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Pass legislation to expand access to Suboxone so opiate addicts can get the help they need

Feb. 2 will be the one-year anniversary of the tragic death of actor Philip Seymour Hoffman from a heroin overdose. The much larger picture, however, is the tragedy of opiate addiction occurring in our communities across America.

The Centers for Disease Control and Prevention refers to this serious public health issue as an opiate addiction epidemic. This includes opiate analgesic medication such as hydrocodone, morphine and fentanyl. But it also includes heroin, which is an illicit opiate.

Let’s talk about what is currently happening in Western New York. The recent article in The Buffalo News titled, “City cops use Narcan, save three suburban residents,” refers to three heroin overdoses in the Buffalo area in just four days this month. Fortunately, the overdoses were reversed.

The statistics in the article are also staggering. Officials say there were 78 deaths attributed to heroin and prescription opiates from January to August 2014. Why the increase in prescription opiate and heroin overdoses? Here is one perspective:

I am a nurse practitioner at Horizon Health Services, an agency that treats individuals with drug dependence. The clients we service, many of them young adults, have become addicted to prescription painkillers. With recent legislation that makes it more difficult to obtain these prescription opiates, people are turning to a cheaper and more readily available alternative by using heroin.

The progression of this drug use has resulted in multiple health, legal, family and community issues. According to the National Institute on Drug Abuse, illicit drug use alone accounts for $181 billion per year in health care, productivity loss, crime, incarceration and drug enforcement.

Drug addiction is considered a chronic illness and thus there are medically based treatment solutions that can be very successful. One such treatment is with Suboxone, which is an FDA-approved medication to treat opiate dependence. Suboxone is also an opiate (albeit a partial opiate), and should be prescribed under the proper guidance of a medical provider. When Suboxone is coupled with drug treatment, it has proven to be very successful in many circumstances.

However, there is a shortage of health care providers who can legally prescribe Suboxone. Under current federal legislation, only medical doctors can prescribe this medication after they have taken an eight-hour training course. Additionally, once able to prescribe Suboxone, physicians must limit the number of patients on their Suboxone caseload.

Nurse practitioners (NPs) and Physician Assistants (PAs) can prescribe all other medications, including all prescription opiates, and we provide a wide range of medical services. However, because of an outdated and arbitrary law created in 2000, we are not able to prescribe Suboxone for addiction treatment. The legislation has left a shortage of Suboxone prescribers. This, in turn, results in a waiting list of several weeks to months before someone with an opiate addiction can obtain this often essential treatment.

While awaiting an appointment to receive Suboxone, individuals are exposed to multiple risks, including overdose and death. I therefore implore you, as a concerned citizen, to assist in any way possible so that legislation at the federal level can be changed.

There is currently a bill in the U.S. Senate, S. 2645, the Recovery Enhancement for Addiction Treatment Act, which would grant NPs and PAs the ability to prescribe Suboxone. There are two major changes within the bill: It would increase the number of patients a health care provider is allowed to treat with Suboxone, and it would allow NPs and PAs to prescribe this medication, providing they meet certain education qualifications.

Please call or write your local congressional representatives to express your concerns regarding the opiate addiction epidemic and to support the Senate Bill, S. 2645. It takes a village.

Christene Amabile, C-FNP, is a nurse practitioner working in the field of Addiction Medicine at Horizon Health Services in Niagara Falls.