What the BUPE Act Means for Better Addiction Treatment

Congressman Paul D. Tonko (D-NY) and Senator Martin Heinrich (D-NM) announced in early October the introduction of a bill known as the Broadening Utilization of Proven and Effective Treatment for Recovery, or BUPE Act. The BUPE Act is a powerful legislative tool that can improve access to addiction treatment. Stigmas on opioid agonist treatment, barriers due to the DEA’s SORS requirements, and lack of education on the benefits of medication-assisted treatments are some reasons that the BUPE Act is necessary.

What is the BUPE Act Proposing?

The BUPE Act aims to expand access to evidence-based treatments for opioid use disorder, specifically focusing on medication-assisted treatment (MAT) using buprenorphine. This bill will help remove outdated barriers and restrictions that have hindered individuals from receiving timely access to buprenorphine (also known as “Bupe” for short).

Specifically, the bill aims to reduce barriers imposed by the DEAs Suspicious Order Reports System, or SORS. The bill would require the DEA to exempt buprenorphine from its SORS until the opioid crisis epidemic improves.

In a press release dated October 4, 2024, Senator Heinrich said, “My legislation aims to change reporting requirements for buprenorphine, ensuring that patients receive timely and effective treatment for opioid use disorder. This will help save lives and help New Mexicans get the care they need.”

The SORS – a Barrier for Medication-Assisted Treatment

While the DEA’s SORS is intended to help monitor suspicious orders of controlled substances and limit illegal activity, it has had an unintended consequence on access to medication-assisted treatment. Not properly reporting unusual activity for a regulated drug, like buprenorphine, means that pharmacists could be prosecuted. It also means pharmacies can lose their DEA license, wreaking havoc on small, family-owned businesses in addition to aggravating the opioid crisis.

Further, this reporting requirement can also lead to unnecessary delays in patients receiving buprenorphine. A 2022 study on government regulation of buprenorphine found devastating consequences of the SORS. These include:

  • Delayed or suspended shipments of buprenorphine to pharmacies
  • Pharmacies not properly stocking Buprenorphine
  • Declined and unfilled buprenorphine prescriptions

These issues highlight the unintended, but severe, impact the SORS has had on medication-assisted treatment for opioid use disorder. During the opioid epidemic, it makes sense to encourage medications that can help reduce cravings and reduce fatal overdoses. Unfortunately, the opposite is happening due to the SORS requirement.

What is Buprenorphine?

Buprenorphine, also known as Subutex or Suboxone, is a medication treatment for opioid use disorder. It works by binding to the same receptors in the brain as opioids, but with less intensity and potentially fewer side effects. This allows individuals with opioid use disorder to manage their cravings and reduce their risk of relapse.

Buprenorphine also has a half-life of 24-70 hours. It stays in the body for longer compared to short-acting opioids. This makes it slower to act and, therefore, allows people in the midst of withdrawal to experience less painful side effects and cravings.

This drug falls into the same category as methodone, both considered Opioid Agonist Treatments (OATs). However, unlike methadone which is a full opioid agonist, buprenorphine is a partial opioid agonist. This means it has lower abuse potential and less severe symptoms compared to full opioid agonists. It is still, however, a schedule III drug, and can be harmful if not taken as directed or illegally misused.

Buprenorphine and OAT

Buprenorphine is an opioid agonist treatment and acts as a substiute for other opioids. It is an effective treatment option for opioid use disorder. In fact, studies on the effectiveness of opioid agonist treatment show that people who participate in OAT have higher rates of abstinence compared to those who don’t.

However, there is still a negative stigma surrounding OAT. There is a common myth that using methadone or buprenorphine is just substituting one addiction for another. This is not true, as OAT works differently on the brain. Key differences between buprenorphine and other opioids include:

  • Buprenorphine has a ceiling effect, meaning taking more of it will not produce the same high as other opioids. The ceiling effect also reduces the risk of abuse.
  • It is long-acting, meaning its effects are sustained over time and there is no need for frequent doses.
  • It does not cause the same level of euphoria or sedation as full opioid agonists.

Additionally, OAT is most effective when combined with psychosocial treatments such as therapy and support groups. These treatments address the underlying causes of opioid use disorder and help individuals maintain their recovery in the long term.

The BUPE Act is a Step Forward

The BUPE Act is one of many progressive changes to help combat stigma. It, ultimately, improves access to life-saving medications for substance abuse treatment. Recently in February of 2023, the X-Waiver training requirements were waived by the federal government. Doing so allows all licensed physicians to prescribe buprenorphine without X-Waiver certification.

Physicians are now no longer required to have a special certification to prescribe buprenorphine, making it more accessible for individuals seeking treatment. However, even with more providers able to provide prescriptions, the SORS and regulation on the prescription-filling process remain in place.

The BUPE Act is a step in the right direction towards addressing the opioid epidemic and improving access to treatment. However, more work needs to be done to reduce stigma, increase education and awareness, and provide more comprehensive resources for those with opioid use disorder.

Get Help for Opioid Use Disorder

At Addiction Programs, we’re in support of the BUPE Act and any positive changes in legislation that can push towards effective treatment and recovery for individuals struggling with opioid use disorder. If you or someone you know is in need of help, please do not hesitate to reach out for support.

You can start by talking to reaching out to one of our caring consultants today! We’re here to put you in touch with the best treatment programs for opioid use disorder, alcohol, and substance use disorder. Don’t let stigma or fear hold you back from seeking help – recovery is possible. We’re here to help guide you towards it! Call us today at 600-626-8014.