Trends in Buprenorphine Treatment in the United States, 2009-2018

Abstract

Author Contributions: DrZhanghadfullaccesstoallofthedatainthestudyandtakes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Olfson, Zhang, Schoenbaum. Acquisition, analysis, or interpretation of data: All authors.

Prevalence and Geographic Distribution of Obstetrician-Gynecologists Who Treat Medicaid Enrollees and Are Trained to Prescribe Buprenorphine

“…26 We found a higher prevalence of X-waivered obstetrician-gynecologists in suburban counties and in counties with fewer uninsured residents. This finding aligns with prior evidence that, despite overall uptake in buprenorphine use, 27 access remains uneven based on race, insurance status, and geographic area. 28 As demonstrated by a recent national study, buprenorphine treatment is concentrated among White patients and those with private insurance.…”

Medication Improves Age Disparities in Six-Month Treatment Retention for Opioid Use Disorder

“…Our findings suggest that pharmacologic treatment is superior to psychosocial treatment alone for treatment retention within the adolescent population, and provide further evidence that medication treatment should be offered to adolescents with OUD. This is of particular import given the low rates with which adolescents are prescribed medication, and given recent findings that the prevalence of buprenorphine prescribed to youth with OUD has decreased in recent years (Olfson et al, 2020). While the previously mentioned barriers to pharmacologic treatment for adolescents with OUD are numerous, our results add to the growing literature that points to need for increased access to medication treatment for adolescents with OUD (Committee On Substance Use and Prevention, 2016;…”

Continuing increased access to buprenorphine in the United States via telemedicine after COVID-19

“…( Sordo et al., 2017 ) Although buprenorphine treatment has increased over the past decade, it is often not available when and where it is most needed. ( Olfson, Zhang, Schoenbaum, & King, 2020 ) Federal laws that make buprenorphine for OUD difficult to access for many patients, including those most at-risk for overdose death, are a key driver of the persistent gap between treatment need and availability. ( Davis & Carr, 2019 )…”

“…While use of buprenorphine has modestly increased in recent years, due in part to the Medicaid expansion permitted by the Affordable Care Act, ( Olfson, Zhang, Schoenbaum, & King, 2020 ; Sharp et al., 2018 ) there remain significant gaps and inequities in treatment access and availability by geographic location and race. ( Jones, Campopiano, Baldwin, & McCance-Katz, 2015 ) Currently, only approximately five percent of US physicians are waivered to provide buprenorphine, ( Olfson et al., 2020 ) and more than half of rural counties lack a waivered buprenorphine provider. ( Andrilla, Moore, Patterson, & Larson, 2019 ) The restrictive regulatory regime can also impact buprenorphine dispensing.…”