The Recovery Enhancement for Addiction Treatment Act (TREAT Act) Senator Edward J. Markey (D-Mass.)

Maappn members we would like to hear your thoughts on the Treat Act. You can read about it below.


Overdoses from opioids, including prescription pain relievers and heroin, have increased dramatically in the United States. Nationwide, drug overdoses now claim more lives than car accidents. Opioid addiction is a chronic disease that, untreated, places a large burden on the healthcare system. Roughly 480,000 emergency room visits each year are attributable to the misuse and abuse of opioid pain killers. Effective medication-assisted therapy for opioid addiction, such as buprenorphine, combined with social and behavioral supports, can decrease overdose deaths, be cost-effective, reduce transmissions of HIV and viral hepatitis, and can reduce other social harms such as criminal activity.


Unfortunately, of the approximately 2.4 million Americans who abused or were dependent on opioids in 2013, only half received treatment for their condition. That’s because access to effective and evidence based treatments to help treat opioid addiction in outpatient and primary care settings, remains limited in part due to current federal restrictions.


More than ten years of experience in the United States with buprenorphine (Suboxone) to help treat opioid addiction has informed best practices for delivering successful, high quality care for patients with opioid use disorders. Thoughtfully expanding existing federal restrictions, with a focus on expertise and quality will help increase the number of patients who have access to life-saving treatment and will decrease long waiting lists that currently exist for many treatment facilities.


Unlike any other treatment regimen for any other disease, under current law in order for physicians to prescribe and use certain opioid addiction medicines, they must meet specific conditions and apply for a special federal waiver. Even with such a waiver, physicians are severely limited in the number of patients they can treat, contributing to long waitlists and the inability of patients to get treatment for their addiction when they need it.


The Recovery Enhancement for Addiction Treatment Act (TREAT Act):


  • Increases the number of patients a provider is initially allowed to treat from 30 patients to 100 patients per year.
  • Allows certain nurse practitioners and physicians assistants to treat up to 100 patients per year, provided they:
    • Are licensed in a state that already allows them to prescribe controlled substances
    • Complete approved training on opioid addiction treatment and
    • Are supervised by a physician who is approved to prescribe opioid addiction medicine, or are certified addiction treatment nurse practitioners who practice in collaboration with such a physician in a “qualified practice setting,” where allowable by state law.
  • Allows certain physicians, after one year, to request removal of the limit on the number of patients they can treat. To be eligible:
    • Physicians must be substance abuse treatment specialists, as recognized by specific board or society certifications, or
    • Non-specialist physicians must complete approved training and practice in a “qualified practice setting.”
  • “Qualified practice settings” are named in the legislation and include clinical settings that have defined oversight, performance metrics, or quality review, or that are part of systems serving populations with high need.
  • Requires the GAO to examine changes in treatment availability and utilization; quality of treatment programs; integration with routine healthcare services; diversion; impact on state-level policies and legislation; and use of nurse practitioner and physician’s assistant prescribers.

The TREAT Act is supported by the following organizations:


  • American Medical Association (AMA),
  • American Society for Addiction Medicine (ASAM),
  • Trust for America’s Health (TFAH),
  • American Association of Nurse Practitioners (AANP),
  • Association of American Medical Colleges (AAMC),
  • Harm Reduction Coalition,
  • Big Cities Health Coalition,
  • National Association of State and Territorial AIDS Directors (NASTAD),
  • Drug Policy Alliance,
  • Association of State and Territorial Health Officials (ASTHO),
  • National Association of County and City Health Officials (NACCHO),
  • Massachusetts Sheriffs’ Association,
  • Association for Behavioral Healthcare Massachusetts,
  • Connecticut Certification Board, Inc.,
  • Massachusetts Medical Society,
  • Massachusetts Association of Behavioral Health Systems, Inc.
  • The Massachusetts Hospital Association

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