AMA delays decision on removing waivers for buprenorphine

The American Medical Association delayed a measure on Monday that would have allowed physicians to prescribe the drug buprenorphine for the treatment of opioid abuse without obtaining a waiver.

At the AMA’s annual meeting in Chicago, the organization’s house of delegates voted to refer the proposal for decision at a later time after contentious discussion among the delegates.

Currently, physicians must obtain a waiver before they can prescribe buprenorphine to treat opioid addiction. Doctors must complete an eight-hour training session and other requirements before receiving the waiver.

Members of the AMA House of Delegates who supported removing the training waiver requirement alleged it’s a barrier preventing physicians from treating patients suffering from opioid abuse.

“It’s our position in this house to take a stand to do everything we can as physicians to treat this population,” said a member of the American Academy of Pain Medicine.

Those opposed to the measure were concerned buprenorphine wouldn’t be administered properly without waivers, and that patients would be able to go to an emergency department for a buprenorphrine prescription refill without receiving other ongoing therapies to treat their addiction.

The delegates also debated whether the rule violated a federal law allowing physicians to prescribe narcotics for pain treatment, but not for the treatment of addiction without waivers. Buprenorphine can be prescribed for pain as well as an opioid addiction treatment.

Providers in support of removing the waivers opposed rules that allow for easier prescription of pain medications than addiction treatments.

“You can prescribe as many opioids you want … but you have (to complete a waiver) for a therapeutic medication … It just doesn’t make sense,” said a delegate from Wisconsin.

The AMA’s house of delegates will likely vote on the measure again during its interim meeting in the winter or at next year’s annual meeting.