Commentary: Providing technical assistance for the state targeted response for opioid use disorders: Time is of the essence

Levin, Frances R.; Cates-Wessel, Kathryn

doi:10.1111/ajad.12705

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…8,9 Although treatment availability has increased across the United States, as of 2017, 56% of rural counties still did not have a single buprenorphine prescriber, compared with 23% of urban counties. 8 As increased resources are being dedicated to increase treatment access, 10,11 it is critical to understand whether there are differences in physician characteristics and treatment practices between nonmetropolitan and metropolitan areas, which may inform tailored strategies to address treatment needs in these different locations.…”

Section: Introductionmentioning

confidence: 99%

Comparing Buprenorphine-Prescribing Physicians Across Nonmetropolitan and Metropolitan Areas in the United States

Lin

Knudsen

2019

Ann Fam Med

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PURPOSE Although there is a tremendous need to increase the use of buprenorphine for the treatment of opioid use disorder in rural areas, little is known about current rural/urban differences in treatment practices. We aimed to examine physician characteristics, treatment practices, and concordance with treatment guidelines among buprenorphine prescribers across different locations of practice. METHODS A national random sample of buprenorphine physician prescribers was surveyed (n = 1,174, response rate = 33%) from July 2014 to January 2017. Analyses examined buprenorphine treatment across locations of practice (categorized as nonmetropolitan, small metropolitan, and large metropolitan). RESULTS Among buprenorphine prescribers surveyed, 11.2% (n = 132) practiced in nonmetropolitan/rural areas, 32.5% (n = 382) in small metropolitan areas, and 56.2% (n = 660) in large metropolitan areas. Buprenorphine prescribers in nonmetropolitan areas were much more likely to be primary care physicians, accept Medicaid, and less likely to work in an individual practice. Overall, buprenorphine prescribers across the rural/urban continuum were similar in many of their treatment practices, including induction, frequency of visits, dosing, and use of psychosocial treatment, which were generally consistent with buprenorphine treatment recommendations. CONCLUSIONS There are important differences in characteristics of buprenorphine prescribers in nonmetropolitan areas compared with more urban areas, including the fact that the majority of nonmetropolitan physicians are primary care physicians. Although treatment access in rural areas is an ongoing challenge, buprenorphine treatment practices are similar. Understanding buprenorphine prescribers and their treatment practices may help inform tailored strategies to address treatment needs in different locations.

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