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Kentucky Organizations Unite: Statewide Sign-On Letter Supporting HB 153 / SB 82 to Expand Lifesaving Buprenorphine Access

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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.

Dear Honorable Members of the General Assembly: 

The undersigned organizations, representing more than ____ 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 February 20, 2026 — More to Come):

Kentucky Society of Addiction Medicine

Kentucky Sheriffs’ Association

Kentucky Wounded Heroes

Kentucky Psychiatric Medical Association

American Academy of Addiction Psychiatry

Kentucky Psychological Association

Kentucky Academy of Physician Assistants

Kentucky Pharmacists Association

Kentucky Society of Health-System Pharmacists

Kentucky Ambulance Providers Association

University of Louisville Division of Palliative Medicine

Cardinal Street Medicine — UofL School of Medicine

Doctors for America — Kentucky Membership

Kentucky Social Work Advocacy, Justice, and Leadership

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.”

Additionally, 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:

American Medical Association

Kentucky Medical Association

American Academy of Family Physicians

Kentucky Academy of Family Physicians

American Society of Addiction Medicine

American Psychiatric Association

American Academy of Addiction Psychiatry

American College of Obstetricians and Gynecologists (ACOG)

Kentucky Section of the American College of Obstetricians and Gynecologists

Association for Multidisciplinary Education and Research in Substance Use and Addiction

[i] U.S. Department of Health and Human Services. (2026, February 2). ACF Expands Access to Medications for Opioid Use Disorder for At-Risk Families. Administration for Children & Families. https://acf.gov/media/press/2026/acf-expands-access-medications-opioid-use-disorder-risk-families

[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

[v] October 2025 Letter: https://apps.legislature.ky.gov/CommitteeDocuments/3/42171/ASAM-KSAM%20Statement%20re%20201%20KAR%209-270%20%28October%202025%29.pdf

[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

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Now is the winter of our discontent

today

a loved one died

a preventable death

from a treatable disease

because treatment was prevented

yesterday

These are dark days: 

  • 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 decreases overdoses by 50% 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!

Program
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A swing and a miss

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

MemberVoteMeaning
Rep. MarzianYESRegulation is deficient
Sen. AdamsYESRegulation is deficient
Sen. WilsonYESRegulation is deficient
Rep. GordonNORegulation is not deficient
Sen. WestNORegulation is not deficient
Rep. LewisNORegulation is not deficient
Rep. BridgesABSTAIN—
Sen. ArmstrongABSENT—

Result: 3 YES, 3 NO.

But because the ARRS seats eight members, 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.

And It Was the SIXTH Time This Year!

April. July. August. September. October. November.

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…

Again, to quote Shakespeare: 

“If it be not now, yet it will come.”

If you want to see exactly what happened on November 10, here’s the meeting video:
https://www.youtube.com/watch?app=desktop&v=WMvRlWpK6m0

And next time…

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Doctor Thornbury, Tear Down That Wall

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.

Learn more about this issue here: https://ket.org/program/kentucky-health/managing-the-disease-of-addiction/

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Kentucky needs the A.R.R.S. STARS to shine.

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.

If you would like to know more about how buprenorphine works to save lives, please check out this recent KET special:
🎥 Managing the Disease of Addiction (KET Kentucky Health)

2. Kentucky needs fewer barriers.

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.

📞 Phone: 502-564-8100

Email ARRS Members:

This issue has flown under the radar for far too long. Now that you know, please help get this outdated regulation off the books.

And if you can, join us in Frankfort on November 10 for the ARRS meeting — it’s open to the public. Maybe I’ll see you there.

In hope for a better future for Kentucky,
James Patrick Murphy, MD

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NOTICE: The Public Hearing on KY’s Buprenorphine Regulation has been moved to June 27, 2025 via Zoom!

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.

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Urgent request! Dr. Murphy is asking you to email KBML by June 27 and call for a halt to 201 KAR 9:270. Eliminating this regulation will save lives! (Post updated on 5/8/2025)

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.

https://mailchi.mp/kypar/take-1-minute-to-make-a-differencesave-lives?e=411f28ea2

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.

Why is this necessary?

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.

How did we get here?

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 the latest scientific evidence, expert recommendations, and current federal guidelines. Continuing with Kentucky’s flawed regulation will only result in more preventable overdose deaths in our state.

If you’d like to read the experts’ perspectives, check out this letter from the Kentucky Society of Addiction Medicine to Governor Beshear: KYSAM Advocacy Letter link: https://www.kysam.org/kysam-advocacy

The proposed KBML regulation update includes several provisions that are not evidence-based, such as:

  • Arbitrary dosage limits
  • Mandatory behavioral and psychosocial interventions
  • Inconsistent, compulsory appointment scheduling
  • Non-evidence-based laboratory testing requirements
  • Forced specialist referrals for certain patients
  • 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!

