All hands on deck to address the opioid crisis in Connecticut

I agree with and applaud The Day Editorial Board for the Sept. 21, 2018 editorial, “Opioid use victims need more doctors, medical options,” which cogently argued that Connecticut needs more prescribing of the life-saving medication, buprenorphine (Suboxone), in order to better address the opioid crisis.

Despite the beginning of a levelling off of overdose deaths nationally, as well as increased federal and state funding granted to Connecticut to address the problem, more than 1,000 state citizens lost their lives to opioid use disorder (OUD) in 2017 and again in 2018. This is despite the fact that our state has more of the would-be prescribers of Suboxone – psychiatrists and primary care physicians – per capita than many other states.

So, why are we tolerating double the number of deaths we would have if Suboxone was available to all who needed it? It is simply because the physicians who are eligible to prescribe it are not doing so. Only 5 percent of physicians nationally, including psychiatrists whose charge it is to treat mental diseases, of which OUD is one, have opted to get approved to prescribe Suboxone. While 8 hours of additional training and a Drug Enforcement Administration waiver are required to prescribe the medication, this minor obstacle could not possibly account for the paltry engagement. Further, physicians who can prescribe Suboxone frequently do not treat anywhere near the permissible patient limit, if they treat any patients at all. This was the conclusion of a recent study by the psychiatrist head of the U.S. Health & Human Service’s Substance Abuse & Mental Health Services Administration.

It appears that many physicians, especially psychiatrists, are simply not interested in treating these patients. However, psychologists are. While psychologists currently cannot prescribe any medication in the state of Connecticut, with the right training they certainly could do so safely and effectively. They have been doing so in six states and the armed forces for the past 20 years. Since the late 1990s, prescribing psychologists have safely written hundreds of thousands of prescriptions for psychotropic medications to assist patients in enhancing access to treatment in a complex mental health and addiction treatment system.

It is time for an all-hands-on-deck approach to the opioid crisis by including psychologists in the solution. Giving appropriately trained psychologists (i.e., medical psychologists) the authority to prescribe medications for the treatment of mental illness, including addictions, would prepare them to become Suboxone prescribers.

Similar calls have recently led to Advanced Practice Registered Nurses and Physician Assistants gaining permission from the DEA to prescribe Suboxone. But we still do not have nearly enough prescribers. Even physicians and bipartisan federal committees are beginning to call for additional types of Suboxone prescribers. We need all health professionals who are ready, willing and able to treat addictions to fight this and future epidemics with all the available tools. As such, it is time for Connecticut’s state legislature to pass a psychologist prescriptive authority bill into law, paving the way to saving hundreds of lives in our state.

If you agree, please contact your local state senator and representative and tell them you are in favor of SB 966 AAC "The Prescriptive Authority of Psychologists." The Public Health Committee has scheduled a hearing on the measure March 25.

Michael V. Pantalon serves on the Connecticut State Psychological Association’s Psychologists’ Prescriptive Authority Task Force.

 

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