DEA cracks down on suspect dispensing of buprenorphine, which could pose obstacles to rural patients seeking help

In April, the Department of Health and Human Services began allowing most medical providers to prescribe buprenorphine for opioid-use disorder without having to obtain special training. But the Drug Enforcement Administration's aggressive tactics against pharmacies suspected of improperly dispensing the drug may dissuade stores from carrying it, making prescription filling more difficult.

"The ramifications can be particularly acute in rural areas, where a dearth of addiction treatment providers, lack of transportation and stigma against these medications already create barriers," Aneri Pattani reports for NPR. "If pharmacies decline to provide buprenorphine too, patients will have few options left." Buprenorphine is the gold standard for treating opioid addiction, and though drug overdose deaths hit record highs in 2020, fewer than 20% of people who misuse opioids receive medication to treat it. About one-in-five pharmacies in the U.S. don't dispense buprenorphine. 

Buprenorphine has some value as a street drug, but "research suggests that buprenorphine misuse has decreased in recent years even as prescribing has increased, and that most people who use diverted buprenorphine do so to avoid withdrawal symptoms and because they can't get a prescription," Pattani reports. "Buprenorphine is less likely to cause overdoses than other opioids because its effects taper off at higher doses."

Pattani illustrates the DEA's tactics with the story of a pharmacy in Fayette County, West Virginia. Pharmacist Martin Njoku began dispensing buprenorphine in 2016 after a flood displaced residents in a nearby county. He told NPR he saw it as doing the right thing for people who needed help. But the DEA raided his pharmacy a few years later and revoked its registration to dispense controlled substances. "Although two judges separately ruled in Njoku's favor, the DEA's actions effectively shuttered his business," Pattani reports.