Buprenorphine Treatment By Primary Care Providers, Psychiatrists, Addiction Specialists, And Others

Abstract

Substantial increases in opioid-related morbidity and mortality have motivated the implementation of federal policies to expand the buprenorphine prescribing capacity of primary care providers and other clinicians. Using a national prescription database that covered 72-92 percent of the US population during 2010-18, we analyzed trends in buprenorphine treatment by prescriber specialty. Buprenorphine treatment rates by primary care providers increased from 12.9 people per 10,000 population in 2010 to 27.4 in 2018. The numbers for psychiatrists and addiction medicine specialists increased from 8.7 to 12.0 per 10,000 and those for other prescribers from 5.8 to 16.3 per 10,000. However, treatment of people ages 15-24 by primary care providers and by psychiatrists and addiction medicine specialists declined significantly. Across all patient age and provider groups, most patients were not retained on buprenorphine for the benchmark period of at least 180 days. Despite a recent national increase in buprenorphine treatment fueled primarily by nonspecialists, challenges persist with buprenorphine access-especially for younger people-and with retaining patients in long-term treatment.

Keywords: Abuse treatment; Access to care; Buprenorphine; Drug use; Health policy; Medical treatment; Opioid use disorder; Patient care; Primary care providers; Psychiatrists; Substance use disorder; health conditions.

EXHIBIT 1. Number of people receiving buprenorphine treatment in the United States, by prescriber group, 2010–18

SOURCE Authors’ analysis of IQVIA Real World Longitudinal Prescription Data for 2010–18.