201 KAR 9:270 departs from acceptedstandards by imposing non-individualized requirements across multiple aspects of care, including
treatment initiation,
setting,
dosing,
formulation,
dispensing intervals,
co-prescribed medications,
drug and laboratory testing,
counseling and behavioral requirements,
consultations,
documentation, and
responses to perceived noncompliance.
These requirements delay, disrupt, or block care and impose disproportionate burdens on individuals with OUD, particularly those with transportation issues, housing instability, employment disruption, or childcare responsibilities.
disruption of care for patients with significant physical disabilities;
delays or denials for patients receiving other medically necessary medications;
delayed initiation or continuation due to mandatory specialist consultations;
avoidance of treatment due to perceived regulatory risk;
treatment interruption due to transportation, housing, or cost barriers; and
inability to initiate buprenorphine in emergency, acute care, or unhoused settings due to regulatory or institutional constraints.
The regulatory burden also deters physicians from providing addiction treatment in Kentucky and reduces clinician participation statewide.
The 2023 elimination of the federal X-waiver requirement under the Controlled Substances Act, together with the 2024 Federation of State Medical Boards’ statement affirming access to evidence-based treatment for opioid use disorder, further undermines the justification for the restrictive requirements imposed under 201 KAR 9:270, which are not aligned with prevailing national standards of care. These restrictions appear unnecessary to the safe regulation of buprenorphine given national standards supporting individualized clinical judgment in MOUD treatment.
During a recent state regulatory review, the American Medical Association, American Society of Addiction Medicine, Kentucky Society of Addiction Medicine, and American Psychiatric Association advised that failure to sufficiently amend 201 KAR 9:270 could undermine Kentucky’s response to the opioid crisis.
The Legal Action Center and Kentucky Equal Justice Center further stated the regulation may have a discriminatory effect on individuals with OUD by limiting access to evidence-based treatment based on stereotypes and assumptions rather than clinical justification, and may interfere with providers’ ability to deliver care consistent with ADA requirements.
A September 2022 Kentucky Opioid Response Effort (KORE) flier reported that buprenorphine reduces illicit opioid use and fatal overdose by over 50%. However, only approximately 20% of the estimated 150,000+ Kentuckians with OUD receive MOUD. Given this prevalence, 201 KAR 9:270 affects a substantial population that may be protected under the ADA. By conditioning access to buprenorphine on blanket regulatory requirements rather than individualized clinical judgment, the regulation creates statewide barriers to medically necessary care across settings and regions.
I respectfully request that the Department investigate 201 KAR 9:270 and consider enforcement action to remedy potential ADA violations. I will also submit supporting documentation by email.
A broad coalition of healthcare, public safety, and recovery organizations across Kentucky has come together to back HB 153 / SB 82, legislation that removes outdated barriers to evidence-based treatment for opioid use disorder. The coalition includes advocacy groups, recovery organizations, and prominent voices such as the Kentucky Sheriffs’ Association, Kentucky Society of Addiction Medicine, Greater Louisville Medical Society, Kentucky Nurses Association, and Appalachian Regional Healthcare. This unified support highlights the urgent need to expand access to proven treatments and save lives in communities across the state.
Note: The letter is still open for signatures. Email James Patrick Murphy MD at jpmurphy.mpc@gmail.com to join the support for HB 153 / SB 82.
Updated: April 22, 2026
Dear Honorable Members of the General Assembly:
The undersigned organizations, representing more than twenty-four law enforcement, medical societies and patient advocacy groups, respectfully request your co-sponsorship and support for HB153 / SB82. This important legislation would remove harmful regulatory barriers that unnecessarily limit access to the medication buprenorphine. As a result of these restrictions, too few Kentuckians with opioid use disorder (OUD) receive this life-saving medication at great cost to the people of our Commonwealth.
