By Eilis O’Neill
The death toll of the opioid crisis is rising faster in Washington state than anywhere else in the country.
Addiction researchers say one thing that could help would be revisiting federal prescribing guidelines for buprenorphine, one of the main medications that can help people addicted to fentanyl or other opioids by reducing withdrawal symptoms and cravings.
Patients who’ve been using fentanyl need a high dose of buprenorphine to control their symptoms, said Lucinda Grande, a UW School of Medicine professor and primary care doctor who focuses on treating addiction.
“An adequate dose of buprenorphine allows a person to feel normal — like they don’t think about using opiates,” she said. “While if they are on too low a dose, then their mind will constantly go back, ‘I feel a little bit sick; I feel kind of sweaty, chills.’”
Grande is the lead author of a paper arguing that, for patients addicted to fentanyl or other opioids, decades-old FDA guidelines are keeping them from getting an effective dose of buprenorphine. The guidelines don’t mandate what providers can prescribe, but many insurers only cover up to the maximum recommended dose.