Legislators are pushing Pennsylvania backward on opioids | Opinion

Two bills under consideration by Pennsylvania legislators threaten to take the commonwealth backward on opioids. The first is an effort to limit already-scarce evidence-based treatment. The second limits physician discretion when prescribing opioids. If either bill becomes law, Pennsylvania will be worse off, not better.

The first proposed bill is the sponsored by Senate Republicans. The bill adds further certification requirements to physicians who prescribe buprenorphine (commonly called by the brand name suboxone), including a fee that originally was set at $10,000 and was reduced to $500.

“While $500 may not seem like a large sum, I assure you that it would be an impediment to physicians who want to practice in this area,” read a statement by Brad Bachman of the American Society of Addiction Medicine in an email to members in Pennsylvania. Bachman called any further burden on treatment providers “incomprehensible.”

Using medication to treat opioid-use disorder is the gold standard of treatment. Multiple studies have shown that the use of  or to manage cravings dramatically reduces illicit drug use and retains people on treatment. Access to this evidence-based treatment is .

One reason for the lack of access is regulation. Methadone can only be administered in federally certified clinics and buprenorphine can only be prescribed by providers who undergo a training and receive a special waiver. The waiver limits the number of patients to whom a provider can prescribe buprenorphine.  . The majority of these physicians are limited to treating 30 patients maximum and in reality most treat . According to the , currently six counties in Pennsylvania have no physician certified to prescribe buprenorphine and six others have only one.

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When a person in addiction decides that she or he is ready for treatment, as a society we must ensure that evidence-based treatment is readily available. The bill does exactly the opposite of that by creating another barrier.

Why would anyone want to limit access to evidence-based treatment? and the incorrect belief that giving out buprenorphine is equivalent to flooding the streets with heroin. According to a memo written by Sen. Michele Brooks, who is the lead sponsor of the bill, buprenorphine has “become a drug that is abused, misused and is now out of control here in Pennsylvania.” Pennsylvania does not screen for buprenorphine in toxicology reports; however, a spokesperson for the state Department of Health told me that the medication is “not a significant contributor to overdose deaths. While these do occur, it is rare.” We can look at Allegheny County to try to learn how rare. In 2016, buprenorphine accounted for . Data don’t seem to support Sen. Brooks’ claim.


Like the buprenorphine act, the prescription guidelines act also reduces access to important care – pain treatment. Opioids have an important role in the treatment of pain. Research shows that  after a procedure varies dramatically between patients in unpredictable ways.

The Pennsylvania Medical Society opposes this bill, stating in an email to members that “decisions on patient care should be made by individuals in consultation with their physicians, not by legislative mandates.”  Further, some physicians warn that by reducing the supply of provider-prescribed pills, .

Multiple states responded to by legislating them into law, even though the guidelines were intended as “recommendations for primary care clinicians.” Two years after the guidelines, . In 2016, given out in the emergency room, urgent care, to patients in hospital observation or in any prescription for a minor. The new guidelines will cover many more settings and patients.

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. Proven solutions include opening syringe exchange programs and safe consumption facilities, increasing access to evidence-based treatment such as methadone and buprenorphine, . In the case of the bills currently proposed in our commonwealth’s Senate, doing nothing will be better than doing something.