The ongoing overdose crisis demands a bold response which utilizes all policy tools to support our families, friends, and communities. Buprenorphine is an U.S. Food and Drug Administration-approved medication for the treatment of OUD and has been proven to significantly improve health outcomes for people with OUD.[i] Specifically, buprenorphine treatment is associated with reduced overdose deaths and criminal activity.[ii][iii] Further, evidence suggests that expanding access to this medication is a cost-effective strategy that would save both lives and taxpayer money.[iv]
In fact, the U.S. Department of Health and Human Services recently added all forms of medications for opioid use disorder (MOUD), including buprenorphine, as preventive services eligible for federal funding through the Administration for Children and Families under President Trump’s recent Executive Order: Addressing Addiction Through the Great American Recovery Initiative. Supporting HB153 / SB82 would help Kentucky follow the Trump Administration’s lead in promoting evidence-based treatment and recovery for more Americans with OUD.
Further, Kentucky’s special regulations governing buprenorphine are burdensome, flawed, and unnecessary. Last year, leading state and national medical societies identified several deficiencies with the regulations that remain unaddressed.[v]As such, the General Assembly now has an opportunity to correct course and remove this deficient regulation altogether. Notably, if HB153 / SB82 is enacted, buprenorphine will be regulated in the same manner as other Schedule III controlled substances. Therefore, HB153 / SB82 is a common-sense effort to simplify our regulatory scheme and return treatment decisions to clinicians and patients.
Opponents of this legislation warn that removing special regulations on buprenorphine would increase the risk that this medication is diverted. However, evidence suggests that most people use any diverted buprenorphine to self-treat withdrawal and more strictly regulating buprenorphine may actually increase diversion risk.[vi]As such, we must work to ensure that evidence-based treatment for OUD is more accessible in Kentucky. Enacting HB153 / SB82 is a significant step towards accomplishing that goal.
Ultimately, HB153 / SB82 is sensible legislation that would reverse flawed regulations and promote treatment, remission, and recovery for more Kentuckians. As such, we are proud to support this legislation and respectfully urge your co-sponsorship and support for its passage soon. Thank you for your consideration.
Sincerely,
Signatories in Support of HB 153 / SB 82 (Updated April 22, 2026):
Appalachian Regional Healthcare officially supports HB 153 / SB 82 – ARH, with more than 1,300 providers across its multi-state system, is the largest provider of care and the single largest employer in southeastern Kentucky.
Leadership representing over 30,000 first responders and frontline workers—including Louisville EMS and MetroSafe— supports HB 153 / SB 82.
Kentucky Professional Fire Fighters, representing forty-three fire fighter and EMS unions throughout Kentucky, officially supports HB 153 / SB 82.
Kentucky Firefighter’s Association, serving and promoting the interests of all firefighters in the Commonwealth of Kentucky, officially supports HB 153/ SB 82.
The Greater Louisville Medical Society independently expressed strong support for HB 153 / SB 82 (full letter to the General Assembly attached below), stating:
HB 153 / SB 82 is sensible legislation that would update flawed regulations and promote treatment, remission, and recovery for more Kentuckians. We are proud to support this legislation and respectfully urge your co-sponsorship and support for its passage soon.
Consistent with the goals of HB 153 / SB 82, the following organizations have previously called for the revision or repeal of Kentucky’s buprenorphine regulation, 201 KAR 9:270:
In August 2025, the Kentucky Medical Association (KMA) House of Delegates adopted a range of resolutions submitted by the Greater Louisville Medical Society (GLMS). Of particular note, the buprenorphine-related resolutions align closely with the goals of HB 153 / SB 82:
Buprenorphine Saves Lives: Recognized as a life-saving, evidence-based treatment for opioid use disorder, reducing overdose deaths.
Remove Barriers: Calls for eliminating unnecessary regulatory (i.e., KBML Regulation 201 KAR 9:270) and insurance obstacles that limit patient access.
Protect Physician Judgment: Safeguards doctors prescribing buprenorphine within accepted standards of care.
Chronic Pain Care: Supports evidence-based use of buprenorphine—including off-label applications—for appropriate patients.
Expert Input: Urges the Kentucky Board of Medical Licensure to consult widely with clinicians and subject matter experts when updating regulations.
These resolutions demonstrate GLMS and KMA’s commitment to expanding access to effective, evidence-based treatments and improving patient outcomes across Kentucky.
