Recommendations For Action from the Johns Hopkins Bloomberg School Of Public Health report “The Prescription Opioid Epidemic: An Evidence-Based Approach.”


6.1 INVEST IN SURVEILLANCE. Improve epidemiologic surveillance of opioid addiction by revising the National Survey on Drug Use and Health (NSDUH) questions to capture opioid use disorders in patients receiving opioids for the treatment of chronic pain and by identifying other strategies to track the incidence and prevalence of opioid addiction. This effort will involve collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC). Rationale: Understanding the size and scope of the opioid addiction problem is essential for developing effective interventions. Revising an existing surveillance tool is a cost effective way to obtain needed information. Current Status: This effort is not yet underway. 
6.2 EXPAND ACCESS TO BUPRENORPHINE TREATMENT. Addiction specialist physicians are prohibited under federal law from treating more than 100 patients with buprenorphine — a restriction with no counterpart anywhere in medicine and which has led to waiting lists for patients to receive treatment. These federally imposed caps should be lifted. Additional training of prescribers on medication-assisted treatment should be offered and treatment guidelines, such as the American Society of Addiction Medicine (ASAM) Guideline for Medication Assisted Treatment, should be disseminated. Access to buprenorphine treatment across the country should be closely monitored by the federal government. This effort will involve collaboration with SAMHSA and the Drug Enforcement Agency (DEA).  Rationale: Federally imposed caps on the number of patients a physician can treat limit access to buprenorphine.  Current Status: Legislation seeking to lift the buprenorphine patient cap has been introduced in the U.S. Senate. In addition, the Department of Health and Human Services recently announced a plan to lift the cap through the regulatory process. 
6.3 REQUIRE FEDERALLY-FUNDED TREATMENT PROGRAMS TO ALLOW PATIENTS ACCESS TO BUPRENORPHINE OR METHADONE Policies that prevent access to medication-assisted treatment are counter to the evidence and the current standard of care for effective treatment of opioid addiction. This effort will involve collaboration with the SAMHSA, the Centers for Medicare and Medicaid Services and the White House Office of National Drug Control Policy (ONDCP). Rationale: Buprenorphine is an effective treatment for opioid addition. Current Status: In 2015, the ONDCP announced that drug court programs will be ineligible to receive future federal funding if they prohibit receipt of buprenorphine and methadone.

To view the full report, "The Prescription Opioid Epidemic: An Evidence-Based Approach," visit: http://www.jhsph.edu/research/centers-and-institutes/center-for-drug-safety-and-effectiveness/opioid-epidemic-town-hall-2015/2015-prescription-opioid-epidemic-report.pdf