Nov. 6, 2018 — While the law can help deal with the nation's ongoing opioid crisis, it can also serve as a hindrance said Yale Law School Professor Abbe Gluck who spoke recently at the University of Houston Law Center as the Order of the Coif's 2018 Distinguished Visitor.
Gluck made her remarks in her presentation, "Legal Perspectives on the Opioid Crisis: Law in the Courts, the Statehouses and the Medical Clinics." The event was hosted by the Law Center and its Health Law & Policy Institute.
"While law can only be part of the solution, any legal solution has to hit a lot of different topics," Gluck said. "The crisis is daunting because it is extremely complex. It is truly the result of multiple intersecting causes, and so it's going to have to be resolved by a variety of intersecting solutions across disciplines. Even within the law, it's a criminal law problem, it's a physician regulation problem, it's an insurance problem and it also involves FDA law, complex litigation, race and social justice and federalism."
Gluck noted that as a vestige of early efforts to address the war on drugs, federal law requires that methadone, one of the most effective medicine-based treatments for opioids, must be provided in separate standalone clinics, creating a major obstacle for physicians who treat patients suffering from addiction.
"These clinics have very rigid rules about timing, and a lot of doctors don't want to be associated with them because there's a stigma," Gluck said. "A lot of patients don't want to be associated with them. So methadone is not that easily accessible because of these rather outdated federal laws.
"There are new medications that work in similar ways. A medication known as buprenorphine is the most prominent. Here too federal laws interfered in a very unusual way. The law limits the amount of patients any doctor can treat with buprenorphine at any one point, and requires doctors to take eight hours of training before administering a dose. Nurses and other non-physicians who treat have 24 hours of training."
Gluck said this dynamic is unusual because there is no other medicine with similar limitations and training requirements for medical professionals.
"This structure has disincentivized doctors from treating patients with addiction because they don't have access to or face huge obstacles to administering buprenorphine," she said.
Gluck is the faculty director of the Solomon Center for Health Law and Policy at Yale Law School. She joined Yale Law School in 2012, having previously served on the faculty of Columbia Law School. Her scholarship has been published in the Yale Law Journal, the Harvard Law Review, the Stanford Law Review, the Columbia Law Review, the New England Journal of Medicine, Health Affairs and many others.