On August 1, 2024, a petition delivered to the Kentucky Board of Medical Licensure called for removing barriers to buprenorphine treatment and creating a transparent review process—steps fully aligned with HB 153 / SB 82. Both the petition and the bill aim to:
• Expand access to evidence-based treatment for opioid use disorder • Support patient-centered care • Help Kentucky physicians save lives
The 350+ petition signers include prominent voices affiliated with—although not necessarily representing—the following organizations:
Medical & Academic Institutions: • University of Louisville School of Medicine & Class of 1985 alumni • University of Kentucky College of Medicine & UK HealthCare • UofL Health • Penn State College of Medicine • Stanford University School of Medicine • University of Central Florida • University of Pennsylvania • University of Colorado School of Medicine • Johns Hopkins University • University of New Mexico • Robley Rex VA Medical Center
Medical Societies & Associations: • Greater Louisville Medical Society (GLMS) • Kentucky Society of Addiction Medicine (KYSAM) • American Society of Addiction Medicine (ASAM) • American Academy of Addiction Psychiatry • Kentucky Medical Association (KMA) • American College of Obstetricians & Gynecologists (ACOG), KY Section
Hospitals, Recovery & Behavioral Health Organizations: • St. Elizabeth Physicians & Journey Recovery Center • Brighton Recovery Center • Norton Healthcare • Baptist Health Louisville • Appalachian Regional Healthcare • BrightView Health & Brightview Addiction Centers • Alteri Behavioral Health • East Kentucky Rehabilitation Centers • Healing The Children KY • Discover Recovery, LLC • Bluegrass Care Navigators • Beacon House Aftercare • Ultimate Treatment Center, Ashland KY
Clinical Experts & Practitioners: • Addiction medicine physicians and specialists (MD, DO, FASAM) • Psychiatrists & psychiatric nurse practitioners (PMHNP-BC) • Pain management specialists & anesthesiologists • Internal medicine, family medicine, OB/GYN, pediatrics, and palliative care physicians • Licensed clinical social workers (LCSW, LCADC) • Pharmacists, CRNAs, and other allied health professionals • Medical students, residents, and fellows from ULSOM and UK
Additional Stakeholders & Advocates: • Elected members of the Kentucky General Assembly • Patient advocates, concerned citizens, and bereaved family members • Military and public safety professionals • Attorneys, researchers, and public policy experts
Affiliations reflect the organizations of individual petition signers and do not imply official institutional endorsement.
[ii] Santo, T., Clark, B., Hickman, M., Grebely, J., Campbell, G., Sordo, L., Chen, A., Tran, L. T., Bharat, C., Padmanathan, P., Cousins, G., Dupouy, J., Kelty, E., Muga, R., Nosyk, B., Min, J., Pavarin, R., Farrell, M., & Degenhardt, L. (2021). Association Between Length of Buprenorphine or Methadone Use and Nonprescribed Opioid Use Among Individuals with Opioid Use Disorder: A Cohort Study. JAMA Psychiatry, 78(9), 979. https://doi.org/10.1001/jamapsychiatry.2021.0976
[iii] Molero, Y., Zetterqvist, J., Binswanger, I. A., Hellner, C., Larsson, H., & Fazel, S. (2018). Medications for Alcohol and Opioid Use Disorders and Risk of Suicidal Behavior, Accidental Overdoses, and Crime. American Journal of Psychiatry, 175(10), 970–978. https://doi.org/10.1176/appi.ajp.2018.17101112
[iv] Fairley, M., Humphreys, K., Joyce, V. R., Bounthavong, M., Trafton, J., Combs, A., Oliva, E. M., Goldhaber-Fiebert, J. D., Asch, S. M., Brandeau, M. L., & Owens, D. K. (2021). Cost-effectiveness of Treatments for Opioid Use Disorder. JAMA Psychiatry, 78(7), 767. https://doi.org/10.1001/jamapsychiatry.2021.0247
[vi] Rubel, S. K., Eisenstat, M., Wolff, J., Calevski, M., & Mital, S. (2023). Scope of, Motivations for, and Outcomes Associated with Buprenorphine Diversion in the United States: A Scoping Review. Substance Use & Misuse, 58(5), 685–697. https://doi.org/10.1080/10826084.2023.2177972
Over 270,000 Kentuckians have opioid use disorder – almost 6% of our state’s population.
