A pandemic rule change could make it easier to get treatment for opioid addiction in Alaska

a woman sits at a desk behind a reception counter
Medical assistant Sarah Martin sits at the reception desk of Ideal Option, a medication assisted addiction treatment clinic in Juneau. (Kavitha George/KTOO)

Alaska doctors have temporary permission from the state to use telehealth to prescribe a controlled, but life-saving drug used to treat opioid addiction. State officials say they’d like to make the change permanent.

Once a patient says they’re ready for treatment, physicians like Dr. Janice Sheufelt want to get them the medication that prevents withdrawal symptoms as soon as possible.

“Honestly, even a few days makes a difference because of how many people are dying from opioid overdoses in our state,” she said.

She got to sidestep a significant barrier to care for people with opioid addictions during the pandemic — the clinic visit. That is, until February when the state’s emergency order lapsed and the state tightened restrictions on telehealth.

That meant she and her patients had to schedule an in-person appointment with another doctor to prescribe the drug, buprenorphine. It’s also called by its brand name, Suboxone. An extra step, and extra time, when withdrawal symptoms can manifest within hours.

“Every patient I speak to, they tell me about their friends or family members who have died. So I really think time is of the essence, and even a few days can make a difference. I’ve had people overdose and die who were waiting to get into treatment,” said Dr. Sheufelt.

Last week, the state’s medical board approved an emergency order from the state health department to reinstate buprenorphine prescriptions by telehealth for 120 days. But there was a four-month period where providers had to set up in-person appointments to get prescriptions.

In that time, Dr. Sheufelt says more than 200 patients asked to start medicated treatment at her clinic alone.

The lapse came at a critical time: hospital visits for overdoses involving heroin have increased dramatically in the state since March. Overdose visits from March to May this year are more than double last year’s visits over the same period of time.

Officials from the state’s medical board declined recorded interviews but wrote in a statement that the board will work to make the change permanent and allow Alaska doctors to prescribe and renew prescriptions for buprenorphine without an in-person appointment.

“Medication is a key part of helping people who have opioid use disorder in stopping,” said Jeannie Monk, a senior Vice President at the Alaska State Hospital and Nursing Home Association, or ASHNAH.

She testified before the medical board on behalf of Alaska physicians who said the change is necessary to help their patients. She said the COVID-19 pandemic illuminated a real need.

“Because people couldn’t go in to see doctors and people in rural areas couldn’t travel, giving them access to really life-saving medication by telehealth has been essential,” she said.

Buprenorphine typically requires an in-person visit for a prescription because it is categorized as a controlled substance. It works to block withdrawal symptoms but doesn’t get users high like heroin or fentanyl do.

“It took quite a while to kind of get the State Medical Board to kind of understand the situation and take action,” Monk said.

Even though current state and federal law do not allow that type of drug to be prescribed without an in-person visit, the state’s medical board is working to keep the exemption in place. It cites high rates of opioid overuse, overdose and death in the state as reasons it will work towards the permanent change.

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