The counseling controversy: will we medicate our way out of the opioid crisis?

Summary and Analysis

Ohio is now debating the validity of keeping counseling as part of the requirements for patients that are administered Suboxone in order to fight an opioid addiction. Several doctors are espousing the position that counseling is not effective and that therefore adding more rules will keep physicians and other providers from considering treating people with addiction.

Others in the treatment community believe that counseling is necessary in order to get the the root of the addiction which must be addressed in order to achieve long-term recovery.

Excerpted from Dayton Daily News

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A proposed state rule change has raised debate about what is the most effective way to treat opioid addiction.

The Ohio medical board proposed new rules late last year for doctors prescribing buprenorphine — one of the three FDA-approved drugs for treating opioid use disorder, also called Suboxone.

The state already requires patients receiving Suboxone to get counseling. The proposed rules specify what type of counseling or therapy qualifies.

Several doctors have raised issues with the requirement to get counseling, saying it isn’t medically necessary and limits the number of doctors offering MAT and number of patients getting help.

“There are a lot of barriers that we’re putting in the face of treatment,” said Dr. Jeanette Moleski, a board certified addiction and family medicine doctor in Portage County near Cleveland. She wrote to the board about the rule changes saying, “What I am afraid more rules will do is keep good physicians and other providers from even considering treating people with addiction.”

Others in the treatment community say giving someone Suboxone without treating the underlying behavioral problems will not lead to long-term recovery.

“Addiction is a disease … It’s also fundamentally a lack of skills,” said Marcia Weber, manager of program development and quality assurance at Cornerstone Project treatment center in Dayton.