While we might be saving more Kentuckians from overdose deaths, we are not seeing fewer overdoses. The number of overdose events in Kentucky is actually rising.
And about four Kentuckians die from overdose every single day.
But light is coming…
Senator Julie Raque Adams, has submitted a bill request to fix this problem. The bill, which is still being finalized: (1) restores autonomy for patients, (2) empowers EMS to treat within the full scope of their practice, (3) protects physicians practicing responsibly, and (4) ensures veterans can access medications endorsed by the experts in accordance with research-based best practices.
In short, this bill will save lives.
Treatment approaches for addiction are generally as successful as those for other chronic diseases, and buprenorphine is proven to be our best medication to treat opioid addiction and prevent overdose deaths. Senator Adams’ bill will allow our loved ones with opioid addiction, who need buprenorphine, to get buprenorphine when they need buprenorphine. Please support Senator Julie Raque Adams’ bill.
The Kentucky General Assembly starts on January 6, 2026.
Questions for our Commonwealth…
• Why is it easier to prescribe OxyContin –which CAUSES addiction—than to prescribe buprenorphine—which TREATS addiction?
• Why are FIRST RESPONDERS allowed to reverse overdoses, but not allowed to prevent overdoses?
• Why are VETERANS denied safe medications – like buprenorphine – only to be forced onto dangerous medications – like fentanyl?
• Why do our state officials proclaim that buprenorphine decreasesoverdoses by50% and then enforce outdated laws that deny access to it?
• And why does our state require a federal “waiver” to prescribe buprenorphine, when the feds eliminated that “waiver” THREE years ago?
Let’s pass Senator Julie Raque Adams’ addiction treatment access bill in 2026 to make these questions moot – and make Kentucky a safer, healthier place to live long and prosper. That would be glorious!
November 10th should have been a turning point in Kentucky’s effort to reduce overdose deaths. But instead of ending a broken and outdated rule, the Administrative Regulation Review Subcommittee (ARRS) stepped in to revive 201 KAR 9:270—Kentucky’s deeply flawed buprenorphine regulation.
It was a moment that called for moral clarity. The appropriate response should have been simple: Do Not Resuscitate.
Yet, the committee chose otherwise.
It was a swing and a miss at a golden opportunity.
What the Voting Members Said
Chairman, Rep. Derek Lewis: “If you’re opposed to finding it [the regulation] deficient and think it should move forward, please vote no.”
Sen. Julie Raque Adams:“Aye.”
Sen. Mike Wilson:“Aye.”
Rep. Randy Bridges:“I’m going to abstain.”
Rep. Deanna Gordon: “I’m going to vote no, but I’m on the health committee, and this is probably the place where it’s going to go after this.”
Rep. Mary Lou Marzian: “I’m going to vote yes, because I’m really disappointed in the lack of communication from the board of medical licensure, and I have found them to be a little bit obstinate in the past.”
Co-Chair, Sen. Stephen West: “I vote no. The main reason… is that the committee of jurisdiction has the subject matter expertise to cover this particular piece of regulation.”
Chairman Lewis: “I am also a no. I do appreciate the testimony. I appreciate the passion. I truly do. We do have a process in place though.”
The Tally
Member
Vote
Meaning
Rep. Marzian
YES
Regulation is deficient
Sen. Adams
YES
Regulation is deficient
Sen. Wilson
YES
Regulation is deficient
Rep. Gordon
NO
Regulation is not deficient
Sen. West
NO
Regulation is not deficient
Rep. Lewis
NO
Regulation is not deficient
Rep. Bridges
ABSTAIN
—
Sen. Armstrong
ABSENT
—
Result: 3 YES, 3 NO.
But because the ARRS seats eightmembers, to find the regulation deficient required a five vote majority.
So the motion to find it deficient failed—and by the slimmest of margins, 201 KAR 9:270 dragged itself out of the gutter and staggered on.
201 KAR 9:270 needed a whopping SIX appearances before ARRS in an eight month span, before it skidded out of committee by the skin of its teeth. If that’s not a red flag, what is?
