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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Proposed Changes Could Relieve Opiate Treatment Backlog

The Obama administration and Congress are considering changes to a treatment central to Vermont’s effort to combat addiction.

The changes under consideration involve the drug buprenorphine, commonly called Suboxone.

It’s dispensed in Vermont by doctors who offer treatment for opioid addiction.

The Obama administration has indicated it wants to increase a cap on the number of patients a doctor can treat from 100 to 500.

“The majority of physicians in Vermont are not treating near that many, but there are a few that are, so we know have people who definitely would take more [patients] if they could,” says Vermont Health Department Deputy Commissioner Barbara Cimaglio.

She says raising the limit would particularly help practices that specialize in treating addiction disorders.

Congress is also looking at allowing nurse practitioners and physician assistants to prescribe buprenorphine, another change the state supports.

Vermont’s "hub and spoke" system for treating addiction relies on doctors to serve as "spokes", providing local care for many patients who are first treated at a regional hub.

The state has had difficulty enlisting enough doctors willing to treat addiction and also finding physicians who will take more than a handful of patients.

The problem has created a backlog of people waiting for treatment, which Cimaglio says the changes would help address.  

“When we hear about the waiting list for hub services, in order to free up more space in our hubs, if they could move more of their patients out into community practices, it would free up more space for people who need that specialty level of care,” says Cimaglio.

Cimaglio says there’s a lot of interest in the changes because so many states are dealing with opiate addiction.

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