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Growth and Distribution of Buprenorphine-Waivered Providers in the United States, 2007–2017

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Letters7 April 2020Growth and Distribution of Buprenorphine-Waivered Providers in the United States, 2007–2017Ryan K. McBain, PhD, MPH, Andrew Dick, PhD, Mark Sorbero, MS, and Bradley D. Stein, MD, PhDRyan K. McBain, PhD, MPHRAND Corporation, Boston, Massachusetts (R.K.M., A.D.), Andrew Dick, PhDRAND Corporation, Boston, Massachusetts (R.K.M., A.D.), Mark Sorbero, MSRAND Corporation, Pittsburgh, Pennsylvania (M.S., B.D.S.), and Bradley D. Stein, MD, PhDRAND Corporation, Pittsburgh, Pennsylvania (M.S., B.D.S.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-2403 Author Insight Video - Ryan McBain, PhD, MPH; Andrew Dick, PhD; Mark Sorbero, MS; and Bradley D. Stein, MD, PhD In this video, the authors offer additional insight into the article, "Growth and Distribution of Buprenorphine-Waivered Providers in the United States, 2007–2017." SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Expanded access to medication treatment of opioid use disorder is a critical component of the national response to the opioid crisis. Large-scale efforts to increase the number of buprenorphine-waivered prescribers over the past decade have included increasing patient limits to 275 per physician (1) and allowing nurse practitioners and physician assistants to receive buprenorphine waivers (2). As a result, the number of buprenorphine-waivered clinicians has increased from approximately 17 000 in 2009 to approximately 68 000 in 2019 (3). However, how this growth has varied by community characteristics is unclear.Objective: To examine county-level growth between 2007 and 2017 in number ...References1. Substance Abuse and Mental Health Services Administration (SAMHSA), HHS. Medication assisted treatment for opioid use disorders reporting requirements. Final rule. Fed Regist. 2016;81:66191-6. [PMID: 27726319] MedlineGoogle Scholar2. Jones CM, McCance-Katz EF. Characteristics and prescribing practices of clinicians recently waivered to prescribe buprenorphine for the treatment of opioid use disorder. Addiction. 2019;114:471-82. [PMID: 30194876] doi:10.1111/add.14436 CrossrefMedlineGoogle Scholar3. Substance Abuse and Mental Health Services Administration. Practitioner and program data. 2019. Accessed at www.samhsa.gov/medication-assisted-treatment/training-materials-resources/practitioner-program-data on 17 June 2019. Google Scholar4. Kaiser Family Foundation. Professionally active physicians. March 2019. Accessed at www.kff.org/other/state-indicator/total-active-physicians on 17 June 2019. Google Scholar5. Palombi LC, St Hill CA, Lipsky MS, et al. A scoping review of opioid misuse in the rural United States. Ann Epidemiol. 2018;28:641-52. [PMID: 29921551] doi:10.1016/j.annepidem.2018.05.008 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: RAND Corporation, Boston, Massachusetts (R.K.M., A.D.)RAND Corporation, Pittsburgh, Pennsylvania (M.S., B.D.S.)Disclaimer: The findings and conclusions in this report are solely those of the authors. The study was deemed exempt by the RAND Institutional Review Board.Financial Support: This study was supported by grants 5R01DA045800-02 and 5P50DA046351-02 from the National Institute on Drug Abuse, which had no role in the study's design, conduct, or reporting, apart from general oversight in accordance with National Institutes of Health guidelines.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2403.Reproducible Research Statement: Study protocol and statistical code: Available from Dr. McBain (e-mail, [email protected]org). Data set: The Centers for Disease Control and U.S. Census Bureau data sets used in this analysis are publicly available.This article was published at Annals.org on 7 January 2020. PreviousarticleNextarticle Advertisement Author Insight Video - Ryan McBain, PhD, MPH; Andrew Dick, PhD; Mark Sorbero, MS; and Bradley D. Stein, MD, PhD In this video, the authors offer additional insight into the article, "Growth and Distribution of Buprenorphine-Waivered Providers in the United States, 2007–2017." FiguresReferencesRelatedDetails Metrics Cited byMeeting the Moment: More Infectious Disease Physicians Must Be Prepared to Provide BuprenorphineDisparities in receipt of medications for opioid use disorder among pregnant womenA bridge too far? Distance to waivered physicians and utilization of buprenorphine treatment for opioid use disorder in West Virginia MedicaidState Policies and Buprenorphine Prescribing by Nurse Practitioners and Physician AssistantsRural and urban differences in undersupply of buprenorphine provider availability in the United States, 2018Differences in buprenorphine treatment quality across physician provider specialtiesAvailability of buprenorphine/naloxone films and naloxone nasal spray in community pharmacies in 11 U.S. statesBarriers to Buprenorphine Prescribing for Opioid Use Disorder in Hospice and Palliative CareBeyond the Waiver: Multilevel Interventions Needed to Expand Buprenorphine TreatmentHow Physician Workforce Shortages Are Hampering the Response to the Opioid CrisisAre x‐waiver trainings enough? Facilitators and barriers to buprenorphine prescribing after x‐waiver trainingsOpioid treatment program and community pharmacy collaboration for methadone maintenance treatment: results from a feasibility clinical trialPopulation-based estimates of geographic accessibility of medication for opioid use disorder by substance use disorder treatment facilities from 2014 to 2020Development of an unannounced standardized patient protocol to evaluate opioid use disorder treatment in pregnancy for American Indian and rural communitiesBuprenorphine prescriber monthly patient caseloads: An examination of 6-year trajectoriesPharmacists should treat patients who have opioid use disorders, not police themPolysubstance use trends and variability among individuals with opioid use disorder in rural versus urban settingsComparing the feasibility of four web-based recruitment strategies to evaluate the treatment preferences of rural and urban adults who misuse non-prescribed opioidsTrends in and Characteristics of Buprenorphine Misuse Among Adults in the USBuprenorphine physician–pharmacist collaboration in the management of patients with opioid use disorder: results from a multisite study of the National Drug Abuse Treatment Clinical Trials NetworkGrowing racial/ethnic disparities in buprenorphine distribution in the United States, 2007-2017The Number Needed to Prescribe — What Would It Take to Expand Access to Buprenorphine?Quality of Buprenorphine Care for Insured Adults With Opioid Use DisorderIt will end in tiers: A strategy to include "dabblers" in the buprenorphine workforce after the X-waiverPatient, prescriber, and Community factors associated with filled naloxone prescriptions among patients receiving buprenorphine 2017-18Treating Addiction Like a Chronic IllnessPerioperative Pain Control in the Opioid-Dependent Patient: Just Bite the Bullet?The state of the science in opioid policy research 7 April 2020Volume 172, Issue 7Page: 504-506KeywordsDeath ratesDisclosureDrug abuseDrug administrationHealth services administration and managementNursesOpioidsRegression analysisStandard errorYoung adults ePublished: 7 January 2020 Issue Published: 7 April 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. 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