Shakespeare might have said: “Something is rotten in the state of Denmark.”
My Testimony to the Committee
You have enough information. You know what the right answer is. And I ask you on behalf of your families and everyone in this state who is suffering and dying— for the four people who will die today from an overdose. Think about those four people who die every day. Every overdose is preventable.
Don’t let this go forward.
What Happens Next?
Sen. West offered a clue:
“There will be another chance…in the subject matter committee, as well as a legislative session that is coming up. We have 138 members of the General Assembly, and you can ask any of them to file a bill… and they can attack this problem for you.”
He’s right. 201 KAR 9:270 has not cleared all of the hurdles yet. We will have another opportunity, or two, or three…
Kentucky’s 201 KAR 9:270 is a barrier to lifesaving care
If a medication prevents overdose deaths, and a regulation prevents treatment with that medication, then removing that regulation will save lives.
The lifesaving medication is buprenorphine. The barrier regulation is 201 KAR 9:270.
So why is 201 KAR 9:270 still on the books?
On Monday, November 10, 2025, the Administrative Regulation Review Subcommittee (ARRS) of the Kentucky General Assembly will ask that question—again. It’s the same question they asked the Kentucky Board of Medical Licensure (KBML) in October, when they urged the Board to work with the many medical and community groups opposing the regulation and return with a compromise.
A Month Wasted
The record speaks for itself.
October 14, 2025 — ARRS Meeting Discussion KBML President Dr. Thornbury told legislators:
“Mr. Chairman, I think what we’d like to do is work with you and the committee to help our colleagues come together if we can.”
October 16, 2025 Two days later, KBML declined a meeting and asked the Kentucky Society of Addiction Medicine (KYSAM) to submit written amendments instead.
October 24, 2025 KYSAM submitted a detailed 8,000-word, 10-page markup of 201 KAR 9:270, along with an email from KYSAM President Dr. Colleen Ryan extending an open invitation for continued collaboration.
October 31, 2025 No discussion. No dialogue. No compromise. Instead, KBML submitted two inconsequential edits to its 3,000-word regulation:
• Page 3: deleting “a” and inserting “an” • Page 7: replacing “best efforts” with “a good-faith effort.”
Honestly, was this a good-faith effort by the medical board?
Dismissive and Counterproductive
KBML’s response to ARRS is dismissive, perfunctory, and contrary to the spirit of collaboration. For two years, the Board has mechanically engaged with Kentucky stakeholders while refusing to seriously consider the overwhelming professional consensus opposing 201 KAR 9:270. Lives are at stake, yet this pattern of disengagement continues unchecked, raising urgent questions about KBML’s priorities.
A Regulation That Costs Lives
Every day, Kentuckians die from preventable overdoses. Buprenorphine is a proven, evidence-based treatment that dramatically reduces overdose deaths and supports recovery. Yet 201 KAR 9:270 erects unnecessary barriers that make it harder for physicians to prescribe and for patients to receive this lifesaving medication.
When bureaucracy stands between patients and proven treatment, people die.
On October 14, to the ARRS and a televised audience watching on KET (Watch the video at 1:17:28), KBML President Thornbury said the thinking part out loud when he qualified his testimony with:
I want the committee to understand, and
I UNDERSTAND HOW POLITICS IS.
Well, I understand this: with so many Kentuckians dying needlessly every year, reforming this regulation isn’t politics—it’s a moral imperative.
A Call to the ARRS
On November 10, the ARRS will again consider 201 KAR 9:270. I cannot see how anyone in good conscience could support advancing such a deeply flawed regulation.
I respectfully urge the ARRS to return 201 KAR 9:270 to KBML with explicit instructions to engage meaningfully with the medical and addiction-treatment communities—and to seriously consider overhauling or repealing it in favor of a solution that saves, rather than costs, lives.
As ARRS Co-Chair Senator Stephen West said last month:
“My hope is that maybe after the discussions today there would be some possibility of compromise…the reason we’re even asking for this is we realize how very important this decision is…We need to get this right.”
Licensure Board, tear down that regulation — and let Kentucky’s clinicians save lives.