Published: June 22, 2018 — 11:24 AM EDT View Comments Close Comments or .btn-comments { width: 100%; height: 48px; border-radius: 4px; padding: 10px; font-size: 1rem; font-weight: bold; font-style: normal; font-stretch: normal; line-height: normal; letter-spacing: normal; text-align: center; display: flex; flex-direction: row; justify-content: center; /* Comment Bubble Icon */ } .btn-comments .icon-comments { width: 19px; height: 20px; } .btn-comments .icon-comments .icon-comments-view { background-color: #ffffff !important; } .btn-comments .icon-comments .icon-comments-close { background-color: #000000; } .btn-comments-txt { display: flex; flex-direction: row; justify-content: space-around; font-size: 1rem; font-style: normal; font-stretch: normal; line-height: normal; letter-spacing: normal; text-align: center; } .btn-comments-view { background-color: #000000; color: #ffffff; } .btn-comments-view:hover { background-color: black; } .btn-comments-close { display: none; background-color: white; border: solid 1px #222; color: #222; } .btn-comments-close:hover { background-color: white; } .btn-comments-close .txt-comments-close { color: #222; } .btn-comments-close .txt-comments-close:hover { color: #222; } .vf-hr { border-top: solid 2px #cc0000; } .guidelines-container { margin-top: 30px; } .guidelines-container munity-guidelines { color: #000000; font-size: 1rem; text-decoration: none; line-height: normal; } .guidelines-container munity-guidelines:hover { color: #666666; } .vf-login-button, .vf-signup-button { color: #cc0000; cursor: pointer; font-size: 1rem; font-style: normal; font-stretch: normal; line-height: normal; letter-spacing: normal; text-align: left; width: 118px; height: 1rem; } .vf-login-button:hover, .vf-signup-button:hover { color: #666666; } .viafoura a.vf-branding path { fill: #EB2427 !important; } .viafoura .vf-tray-trigger { border: none !important; width: 38px; height: 35px; /* Bell Badge */ } .viafoura .vf-tray-trigger .vf-icon { width: 38px !important; height: 35px !important; } .viafoura .vf-tray-trigger .vf-tray-count { width: 18px; height: 18px; background-color: #cc0000; } .viafoura .vf-tray { top: 60px !important; height: calc(100% – 60px); } .viafoura .vf-tray-ns { top: 100px !important; } (min-width: 31.25em) { .viafoura .vf-tray { top: 90px !important; height: calc(100% – 90px); } .viafoura .vf-tray-ns { top: 130px !important; height: calc(100% – 130px); } } .viafoura .vf-tray button { outline: none; } .viafoura .vf-accent-border-colour { border-color: #cc0000; } .viafoura .vf-comments-sort .vf-comments-sort-option { font-weight: bold; } .viafoura .vf-comments-sort .vf-comments-sort-option .vf-sort-option .vf-label { font-weight: bold !important; } .viafoura .js-cancel, .viafoura .js-cancel:visited, .viafoura .js-cancel:hover, .viafoura .vf-show-all { color: #cc0000 !important; } .viafoura .vf-comment-html a:visited, .viafoura .vf-comment-html a.pseudo-class-visited { color: #0061A2 !important; } .viafoura .vf-comment-submit { background-color: #cc0000; } .viafoura .vf-comment-submit.vf-comment-edit-button { background-color: #cc0000; } .viafoura .vf-comment-submit.vf-comment-edit-save { background-color: #cc0000; } .viafoura .viafoura-owner-badge { display: inline-block !important; } .viafoura .vf-button.vf-button-outline.vf-grey:hover path, .viafoura .vf-button.vf-button-outline.vf-grey:focus path { fill: #666666; } .viafoura .vf-branding-container { visibility: hidden; } .viafoura .vf-user-avatar-btn { display: none; } .viafoura .vf-comments:not(.vf-is-logged-in) .vf-comment-user { display:none; } .viafoura .vf-comments:not(.vf-is-logged-in) .vf-comment-actions{ display:none; } .viafoura .vf-comments:not(.vf-is-logged-in) .vf-page-count-subscribe { display:none; } .vf-loader-dots, .vf-loader-dots:before, .vf-loader-dots:after { border-radius: 50%; width: 2.5em; height: 2.5em; -webkit-animation-fill-mode: both; animation-fill-mode: both; -webkit-animation: load7 1.8s infinite ease-in-out; animation: load7 1.8s infinite ease-in-out; } .vf-loader-dots { color: #999; font-size: 10px; margin: 80px auto; position: relative; text-indent: -9999em; -webkit-transform: translateZ(0); -ms-transform: translateZ(0); transform: translateZ(0); -webkit-animation-delay: -0.16s; animation-delay: -0.16s; } .vf-loader-dots:before, .vf-loader-dots:after { content: ‘‘; position: absolute; top: 0; } .vf-loader-dots:before { left: -3.5em; -webkit-animation-delay: -0.32s; animation-delay: -0.32s; } .vf-loader-dots:after { left: 3.5em; } @-webkit-keyframes load7 { 0%, 80%, 100% { box-shadow: 0 2.5em 0 -1.3em; } 40% { box-shadow: 0 2.5em 0 0; } } load7 { 0%, 80%, 100% { box-shadow: 0 2.5em 0 -1.3em; } 40% { box-shadow: 0 2.5em 0 0; } }