Here’s why you should take action now:

  • Overdose is the leading cause of death for Kentuckians under 40.
  • 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!

Thank you for your support!

Sincerely,
James Patrick Murphy, MD, DFASAM

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…

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ALARM ACT ONE-PAGE ADVOCACY BRIEF

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.

Overdose is the #1 cause of death for Kentuckians under the age of forty.

Every one of these deaths is PREVENTABLE.

• While Narcan may reverse an overdose, it does not treat the underlying cause of the overdose.

• In contrast, buprenorphine stabilizes brain regions that cause addictions & cause overdoses.

• Thus, buprenorphine (sometimes called Suboxone) is highly effective at PREVENTING overdoses.

• In fact, better access to buprenorphine could cut Kentucky’s overdose rate by 50% or more.

• And buprenorphine decreases drug diversion, illicit drug use, and drug-related crime.

• In sum, buprenorphine helps people achieve sustained recovery and lead healthy productive lives.

But there are barriers in 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 only 1 in five people who 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

James Patrick Murphy, MD

doctormurphyglms@gmail.com  

1/29/2025

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Sound the ALARM ! 

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.

On average, overdose kills five Kentuckians every single day.

There is something simple you can do today to help.

A brief call to your legislators, asking them to support the ALARM Act, could help save thousands of lives.

The ALARM Act is a legislative initiative aimed at improving access to buprenorphine – a lifesaving medication to treat opioid addiction – in fact, buprenorphine is our MOST EFFECTIVE measure to decrease overdoses and overdose deaths. The ALARM Act repeals regulation 201 KAR 9:270 – a decade-old KY law that severely hampers our doctors’ ability to prescribe buprenorphine.

Simply dial (800) 372-7181, and your message will be forwarded to your representatives.

You might say something to the effect of: Please help patients get the lifesaving medicine they need to treat addiction and prevent overdose deaths. Please support Dr. James Patrick Murphy and the Kentucky Society of Addiction Medicine by passing the ALARM Act, which repeal KY’s restrictive buprenorphine regulation 201 KAR 9:270.

Thanks! Now that you know my “ask,” please read on for the rest of the story…

IN RECORD NUMBERS, KENTUCKIANS CONTINUE TO DIE FROM OPIOIDS.

Widespread availability of buprenorphine could decrease overdose deaths by 50% or more. Buprenorphine (sometimes know by the trade name Suboxone) is FDA-approved to treat damaged areas in the brain that cause opioid addiction and can prevent dangerous addictive behaviors that lead to overdose.

Distinct from NARCAN – which might reverse an overdose but does not treat the actual addiction –buprenorphine treats the root cause of the overdose. Buprenorphine promotes recovery, reduces crime, prevents overdoses, and saves lives.

Buprenorphine treatment is not simply trading one drug dependency for another. Quite the opposite, buprenorphine is a prescription medicine that treats the disease process, allowing patients to lead productive heathy lives – in much the same way that insulin allows people with diabetes to manage their disease and live well.

Tragically, barriers to accessing buprenorphine exist, such as regulatory burdens, costs, stigma, and unfounded fear of diversion. Thus, only one in five Kentuckians who need buprenorphine can get treatment.

In Kentucky, a major barrier to buprenorphine treatment is 201 KAR 9:270 – an obsolete law that is not aligned with current clinical evidence. This onerous regulation restricts effective dosing and forces doctors and patients to complete costly, unnecessary tasks and imposes unscientific mandates that contradict recommendations of the overwhelming majority of experts. This is beyond illogical – it’s dangerous and deprives suffering people of lifesaving medication.

Ask yourself, would anyone be OK with treating breast cancer this way? Of course not. So why is Kentucky so restrictive with treating ADDICTION ? – the #1 cause of death for adults under the age of forty.

Kentucky is a an outlier. Our federal government and most other states have already done away with antiquated regulations like 201 KAR 9:270, allowing buprenorphine to be regulated like any other DEA schedule 3 controlled substance – as it should be. But Kentucky, despite ranking among the absolute worst states in terms of overdose deaths, somehow is still hanging on to 201 KAR 9:270. This must change. The regulation must be repealed.

The ALARM Act is a vital grass roots legislative initiative, supported by the Kentucky Society of Addiction Medicine and many others, that will repeal 201 KAR 9:270 and allow all Kentucky doctors to confidently treat their patients with buprenorphine – the “gold standard” medication for treating opioid addiction.

Every overdose death is PREVENTABLE.

Sound the ALARM !

Contact Your Kentucky legislators and ask them to support the ALARM Act.

(800) 372-7181 Monday-Friday 7am to 6pm

or

(502) 564-8100 Monday-Friday 8am to 4:30pm,

And email addresses can be found on their individual bio pages:

Senators

Representatives

Ask them to help save lives by joining you in supporting the Kentucky ALARM Act.

James Patrick Murphy, MD, DFASAM

Email: doctormurphyglms@gmail.com