Dr. James Patrick Murphy, MD
Dr. James Patrick Murphy, Region X Director for the American Society of Addiction Medicine, is a Louisville resident and professor at the University of Louisville School of Medicine.
Please take three minutes to read how you can help a small committee make a BIG impact in the lives of Kentuckians battling opioid addiction.
Buprenorphine — a safe and effective medication for the treatment of opioid use disorder (MOUD) — is vital to reducing overdose deaths. Yet Kentuckians’ access to this lifesaving medication is in jeopardy because of an outdated, ten-year-old regulation still on the books: 201 KAR 9:270.
But there’s hope.
On November 10, 2025, the Administrative Regulation Review Subcommittee (ARRS) of Kentucky’s General Assembly has the power to reject the Kentucky Board of Medical Licensure’s (KBML) flawed update to this harmful rule.
Why the KBML Proposal Must Be Rejected
The KBML’s proposed update to 201 KAR 9:270 is insufficient, critically flawed, and should be sent back for comprehensive revision — or better yet, repealed altogether.
At its heart, this is about access.
Kentuckians battling opioid addiction need fewer barriers to buprenorphine, not more. Yet this regulation does the opposite — it’s full of unnecessary restrictions that are:
Outdated
Unsupported by research
Condemned by experts
Punitive toward people with addiction
Four Truths Everyone Should Know
1. Buprenorphine works.
The Kentucky Opioid Response Effort (KORE) reports that buprenorphine (and methadone) reduce illicit drug use and fatal overdose by over 50% — and improve quality of life.
The Federation of State Medical Boards — of which Kentucky is a member — says that “reducing barriers to treatment” with buprenorphine is critical to “decreasing the risk of overdose.”
3. 201 KAR 9:270 is a proven barrier.
A recent study by Kentucky researchers repeatedly cited this KBML regulation as a barrier preventing people from receiving lifesaving treatment.
4. The ARRS has rejected KBML proposals before.
In 2008, after ARRS pushed back, KBML admitted in its fall newsletter:
“Acting on a request of the Kentucky General Assembly’s Administrative Review Subcommittee (ARRS), the Board has agreed to withdraw all of its existing guidelines.”
The Correct Course Is Clear
Reject 201 KAR 9:270.
On November 10, the ARRS can send this regulation back to KBML and direct them to work collaboratively with Kentucky’s addiction medicine specialists and other experts to create evidence-based, compassionate policy that expands access to treatment rather than restricting it.
What You Can Do
You’ve already taken the first step by reading this article. Thank you.
If you want to make your voice heard, contact ARRS members today and urge them to reject KBML’s proposed update to 201 KAR 9:270.
The Kentucky Board of Medical Licensure (KBML) filed their updated version of 201 KAR 9:270 (the buprenorphine regulation) and scheduled an in-person public hearing for March 26, 2025. However, KBML cancelled this hearing due to an overwhelming number of requests by speakers to be heard. KBML has now rescheduled the hearing for June 27, 2025, only this time it’s not in-person. It’s a Zoom meeting! They have not posted the link yet, so stay tuned and monitor the KBML website, link: https://kbml.ky.gov/Pages/index.aspx
Please mark your calendar for June 27th and spread the news. To review, below is a call to action from Dream.org sent prior to the cancelled March 26th hearing. The same issues are still at stake. Your voice is needed now more than ever! Even if you only Zoom in for thirty seconds. Your participation matters and will help prevent overdose deaths and improve the lives of your neighbors, friends, and loved ones.
HERE’S THE LATEST: The Kentucky Board of Medical Licensure (KBML) filed their updated version of 201 KAR 9:270 (the buprenorphine regulation) and scheduled an in-person public hearing for March 26, 2025. However, KBML cancelled this hearing due to an overwhelming number of requests by speakers to be heard. KBML has now rescheduled the hearing for June 27, 2025, only this time it’s not in-person. It’s a Zoom meeting! They have not posted the link yet, so stay tuned and monitor the KBML website, link: https://kbml.ky.gov/Pages/index.aspx
Please mark your calendar for June 27th and spread the news. To review, below is a call to action from Dream.org sent prior to the cancelled March 26th hearing – NOW JUNE 27. The same issues are still at stake. Your voice is needed now more than ever! Even if you only Zoom in for thirty seconds. YOUR WRITTEN COMMENTS MATTER TOO! THANK YOU!
