Buprenorphine availability limited in the Midwest, South

  • Jones CW & al.
  • J Subst Abuse Treat
  • 23 Aug 2018

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Availability of buprenorphine providers for patients with opioid use disorder (OUD) varies widely across the US counties, with parts of the Midwest and South having the lowest rates of buprenorphine use relative to the number of regional opioid-related deaths.

Why this matters

  • Completion of an 8-hour course is required to receive a Drug Enforcement Agency
    (DEA) waiver to prescribe buprenorphine, and even then clinicians are restricted on the number of patients they can treat.
  • Easing these restrictions could significantly expand the availability of buprenorphine, which has a better safety profile for OUD than methadone.

Study design

  • Cross-sectional study of 846 counties assessing the number of available buprenorphine providers and the number of opioid-related overdose deaths between 2013 and 2015.
  • Funding: None.

Key results

  • Overall, median number of opioid overdose deaths per county was 20 deaths per 100,000 residents (interquartile range [IQR], 13.4-29.9).
  • Number of buprenorphine providers per 100,000 county residents ranged from 0 to 45 (median, 5.9; IQR, 3.2-9.5).
  • Analysis showed lower-than-average buprenorphine providers and higher-than-average deaths across the Southern, Midwestern counties in the United States.

Limitations

  • Counties with fewer deaths were excluded.
  • Data from methadone clinics or inpatient opioid treatment centers were not included.

Coauthored with Anand Ramanathan, PharmD

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