Capital New York: In D.C., Bassett urges looser restrictions on opioid therapies


In D.C., Bassett urges looser restrictions on opioid therapies

Dan Goldberg | September 16, 2014

The city health commissioner went to Washington Tuesday and urged Congress to make it easier for doctors to prescribe drugs that wean people off of heroin and other opioids.

Dr. Mary Bassett was one of three health officials from large cities who travelled to the capital to discuss the opioid epidemic that has swept across the nation.

“Misuse and overdose related to opioid analgesics, or prescription painkillers, is a national and local health crisis,” Bassett said during a congressional briefing. “From 2000 to 2013, rates of overdose death from opioid analgesics increased 256 percent in New York City. In 2013, about one New Yorker died every other day from an opioid analgesic overdose.”

Bassett was joined by public health officials from Boston and Chicago, known as the Big Cities Health Coalition.

“Opioid addiction is one of the most challenging problems for health departments to address on a local level. Throughout the nation, cities have taken innovative approaches to respond to this epidemic, but working collaboratively with federal agencies on this issue could improve our outcomes,” said Dr. Barbara Ferrer, Executive Director of the Boston Public Health Commission and Chair of the Big Cities Health Coalition. “We’ve worked with local partners to implement innovative prevention and treatment strategies, but this calls for an all hands on deck approach.”

Bassett highlighted some of New York’s recent success, pointing out that deaths attributed to prescription opioids had, in 2013, fallen 32 percent on Staten Island, the county that had been most severely impacted.

Last month, Capital reported that prescriptions for oxycodone across the city declined for the first time in several years, a possible sign that city efforts to educate physicians about the dangers of overprescribing were having an effect.

While Bassett was in D.C., a group of local politicians and activists rallied on the steps of City Hall to call attention to the increasing number of fatal overdoses throughout the state.

“We’re here with a very simple message … When we talk about drug addiction we must approach it as a public health issue and not a criminal justice issue,” State Senator Gustavo Rivera told the crowd.

The advocates hope the state will move quickly to implement a law, passed in June, that allows community based organizations (CBOs) to dispense naloxone, which can act as an antidote to an opioid overdose, without a physician present.

VOCAL New York, the advocacy group that organized the rally, has called for broader access to naloxone and syringe exchange programs, improvements in drug treatment and public health surveillance, criminal justice reform and new strategies including attention to cocaine-involved deaths and allowing supervised injection facilities in New York.

On the federal level, Bassett said Congress needs to loosen restrictions for prescribing buprenorphine, also known as Suboxone, which she said is the most effective way to treat an opioid addiction.

Current federal policy, she said, has made it hard for people to access these medications.

Only physicians can prescribe the medication, as opposed to nurse practitioners or physician assistants, and they are restricted to the number of patients they can prescribe the drug for at any one time. Federal rules limit physicians to 30 patients during the first year of prescribing, and 100 after the first year with submission of a special application.

“These restrictions unnecessarily limit access to this life-saving medication for the many individuals in urgent need of treatment,” Bassett said. “The Department and the Big Cities Coalition ask Congress to take action so that nurse practitioners and physician assistants are authorized to prescribe buprenorphine, and to lift the restriction on the number of patients that can be treated with buprenorphine at one time.”

Senator Edward Markey of Massachusetts recently introduced legislation to expand the availability of such medication-assisted therapy.

“We are committed to fighting this epidemic in every way possible, but we cannot do this work alone,” said Dr. Bechara Choucair, Chicago Public Health Commissioner. “That is why we are calling on Congress to take swift action.”

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