There is no question the government and its hand-picked advisors have hyped claims of opioid addiction beyond all sense. Doctors, pharmaceutical companies, and legitimate pain patients have all been steamrolled in an effort to stop what is really a recreational use problem.
But if we are going to worry more about recreational addicts than pain patients, buprenorphine, a Schedule III outpatient medication for drug addicts, should be taken off prescription. Does this mean 130 people who overdose each day will suddenly stop? No, many of them do not want to quit, but at least those who recognize they have a problem will have an easier time. Currently the Drug Addiction Treatment Act of 2000 keeps buprenorphine prescription only, which creates a barrier. Most addicts have never visited a doctor and don't want them to know, and for a doctor to obtain a prescription in the modern government climate is onerous.
A recent article argues that buprenorphine could be offered without a prescription, available behind the counter in a model similar to that used for other medications, while limiting unrestricted access by setting age and quantity limitations. "Limiting quantities to a three-day supply could encourage patients to seek long-term treatment from a clinician for their medical and psychosocial needs. But having the choice to walk into a pharmacy, any time day or night and buy a dose of buprenorphine rather than inject a dose of fentanyl that can kill you, seems a good option," says co-author Michael Stein, MD, professor and chair, Health Law, Policy&Management at Boston University School of Public Health.
There are challenges when it comes to providing buprenorphine without a prescription, including the risk associated with taking the drug in combination with other drugs and/or alcohol and the lost benefit of long-term physician monitoring.