Abstract
Buprenorphine is an effective treatment for opioid use disorder (OUD). Despite the demonstrated efficacy of Medication Assisted Treatment (MAT), few healthcare providers are licensed to prescribe Buprenorphine for OUD. The purpose of this study was to assess the attitudes and prescribing practices of providers licensed to treat patients Buprenorphine in two counties in Northern California. We aim to identify barriers to prescribing Buprenorphine for OUD. This is a descriptive study to understand provider practices, attitudes, and barriers towards Buprenorphine prescribing. Of the 95 x-waivered providers identified in Sacramento and El Dorado County, 36 (38%) responded to our phone survey. 12 (33%) were women, and the three most common specialties were Family Medicine 19 (53%), Addiction Medicine 8 (22%), and Psychiatry 8 (22%). Of the survey participants, 33 (92%) actively prescribe Buprenorphine. Self-motivation was cited as the most common reason to become x-waivered 29 (81%), while the least cited reason was an institutional requirement 3 (8%). The most common motivations for prescribing Buprenorphine included low overdose potential 30 (91%), drug efficacy 28 (85%), and low abuse potential 27 (82%). The greatest barriers to Buprenorphine prescribing included poor reimbursement 15 (46%), time constraints 13 (39%), and patient preference for opiates 11 (33%). Overall, most of the interviewed providers 30 (83%) believed Buprenorphine should be prescribed more frequently to manage addiction or pain. This study found that the majority of x-waivered providers in Sacramento and El Dorado Counties do prescribe Buprenorphine but not at their full capacity.
Highlights
The increasing number of opioid related overdose and deaths in the United States has garnered national attention
Unlike other addiction treatments such as Methadone, Buprenorphine can be prescribed in any outpatient setting by a provider with an additional x-waiver attached to their DEA license
We identified 87 x-waivered providers registered with the Substance Abuse and Mental Health Services Administration (SAMHSA) in Sacramento and El Dorado Counties
Summary
The increasing number of opioid related overdose and deaths in the United States has garnered national attention. In 2016 alone there were over 42,000 overdose deaths in the United States from opioids [1]. Between 2012 and 2014, the number of opioid related deaths per 100,000 in Sacramento and El Dorado Counties were 698 and 115 respectively [2]. Given the magnitude of this crisis, accessible and safe treatment options for opioid use dependency is of great importance. Unlike other addiction treatments such as Methadone, Buprenorphine can be prescribed in any outpatient setting by a provider with an additional x-waiver attached to their DEA license. Despite the existence of this powerful opioid cessation tool, relatively few providers have completed the course necessary to obtain the waiver to prescribe Buprenorphine. Our study identified 95 registered Buprenorphine providers (medical doctors, nurse practitioners, and medical assistants) for a population of over
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