In 2023, regulation changes in Michigan are making medication-assisted treatment for opioid use disorder more accessible.
The laws around treating opioid use disorder and prescribing medication-assisted treatment (MAT) can be confusing. This is especially true because those laws vary from state to state. This summer, Michigan’s Bureau of Licensing and Regulatory Affairs (LARA) has simplified things by deregulating the prescribing of buprenorphine and extended-release naltrexone for opioid use disorder. Let’s look at how that changes things for people in treatment for opioid use disorder in Michigan.
What’s different for buprenorphine providers under the new LARA deregulation?
Prior to this change, providers were required to have a special license in order to prescribe buprenorphine medications for opioid use disorder, like Suboxone (buprenorphine/naloxone). Along with that license, providers were also required to follow stringent guidelines. Here’s a brief breakdown of the difference between buprenorphine treatment under the previous policy and under LARA’s new deregulation:
| Previous requirements | 2023 LARA deregulation |
|---|---|
| Recipients needed counseling about their treatment options before they could have their first provider appointment. | Recipients may see a provider right away. |
| Recipients were required to complete a drug screen before buprenorphine could be prescribed. | Buprenorphine may be prescribed without a drug screen at the discretion of the medical provider. |
| The state required drug screening on a strict schedule, and required more frequent screening if results were positive for non-MAT drugs, including cannabis. | Drug screening can be ordered at the discretion of the medical provider. |
| Naloxone must be made available to recipients with a history of opioid use. | |
| Providers can set up branch offices and mobile units to expand access. |
What does this mean for my buprenorphine treatment in Michigan?
If you’re already receiving Suboxone or another buprenorphine medication in Michigan, not much will change for you. Your provider will have greater leeway in setting their own policies for drug screening (commonly called “drug testing” or “urine testing”), following federal guidelines. This does NOT mean that providers are likely to stop using drug screens altogether. For example, at Workit Health, providers use urine drug screens to inform their care and to adjust members’ treatment plans, but those screens will no longer have to be on a timeline determined by the state of Michigan. At Workit, drug screens are submitted securely via our app.
If you’re considering beginning buprenorphine treatment, these changes will make getting started easier and more accessible for you. You will be able to see a provider and receive a prescription without a waiting period for a drug screen ahead of time. This will help you get treatment when you’re ready, with fewer barriers and less red tape. You may also find that some providers will begin to open branch offices and mobile units to reach people who have few providers in their area. This won’t have a big effect on Workit Health members and folks who use other telemedicine providers, but it could be an important opportunity for those in rural areas who prefer in-person care. Research demonstrates that, for people receiving medication for opioid use disorder, telemedicine is as effective as in-office treatment. A study conducted by Workit Health’s research arm, Workit Labs, supports this as well, with Workit’s outcomes meeting or exceeding those reported in other studies of telemedicine treatment for opioid use disorder.
Note that this deregulation applies to buprenorphine and extended-release naltrexone; many of the old regulations do still apply to providers who prescribe methadone.
Why were these regulations changed?
This progress in Michigan’s policy follows the same path as changes taking place at a federal level and in other states. In 2023, the DATA-waiver (also known as the X-waiver)—which required additional training before a provider could prescribe buprenorphine and set limits on the number of recipients they could serve—was eliminated nationally. This made it possible for any provider who was authorized to prescribe controlled substances to prescribe buprenorphine. Naloxone, which is an opioid overdose rescue medication, was also approved for over-the-counter sale this year.
Even before these federal policy changes, there has been a research-based push in Michigan in recent years to improve access to medication-assisted treatment. This encouragement to take a “medication-first” approach is rooted in the evidence that buprenorphine reduces overdose deaths and improves outcomes. Therefore, the proponents of medication-first treatment point out that barriers put in the path of folks with opioid use disorder—like drug screening that delays care by days or weeks—put lives and recovery at risk, for little to no benefit.
Workit Health follows evidence-based practices, and our headquarters are in Ann Arbor, Michigan, so we’re celebrating these changes. Michiganders will be able to access care more quickly and with fewer obstacles. We hope that regulations continue to make MAT more available to those who need it, on a state and national level.