Subcommittee backs bill to let patients continue buprenorphine without counseling at every refill

A House subcommittee on health voted to report House Bill 712 after testimony that counseling mandates are preventing some patients from staying on buprenorphine, a medication used to treat opioid use disorder.

Delegate Waxman introduced the bill, saying federal oversight of buprenorphine loosened in recent years and state regulations now create confusion about whether patients must receive counseling at each dispensing. The bill would direct the Virginia Board of Medicine to amend its regulations so patients can receive the medication without having to meet a counseling requirement every time.

Dr. Grauer, an addiction medicine physician speaking on behalf of the American Society of Addiction Medicine and the Medical Society of Virginia, gave a first‑hand account of two patients who were discharged when counseling was required and later died of overdoses. He told the committee that "for buprenorphine, the number needed to treat is actually 2," arguing that the medication has an outsized life‑saving effect and should not be withheld when counseling is infeasible.

The doctor said the organizations supporting the bill still encourage therapy as part of addiction treatment, but they do not believe continuing a life‑saving medication should be conditioned on therapy attendance. The committee moved to report the bill; the motion passed by voice vote and the subcommittee recommended reporting HB 712 on a recorded vote of 10 to 0.

The next step for the bill is consideration by the full committee or additional referral as determined by the House rules.