SF pharmacies could soon carry opioid-treatment medication

New legislation in San Francisco would make one of the main medications used to treat opioid withdrawal more accessible to those who need it.

The San Francisco Department of Public Health and Supervisor Matt Dorsey introduced a resolution making buprenorphine — one of the most commonly used medications to treat opioid-use disorder, alongside methadone — available in The City’s pharmacies.

“It is critical that people in recovery have easy access to effective and life-saving medications such as buprenorphine and methadone if they are going to be successful entering and staying in treatment,” said Dr. Grant Colfax, The City’s director of health, in a statement Tuesday. “With treatment and support, recovery from opioid-use disorder is possible for every individual.”

Buprenorphine helps reduce cravings for those in withdrawal from opioids and helps alleviate some of its symptoms. According to the Department of Public Health, only 44% of pharmacies in The City have enough buprenorphine in stock to fill a new prescription the same day.

The legislation, which is intended to reduce barriers to the treatment, would change The City’s health code to require all retail pharmacies that dispense controlled-substance prescription drugs to have enough buprenorphine on hand to be able to fill at least two new prescriptions.

The Department of Public Health told The Examiner that the price of the medication would likely be determined by a person’s insurance’s copay. People would only be able to access the medication with prescriptions from providers, who would determine the dosage.

“With few pharmacies in San Francisco currently stocking the medication, this bill aims to ensure people newly prescribed the medication can access it from their pharmacy, when and where they need it,” the department said in a statement.

While buprenorphine is covered by Medi-Cal, Medicare and most commercial plans, those without insurance who don’t qualify for the former two plans and fall below income thresholds can access coverage for the medication through The City’s Healthy San Francisco Program , which would cover the cost.

The legislation, which Supervisors Rafael Mandelman, Hillary Ronen, and Dean Preston co-sponsored, is part of a larger statewide effort to expand treatment and services for those suffering from substance-use disorders.

Matt Haney, who represents San Francisco in the state Assembly, introduced a bill earlier this year, AB 2115, that focuses on methadone access and would allow doctors to prescribe patients up to 72 hours’ worth of doses and increase the dosage patients can take home from clinics.

Methadone has historically been more controlled by regulations than buprenorphine, as it’s more potent for some patients. But things have changed at the federal level recently, with health regulators loosening restrictions in April to allow patients to be able to take doses home with them and for doctors to prescribe methadone remotely.

It’s unclear yet if the state of California will follow suit. The Opioid Treatment Outpatient Program at Zuckerberg San Francisco General Hospital , one of eight licensed methadone programs in The City, is the only one that’s permitted to let patients take home doses due to an outstanding pandemic exemption.

The Department of Public Health and The City have supported Haney’s bill in the hopes that it moves California’s methadone regulations closer to the new federal standards, the department said.