Any of the 900,000 physicians in the country can—and often do—prescribe, at their own discretion, the kind of opioid painkillers whose abuse has led to a 300 percent spike in overdose deaths between 2001 and 2014. But if they want to prescribe medicines to help patients overcome opiate addiction, they face an array of government restrictions and systemic obstacles.
Take a medication called buprenorphine, approved by the FDA in 2002. Buprenorphine’s profile has risen within the last few years. It suppresses drug cravings and quells withdrawal symptoms like muscle aches, sweating, anxiety, agitation, and diarrhea—also called “dope sickness.” The drug is a less potent substitute for the classic opiate replacement drug, methadone, and has less of a potential for abuse. Some patients dose daily over weeks or months as a way to slowly detox from abused opiates. Others stay with buprenorphine for years.
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