Photo by ©istock.com/ognianmA new NIDA-funded study analysis found that the monthly numbers of opioid use disorder patients treated by buprenorphine prescribers were significantly below current limits, suggesting that barriers exist to securing treatment.
Buprenorphine, a medication effective in treating people with opioid use disorders, can be prescribed by addiction specialists or physicians who complete an 8-hour course and obtain a waiver from the U.S. Drug Enforcement Administration. Waivered prescribers are restricted to treating up to 30 patients with an opioid use disorder concurrently; after a year, physicians could request that the limit be increased to 100 patients.
There has been concern that the limits prevent patients from receiving treatment; however this analysis suggests that prescribers are treating fewer patients than even the limits allow. More than 20 percent treated three or fewer patients, and fewer than 10 percent treated more than 75 patients. The median treatment duration (53 days) was lower than expected given clinical recommendations of maintenance treatment for up to 12 months and evidence linking longer treatment to better outcomes.
Using a database of pharmacy retail transactions from more than 80 percent of pharmacies nationwide, the researchers analyzed 3,234 buprenorphine prescribers with 245,015 patients receiving a new prescription of buprenorphine.
The authors suggest that barriers to treating more patients include insufficient access to more experienced prescribers and substance use treatment counseling options. They recommend options for addressing these barriers, such as web-based or tele-counseling for patients and programs providing mentoring and telephone consultation from more experienced prescribers.
For a copy of the paper, "Physician capacity to treat opioid use disorder with buprenorphine‐assisted treatment," published in the Journal of the American Medical Association, go to http://jama.jamanetwork.com/article.aspx?articleid=2553439.
For information about opioids, go to: https://www.drugabuse.gov/drugs-abuse/opioids.
For more information, contact the NIDA press office at media@nida.nih.gov or 301-443-6245. Follow NIDA on Twitter and Facebook.