OSI's International Harm Reduction Development Program, along with 167 organizations in 41 countries, issued an open letter to the World Health Organization (WHO) in response to suggestions within the agency's Expert Committee on Drug Dependence that regulatory restrictions on buprenorphine should be increased. The letter calls on WHO to postpone any consideration of rescheduling until full consultation with civil society and scientific experts can take place—a move in fact required by WHO guidelines.

Buprenorphine, a partial opiate agonist, has proved highly effective in treatment of opiate dependency, and is also used in pain management. The medication is important in an HIV-treatment context as well, by providing a means to stabilize opiate dependent patients and increase adherence to HIV therapies.

Following the sign-on letter, expert testimony, and expressions of concern by a variety of government and nongovernmental agencies, the WHO’s Expert Committee on Drug Dependence met March 28-31, 2006, and decided not to make any decision about rescheduling buprenorphine at that time. The committee, like all who signed the letter, was concerned that a change in the scheduling status of buprenorphine would negatively affect availability of the medication.

It was noted by the Committee that in respect to narcotic analgesics, over 80% of the world population has no proper access to such medications if required. The Committee encourages countries to cooperate with WHO in improving access, and it will discuss in future the accessibility of controlled substances and the prevention of their abuse.

The letter to WHO is available for download below.