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Family Doctors Increasingly Treat Opioid Addiction, But Still Not Meeting Demand

Alex Olgin

It’s not just rehab facilities that are treating opioid addicts. These days family practitioners are taking on more of the responsibility. To do this they need federal approval to prescribe the necessary medications. The number of doctors getting approved to do this treatment is growing, but patients are still being turned away.

Dr. Tagbo Ekwonu started treating patients for opioid addiction with medicines like Suboxone 11 years ago. He was one of the early adopters of the treatment. It started as a way for the Charlotte family physician to help his patients with HIV.

“And obviously found out not just HIV patients, mom’s with their minivan, business owners who were addicted to opioids who needed some kind of help,” he said.

People trying to get this kind of medication assisted treatment used to have to go to methadone clinics. But in 2000 the federal government allowed family doctors to start prescribing the same type of medicines to make it easier for patients to get treatment. But family doctors like Ekwonu don't specialize in treating addiction, and these patients started to overwhelm his practice.

“It became very complicated, so some of us who were initially enthusiastic, eventually kind calm down, taper down to be able to manage a reasonable amount of  patients,” he said.

Ekwonu said he now has about 20 of these patients. He used to see five times that amount, but he scaled back because he couldn’t treat that many people effectively. He says his office now turns away about five people a week seeking treatment, and directs them to other clinics taking patients. Johns Hopkins University researcher Andrew Huhn studied this problem. He surveyed about 500 doctors around the country.

“More than half of patient requests were turned away from physicians in the study,” Huhn said. “These are people who are asking for help and who want the help and it’s a major problem.”

Huhn’s paper published in the Journal of Substance Abuse Treatment said doctors reported they’d be  more willing to take on more patients if they could be connected with experts. That’s what UNC School of Medicine Psychiatrist Robyn Jordan is doing. She’s working to get more doctors in North Carolina trained in this type of treatment..

“I reach out to people that I know and try to bring them in,” she said. “But we also have people specifically funded to do recruitment so they have people that go out to individual practice and talk about what we are doing and how we could support them in this practice.”

The goal is to have at least one doctor who can treat opioid addicted patients with medication assisted treatment in all of North Carolina’s 100 counties. According to federal data, there are more than 600 providers in the state already able to do this treatment. But they aren’t evenly split between rural and urban parts of the state. Jordan eventually wants to see all residents at UNC School of Medicine trained to give Medication Assisted Treatment or MAT.  

“You may not be interested in having a full addiction clinic, but you may have two or three patients in your clinic who may benefit from MAT and it would be appropriate for you to prescribe to them,” Jordan said. “And that's at least two or three patients that received care who wouldn’t have received care otherwise.”

Jordan stressed the great need for this treatment in rural parts of the state. She says her clinic in Raleigh gets up to 50 calls a week and people travel up to three hours to get treatment for their opioid addiction.