One of the best weapons in the fight against the opioid epidemic is mired in red tape.
Treating Opioid Use Disorder (OUD) is hard. It's hard to talk about. It's hard to monitor. It's hard because it requires a strong bond of trust between patient and provider that we rarely have time to build anymore. And it's hard because one of the best weapons in the fight against OUD - buprenorphine (Suboxone) - is restricted to providers who go through an 8-hour online course. Let's note that, with my DEA license, I am free to prescribe morphine, oxycodone, alprazolam, and any number of addictive substances without any formal training. But I can't prescribe buprenorphine since I'm not "certified".
For some of us, the 8-hr certification is just an annoying hurdle that we haven't "gotten around to yet". For others, it serves as a convenient excuse to refer our patients to other providers. But the scale of this epidemic means we should all take part.
In a powerful piece in the New England Journal of Medicine, Dr. Audrey Provenzano tells the story of Ms. L, her patient who suffered from OUD. I had the privilege to discuss the piece with her in this Doc-to-Doc interview:
To become certified to prescribe buprenorphine, you can take this online course.