Kentucky proposes changes to buprenorphine prescribing, dispensing rules
The Kentucky Board of Medical Licensure recently proposed new changes to regulations around the prescribing and dispensing of buprenorphine, also known by its brand name Suboxone, a Food and Drug Administration approved medication used to treat opioid-use disorder.
Experts say the changes would increase barriers for people who rely on it to keep their lives stable.
Michelle Lofwall is a professor in the Departments of Behavioral Science and Psychiatry at the University of Kentucky. She said the stricter rules send a discouraging message to people in recovery.
“And we know,” said Lofwall, “low-barrier care, where patients can really get access to the medication and they can add on what’s needed when they’re not doing well, is really important.”
The new regulations would limit doses patients can receive, mandate participation in counseling services, and require frequent drug testing, among other changes.
Critics of expanding access to buprenorphine, classified as a schedule III substance, argue the drug itself is an opioid that people can become addicted to – and don’t address the root causes of substance-use disorders.
The board did not respond to an email request for comment for this story.
Lofwall pointed to the numerous reasons why requiring regular counseling and drug testing can prevent people from being able to access the medication they need.
The new rules would require clinicians see patients using buprenorphine every ten days, or at two-week intervals, in the first few months – and then every few months after two years of treatment.
“A lot of people have jobs that don’t let them take off from work to come every week,” said Lofwall. “They can be discriminated against because, all of a sudden, they’re late, or they just don’t have the benefits of a job that allows sick days.”
Lofwall said she’s confused by the board’s actions, given the research showing significant declines in overdose deaths among people taking buprenorphine.
“The Kentucky Board of Medical Licensure just really has had a lack of transparency, I think,” said Lofwall, “about the rationale for some of these changes.”
According to the Centers for Disease Control and Prevention, in 2023 Kentucky ranked among the top five states for buprenorphine dispensing rates nationwide, along with West Virginia, Vermont and Maine.
Support for this reporting was provided by The Pew Charitable Trusts.
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