President Joe Biden last week killed a plan from the Trump administration to allow more physicians to prescribe an opioid-treatment drug.
The move from the Trump administration was widely praised by both physicians and lawmakers, and came on the heels of another spike in opioid-related deaths during the pandemic. Criticizing the Biden administration on the reversal, Trump’s Assistant Secretary for Health Dr. Brett Giroir warned the move “will cost thousands of lives.”
In a message obtained by The Washington Post last week, the Biden administration said Trump’s forthcoming Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder issued on Jan. 14 was announced “prematurely.” “Therefore,” team Biden said, “the Guidelines previously announced cannot be issued at this time.”
According to anonymous sources within the Biden team, Trump’s plan “was plagued by legal and operational problems, including a failure to get necessary clearance from the White House budget office,” the Post reported.
“The Biden-Harris administration absolutely supports broader access to medication-based treatment for opioid use disorder, and is working to find ways to lift burdensome restrictions on medications for opioid use disorder treatment,” said a spokesperson from Biden’s drug policy office.
Trump’s plan “would have exempted many physicians from the ‘X’ waiver — a two-decade-old requirement, first mandated by Congress, to undergo a day’s training before they could prescribe buprenorphine for opioid use disorder,” the Post explained. “The Trump administration sought to go around Congress’s requirements by issuing new ‘clinical guidelines’ that would have enabled doctors with a Drug Enforcement Administration narcotics prescribing license to avoid the training.”
The Post underscored that Trump’s plan “was widely hailed by physicians,” noting that the head of the American College for Emergency Physicians Mark Rosenberg deemed the accomplishment “a great day for our patients.'”
“The X-waiver was an outdated and cumbersome barrier to treatment, and it exacerbated stigma for those struggling with opioid use disorder,” said a statement from Rosenberg.
“The Biden administration has been criticized by physicians and lawmakers since reports that the new president would halt Trump’s plan — particularly because as a candidate, Biden had criticized the prescribing rules and vowed to lift them if elected,” noted the Post.
Giroir on Thursday took to Twitter to blast the Biden reversal, warning it “will cost thousands of lives.”
“This [POTUS] decision […] means a tragic day for all suffering with #opioid use disorder, and will cost thousands of lives. The [HHS] practice guidelines stemmed from 2 years of evidence examination, science, legal review, and stakeholder engagement,” Giroir wrote.
#1/2 This @POTUS decision https://t.co/8gwgdQK2oM means a tragic day for all suffering with #opioid use disorder, and will cost thousands of lives. The @HHS_ASH practice guidelines stemmed from 2 years of evidence examination, science, legal review, and stakeholder engagement
— Brett Giroir (@DrGiroir) January 28, 2021
“With US #overdose deaths >83,000/yr and increasing 18% per year, expanding access to medications was supported by @theNAMedicine, @NIH, @FDA commissioner @AmerMedicalAssn @ACEPNow @ONDCP45 @JeromeAdamsMD and numerous other groups. @POTUS: time to put science before politics,” he said.
#2/2 With US #overdose deaths >83,000/yr and increasing 18% per year, expanding access to medications was supported by @theNAMedicine @NIH @FDA commissioner @AmerMedicalAssn @ACEPNow @ONDCP45 @JeromeAdamsMD and numerous other groups. @POTUS: time to put science before politics.
— Brett Giroir (@DrGiroir) January 28, 2021
Giroir added, “If guideline reversed,~1 million doctors can continue to prescribe potentially addictive oxycodone, hydrocodone, codeine, morphine, fentanyl, etc.; but only 66,000 will be able to prescribe the safe and effective treatment for #opioid use disorder, #buprenorphine. #XtheXwaiver.”
If guideline reversed,~1 million doctors can continue to prescribe potentially addictive oxycodone, hydrocodone, codeine, morphine, fentanyl, etc.; but only 66,000 will be able to prescribe the safe and effective treatment for #opioid use disorder, #buprenorphine. #XtheXwaiver https://t.co/x9RW2t9yIz
— Brett Giroir (@DrGiroir) January 28, 2021
In a Jan. 14 release on the Trump plan, the administration underscored the issues with opioids, particularly during the pandemic: “More than 83,000 drug overdose deaths occurred in the United States in the 12 months ending in June 2020, the highest number of overdose deaths ever recorded in a 12-month period, and an increase of over 21% compared to the previous year, according to recent provisional data from the Centers for Disease Control and Prevention (CDC).”
“The increase in overdose deaths highlights the need for treatment services to be more accessible for people most at risk of overdose and today’s action will expand access to and availability of treatment for opioid use disorder,” the HHS continued.
“The medical evidence is clear: access to medication-assisted treatment, including buprenorphine that can be prescribed in office-based settings, is the gold standard for treating individuals suffering from opioid use disorder,” Giroir said at the time. “Removing some of the certification requirements for an X-waiver for physicians is a step toward providing more people struggling with this chronic disease access to medication assisted treatment.”