Dear Friends, Neighbors, and Colleagues,
Now is the time to take action! Your voice can make a difference in Kentucky. A simple email could help save lives. Here’s how: Send an email to the Kentucky Board of Medical Licensure (KBML) via
Leanne K. Diakov, KBML General Counsel at leanne.diakov@ky.gov
To make it easier, simply click on this LINK, where you’ll find a helpful brief to guide you in crafting and sending your email to leanne.diakov@ky.gov
NOTE: KBML HAS RESCHEDULED THE PUBLIC HEARING FOR JUNE 27, 2025, AND ARE ACCEPTING EMIALS AND WRITTEN COMMENTS THROUGH JUNE 27.
Tell KMBL that you do not support the proposed changes Kentucky’s buprenorphine regulation, and you believe Kentucky would be better served by eliminating the entire regulation known as 201 KAR 9:270.
The Kentucky Board of Medical Licensure (KBML) is nearing the final stages of updating the regulation 201 KAR 9:270, which governs the treatment of Opioid Use Disorder with buprenorphine in Kentucky. Even with the proposed changes, this regulation remains flawed and harmful, and KBML has yet to fully acknowledge the impact. You don’t have to take my word for it. Read it for yourself at https://apps.legislature.ky.gov/law/kar/titles/201/009/270/REG/
Unfortunately, KBML’s proposed amendments do not address the damaging, stigmatizing policies first introduced in 2015. But you still have time to help alter this course. Until JUNE 27, you can make your voice heard with an email to KBML.
Despite input from hundreds of specialists, caregivers, and concerned Kentuckians calling for significant revisions to this harmful regulation, KBML has moved forward with publishing insufficient amendments to their outdated regulations on buprenorphine prescribing. Sadly, these amendments do little to improve the situation and further create barriers for patients seeking this life-saving treatment.
Kentucky is out of sync with the rest of the country. While federal guidelines have simplified and streamlined buprenorphine prescribing in recent years, Kentucky remains one of the few states enforcing stricter, punitive measures. Kentucky’s buprenorphine regulation (and its proposed amendments) are not only unsupported by evidence but also contribute to an increase in overdose deaths by limiting access to care.
If 201 KAR 9:270 and its proposed amendments are allowed to proceed, Kentucky will miss the opportunity to align itself with thelatestscientificevidence, expertrecommendations, and current federal guidelines. Continuing with Kentucky’s flawed regulation will only result in more preventable overdose deaths in our state.
A ban on using buprenorphine-naloxone for chronic pain
It’s time to take action!
Now through JUNE 27, you have the opportunity to speak up on behalf of those struggling with opioid use disorder. Email your comments to:
Leanne K. Diakov, KBML General Counsel: leanne.diakov@ky.gov
At the end of this post, you’ll find a sample letter that you can modify to share your personal perspective, if you wish. Personalizing your message can make a big impact!
The Director of the National Institute on Drug Abuse stated that if everyone who needs buprenorphine could access it, overdose deaths could be reduced by half.
201 KAR 9:270 is a barrier preventing Kentuckians from accessing this life-saving medication.
And despite a tsunami of evidence proving the lifesaving effects of this medication, buprenorphine prescribing in Kentucky actually decreased last year! We must do better!
What more motivation do you need? Together, we can make a difference. Let your voice be heard!
Dr. Murphy is Kentucky’s Regional Director for the American Society of Addiction Medicine and is a founding member of the American Medical Association’s Substance Use and Pain Care Task Force. He serves as an Assistant Clinical Professor for the University of Louisville School of Medicine and is board-certified in Anesthesiology, Pain Management, and Addiction Medicine.
