Buprenorphine Prescribing for Opioid Use Disorder in Medical Practices: Can Office-based Outpatient Care Address the Opiate Crisis in the US?

Taeho Greg Rhee, Robert A Rosenheck

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background and aims: Opioid use disorder (OUD) remains a serious public health issue, and treating adults with OUD is a major priority in the United States. Little is known about trends in the diagnosis of OUD and in buprenorphine prescribing by physicians in office-based medical practices. We sought to characterize OUD diagnoses and buprenorphine prescribing among adults with OUD in the United States between 2006 and 2015. Design and settings: We used a repeated cross-sectional design, based on data from the 2006–15 National Ambulatory Medical Care Surveys that surveyed nationally representative samples of office-based out-patient physician visits. Participants: Adult patients aged 18 years or older with a diagnosis of OUD (n = 1034 unweighted) were included. Measurements: Buprenorphine prescribing was defined by whether visits involved buprenorphine or buprenorphine–naloxone, or not. We also examined other covariates (e.g. age, gender, race and psychiatric comorbidities). Findings: We observed an almost tripling of the diagnosis of OUD from 0.14% in 2006–10 to 0.38% in 2011–15 in office-based medical practices (P < 0.001). Among adults diagnosed with OUD, buprenorphine prescribing increased from 56.1% in 2006–10 to 73.6% in 2011–15 (P = 0.126). Adults with OUD were less likely to receive buprenorphine prescriptions if they were Hispanic [adjusted odds ratio (aOR) = 0.26; 95% confidence interval (CI) = 0.11, 0.60], had Medicaid insurance (aOR = 0.27; 95% CI = 0.10, 0.74) or were diagnosed with other psychiatric disorders (aOR = 0.45; 95% CI = 0.25, 0.83) or substance use disorders (aOR = 0.19; 95% CI = 0.09, 0.41). Conclusions: In office-based medical practices in the United States, diagnoses for opioid use disorder and buprenorphine prescriptions for adults with opioid use disorder increased from 0.14 and 56.1%, respectively, in 2006–10 to 0.38 and 73.6% in 2011–15.

Original languageEnglish (US)
Pages (from-to)1992-1999
Number of pages8
JournalAddiction (Abingdon, England)
Volume114
Issue number11
Early online dateJul 15 2019
DOIs
StatePublished - Nov 1 2019

Bibliographical note

Funding Information:
T.G.R. received funding support from the National Institute on Aging (NIA) of National Institutes of Health (NIH) (#T32AG019134). The funding agency had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript and decision to submit the manuscript for publication. Publicly available data were obtained from the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) (https://www.cdc.gov/nchs/ahcd/index.htm). Analyses, interpretations and conclusions are solely those of the author and do not necessarily reflect the views of the Division of Health Interview Statistics or NCHS of the CDC.

Publisher Copyright:
© 2019 Society for the Study of Addiction

Keywords

  • Buprenorphine
  • opioid
  • opioid use disorder
  • out-patient care
  • prescribing trends
  • treatment patterns

PubMed: MeSH publication types

  • Journal Article

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