenorphine are gone.
— There are snags with insurance coverage.
— Some states have their own requirements for physicians to prescribe the drug.
Advocates of the treatment say the government can do more to reduce the opioid death toll: more than 80,000 lives in 2021.
“Any obstacle anyone faces when trying to get life-saving medication needs to be removed,” said Stephen Martin, director of research and education at Boulder Care, a telemedicine addiction treatment clinic.
The DEA responds: A spokesman for the agency said the DEA is reaching out to pharmacies and making public statements to encourage buprenorphine prescribing and is working to identify bottlenecks in the distribution chain.
At a Event at the White House in JanuaryDEA Administrator Anne Milgram called the new law “a game changer” and acknowledged that “there is still more for us to do”.
Here we explore the ideas and innovators shaping healthcare.
A new discovery by researchers at Harvard Medical School suggests that gut microbes could one day be used to help people recover from injuries.
The study in mice found that microorganisms in the mice’s gastrointestinal systems produced T cells that acted as “sentinels, sensing damage at distant sites in the body and then acting as emissaries to repair that damage,” senior author Diane Mathis said the Harvard Gazette.
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healthcare organizations have a new HHS guide to strengthening their cyber defenses.
Compliance with the handbook is initially voluntary.
But the advice comes a week after President Joe Biden’s assistant national security adviser on cyber and new technologies, Anne Neuberger, said she thinks healthcare organizations should be required to meet some sort of minimum cybersecurity standard.
There is support for this from important legislators.
In January he chaired the Senate Intelligence Committee Mark Warner (D-Va.) said Ben that “the amount of damage being done will require standards.”
In the guide: The new HHS roadmap includes best practices and a “common language to combat cybersecurity.” It is a guide to implementation 2018 Cyber Security Standards developed by the Department of Commerce’s National Institute of Standards and Technology.
These standards provided guidance on how to mitigate risk by controlling access to critical systems, monitoring supply chains, and monitoring emerging threats.
“Cyberattacks on healthcare are among the fastest-growing types of cybercrime – compromising patient care, damaging the integrity of healthcare systems and threatening the U.S. economy,” Dawn O’Connell, HHS assistant secretary of preparedness and response, said in a statement .
Game Status: It is unclear how many healthcare organizations have adopted the best practices. A Government Accountability Office Report April 2022 found that HHS — and several other federal agencies — had taken no steps to determine the level of acceptance.
Telemedicine was used more common among Veterans Affairs health care beneficiaries in rural areas than among those who lived in cities prior to the arrival of Covid. But as the use of telemedicine increased during the pandemic, the script flipped.
According to a new study based on more than 66 million visits through the end of 2021, 55 percent of VA patients in rural areas have used telemedicine during the pandemic, compared to 60 percent of patients in urban areas published Tuesday in JAMA Network Open. The gap was more pronounced in mental health care, the study found.
“Widespread expansion of telemedicine without addressing the underlying causes of digital inequality in rural areas may result in rural telemedicine adoption lagging behind,” the UCLA researchers wrote; the University of California, San Diego; the Veterans Health Administration; and other.
The researchers suggested:
— Removal of structural access barriers such as broadband
— ‘Tailoring technology to promote adoption’ in rural patients
— Continue efforts to promote digital literacy
Zoom out: The researchers found that the urban-rural divide persisted despite the VA’s previous efforts to broaden coverage.
The agency has long allowed virtual care across state lines and was an early adopter of telemedicine infrastructure. It began by handing out electronic tablets to veterans who needed a method of meeting practically long before the pandemic.
But the agency has been scrambling to implement a new electronic health record system.
A VA spokesman said the agency has a five-year plan to strengthen virtual care for rural beneficiaries.
