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Biden kills Trump administration plan on opioid-treatment prescriptions hailed by physicians

Physicians celebrated Trump’s last-minute effort to loosen requirements they said hurt the opioid-crisis response. But the Biden administration said the plan was issued “prematurely.”

President Joe Biden signs executive orders after speaking about climate change issues at the White House on Wednesday. Also present are Vice President Kamala Harris (left) and White House science adviser Eric Lander.
President Joe Biden signs executive orders after speaking about climate change issues at the White House on Wednesday. Also present are Vice President Kamala Harris (left) and White House science adviser Eric Lander.Read moreAnna Moneymaker / Getty Images

WASHINGTON — The Biden administration said Wednesday that it is canceling a last-minute plan by the Trump administration to let more physicians prescribe an opioid-treatment drug, despite exhortations from lawmakers and physician groups to keep it.

“On January 14, 2021, HHS announced forthcoming Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder,” the White House’s drug policy office said in a message obtained by The Washington Post. “Unfortunately, the announcement was made prematurely. Therefore, the Guidelines previously announced cannot be issued at this time.”

The Biden administration also vowed to continue working to “increase access to buprenorphine, reduce overdose rates and save lives” in the announcement, which was also posted on the website of the Substance Abuse and Mental Health Administration.

The Trump administration’s plan was plagued by legal and operational problems, including a failure to get necessary clearance from the White House budget office, said two officials who spoke on the condition of anonymity because they were not authorized to discuss it.

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“The Biden-Harris administration absolutely supports broader access to medication-based treatment for opioid use disorder, and is working to find ways to lift burdensome restrictions on medications for opioid use disorder treatment,” said a spokesperson for the White House’s drug policy office.

The Washington Post on Monday reported that Biden was moving to halt Trump’s last-minute plan, which would have exempted many physicians from the “X” waiver — a two-decade-old requirement, first mandated by Congress, to undergo a day’s training before they could prescribe buprenorphine for opioid use disorder. The Trump administration sought to go around Congress’s requirements by issuing new “clinical guidelines” that would have enabled doctors with a Drug Enforcement Administration narcotics prescribing license to avoid the training.

Trump’s move was widely hailed by physicians, with the head of the American College for Emergency Physicians deeming it “a great day for our patients.”

“The X-waiver was an outdated and cumbersome barrier to treatment, and it exacerbated stigma for those struggling with opioid use disorder,” Mark Rosenberg, the head of the emergency-physician group, said in a statement at the time.

The Biden administration has been criticized by physicians and lawmakers since reports that the new president would halt Trump’s plan — particularly because as a candidate, Biden had criticized the prescribing rules and vowed to lift them if elected.

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“Medication-assisted treatment can save lives, and the buprenorphine waiver requirement should be eliminated so that physicians can more easily prescribe it to those who need it,” Sen. Maggie Hassan, D-N.H., wrote on Twitter.

Hassan, who has pushed bipartisan legislation with Sen. Lisa Murkowski, R-Alaska, to eliminate the waiver requirement, will soon reintroduce her bill, an aide said. Rep. Paul Tonko, D-N.Y., has led a similar effort in the House.

Trump administration officials who worked on the plan also defended it this week, saying they had developed the guidelines in consultation with public health organizations.

Biden’s decision to halt the plan “will deny lifesaving treatment to those suffering from [opioid] use disorder and cause the loss of thousands of lives,” Brett Giroir, who served as the Trump administration’s assistant secretary for health, posted on Twitter on Monday.