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Buprenorphine and the elimination of the X-waiver
By Larry Kravitz, MD, Chris Allen, and Matthew Seghers
As primary care physicians, we all want to help end the opioid crisis. But the options for family physicians in this epidemic have been limited. Most of us are not addiction specialists. Most of us do not work in substance abuse rehab clinics. Within the traditional primary care clinic setup is the undercurrent of our daily struggles, as our patients succumb to progressive illness, and with that, often the emergence of chronic pain conditions. Tackling chronic pain can be one of the most vexing issues in medicine, and primary care is at the frontlines of handling these patients.
Statistics from the National Institute on Drug Abuse are staggering: Roughly 21-29% of patients prescribed opioids for chronic pain misuse them, between 8-12% of people using an opioid for chronic pain develop an opioid use disorder, and approximately 80% of people who use heroin first misused prescription opioids. COVID-19 only exacerbated opioid-related consequences, with several publications from prominent organizations such as the Journal of the American Medical Association and the American Medical Association outlining the harrowing spikes in both non-fatal and fatal overdoses. Texas has not been immune to these trends, as highlighted in a KHOU segment from December 2020 that describes a record-breaking number of calls to first responders for overdoses.
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