Buprenorphine prescribing for opioid use disorder in medical practices: can office‐based out‐patient care address the opiate crisis in the United States?. (25th July 2019)

• Record Type: Journal Article
• Authors: Rhee, Taeho Greg; Rosenheck, Robert A.
• Is Part Of: Addiction. Volume 114:Number 11(2019)
• Page Start: 1992
• Page End: 1999
• Publication Date: 2019-07-25
• Subjects: Buprenorphine -- opioid use disorder -- out‐patient care -- opioid -- prescribing trends -- treatment patterns; Alcoholism -- Periodicals; Drug addiction -- Periodicals; 616.86
• DOI: 10.1111/add.14733
• Languages: English
• ISSNs: 0965-2140

Abstract

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.