Amendment would crack down on street sales of opiate treatment drug


State senators Thursday proposed legislation intended to crack down on the amount of the opiate addiction treatment drug buprenorphine that is being sold on the street.

A four-page amendment to a major bill the Senate Judiciary Committee is crafting this session that is related to opiate addiction, proposes stricter rules for doctors who prescribe buprenorphine, also known by the brand name Suboxone.

A VTDigger investigation this week found the state spends $8.25 million in Medicaid dollars on buprenorphine, an unknown amount of which is resold on the street to addicts who can't find a doctor.

Waitlists for buprenorphine-prescribing doctors can be years long in Vermont and many patients travel across New England to find a doctor. In the meantime, some addicts sell their "bupe" to buy other drugs or sell a portion of their prescription.

The amendment asks the Department of Health to create a list of approved buprenorphine prescribers. The list should include Vermont physicians and out-of-state doctors who prescribe to Vermont patients.

Those physicians should be licensed by the federal government, not be subject to any disciplinary action from a professional board related to diversion and meet any standards established by the Department of Health, the amendment reads.

To prescribe buprenorphine a doctor must obtain a waiver from the federal Substance Abuse and Mental Health Services Administration.

The minimum training to receive that waiver is an eight-hour course, which can be taken online or by mail.

The amendment also addresses Vermont's prescription monitoring program, an online database of patients' prescriptions that doctors and pharmacies can consult when prescribing powerful drugs including buprenorphine.

The amendment would require all Medicaid providers, in- or out-of-state, who prescribe to Vermont patients to query the Prescription Monitoring System prior to prescribing buprenorphine to a Medicaid recipient.

It also aims to require doctors to provide counseling to more patients who are receiving the drug. The bill lowers the threshold number of patients from 30 to 10 for which a physician is required to also provide counseling.

Committee Chair Sen. Dick Sears, D-Bennington, said the amendment will be altered so doctors who provide prescriptions for between 10 and 29 patients will have a separate set of rules.

Tuesday, a representative of the Vermont Medical Society warned the Judiciary Committee about imposing too many rules on buprenorphine doctors because it could dissuade them from prescribing.

Finally, the amendment says lawmakers want to "encourage" manufacturers of buprenorphine products to create more tamper-resistant packaging and to endeavor to create products that are less easy to divert.


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