***SAMPLE TEXT***
To: Kentucky Board of Medical Licensure Attention: Leanne K. Diakov, General Counsel Email: leanne.diakov@ky.gov
RE: Public Comments on Proposed Amendments to 201 KAR 9:270
Dear Members of the Kentucky Board of Medical Licensure,
I am submitting my public comments on the proposed amendments to 201 KAR 9:270. Rather than addressing Kentucky’s overdose crisis, I am concerned that these proposed changes will only worsen the situation, creating additional barriers to care and limiting access to critical, lifesaving treatments. I respectfully urge the Board to prioritize evidence-based addiction treatment by rejecting these amendments and fully repealing this outdated and harmful regulation.
Expanding access to medications for opioid use disorder, such as buprenorphine, is crucial for reducing overdose deaths. Unfortunately, the proposed amendments directly contradict the guidance from several leading authorities, including the U.S. Department of Health and Human Services, the Drug Enforcement Administration, the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse, and the Federation of State Medical Boards, all of which support broader access to buprenorphine-based treatments. The restrictions outlined in 201 KAR 9:270 would be counterproductive and could exacerbate health disparities, especially within marginalized communities.
If these proposed amendments are enacted, 201 KAR 9:270 will continue to contribute to Kentucky’s tragically high overdose death rate. I fully support the concerns raised by the Kentucky Society of Addiction Medicine, which has reviewed the proposed changes and deemed them insufficient. In light of these concerns, I strongly advocate for the full repeal of 201 KAR 9:270.
Thank you for considering the potential impact of these amendments on the health and well-being of Kentuckians. I urge the Board to prioritize evidence-based addiction treatment by rejecting these amendments and fully repealing this outdated and harmful regulation.
Sincerely, [Your Name] [Your Credentials/Professional Title, if applicable]
Kentucky House Bill 788 (currently in committee) supports increased access to buprenorphine by empowering Kentucky’s providers to treat patients with evidence-based care. Check out this 9 minute video of Dr. Murphy’s recent testimony in Kentucky’s capital city: https://www.youtube.com/watch?v=3lILI0x4TXo
More and more people and organizations are joining this cause…
3/15/2025 UPDATE – For the time being, the ALARM ACT initiative has been merged with HB 788, which was filed by Representative Kim Moser in the Kentucky General Assembly. For more information check out the KYSAM advocacy HB 788 website: https://www.kysam.org/news
Kentucky House Bill 788 supports increased access to buprenorphine by empowering Kentucky’s providers to treat patients with evidence-based care. Check out this 9 minute video of Dr. Murphy’s recent testimony in Kentucky’s capital city: https://www.youtube.com/watch?v=3lILI0x4TXo
The salient issues remain consistent with the ALARM ACT initiative, thus I’m keeping this post on the website to provide historical context supporting our efforts to save lives.
ALARM Act one-page advocacy brief
On average, FIVE Kentuckians die every day from overdose – about 2000 deaths per year.
• In sum, buprenorphine helps people achieve sustained recovery and lead healthy productive lives.
But there are barriersin the way of Kentuckians’ access to buprenorphine treatment. The barriers include: (1) stigma born of prejudice & misunderstanding, (2) unfounded fear of diversion, (3) excessive costs from unnecessary regulatory requirements, and (4) burdensome administrative hoops.
KY’s buprenorphine regulation 201 KAR 9:270 is a major regulatory barrier.
Frankly, the mandates in 201 KAR 9:270 are inconsistent with clinical evidence, expert opinion, or even the DEA – and even when 201 KAR 9:270 is repealed, the DEA will continue to regulate buprenorphine like any other schedule three controlled medication. But for now, 201 KAR 9:270 still exists and contributes to the fact that only1 in fivepeoplewho need treatment with buprenorphine can access the medication.
Can you imagine restricting treatment of cancer, diabetes, or any other disease in such a callous way?
The ALARM Act is backed by the Kentucky Society of Addiction Medicine, along with a vast majority of professional societies, scientists, scholars, medical school professors, physicians, caregivers, and countless other Kentuckians affected by the disease of opioid addiction. The ALARM Act repeals 201 KAR 9:270 and empowers Kentucky doctors to treat their patients with evidence-based medication, saving valuable healthcare resources and, most importantly, saving precious lives. Please support the ALARM Act.
More information can be found via the Kentucky Society of Addiction Medicine’s website: KYSAM.ORG
Confluential Truth 