Tennessee Mental Health Chief Wants More Regulation For Suboxone Clinics

Tennessee’s mental health commissioner says he’d like to see tighter restrictions on so-called Suboxone clinics. These are doctors’ offices where medication is used to get patients off heroin or pain pills.

Suboxone has been described as a wonder drug for people who’ve become slaves to highly addictive opiates. It gives a low-level high, but it’s very difficult to overdose, which is why it’s considered an improvement on methadone. But just like that drug-replacement medication,
for-profit clinics have cropped up. Tennessee Mental Health Commissioner Doug Varney says some have taken advantage of addicts.

“Unfortunately, we’ve got too many people that are poorly trained, that are just out there writing prescriptions for another opiate, and not really counseling the people properly on what kind of things they need to do,” he says. “Many times once you’ve become addicted to something, there’s other things going on in your life that need to be addressed.”

Varney says telltale signs of bad actors are when they don’t take insurance, don’t make or receive referrals to other physicians, and don’t have licensed counselors on staff.

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Right now, Varney says the state isn’t well-positioned to regulate Suboxone clinics. For example, methadone clinics have to apply for a
Certificate of Need prior to opening. Suboxone clinics are primarily governed by federal rules, which
limit a doctor’s patient load to 100.

Suboxone clinics have proliferated in Tennessee, which has one of the country’s biggest problems with pain pills. The highest concentrations of doctors registered to prescribe buprenorphines like Suboxone, though they don’t necessarily operate dedicated clinics, are in Johnson City and Nashville. (Here’s a
searchable database.)

“If you’re going to hold yourself out as a treatment provider for people with addiction, you need to have a comprehensive program, not just a piecemeal, make-do kind of thing,” he says. “Otherwise, what you’re doing is really more harmful than helpful.”