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As More Physicians Earn Buprenorphine Certification, Opioid Scripts Decrease

October 3, 2018
Expanding treatment and Medicaid coverage for opioid misuse and abuse on the rise

A PPM Brief

According to new findings,1 buprenorphine prescriptions and related spending covered by Medicaid has increased significantly as the number of physicians qualified to provide buprenorphine for opioid use disorder has risen. However, the increased rate of prescriptions is still lagging behind the rate of physicians receiving waivers to prescribe the medication.

“Expanding treatment for opioid addiction has been recognized as an essential component of a comprehensive national response to the opioid epidemic,” the study authors, based at universities across the country, wrote. “The Drug Addiction Treatment Act and its amendments attempted to improve access to treatment by involving office-based physicians in the provision of buprenorphine treatment.”

(Source: 123RF)

Researchers conducted an economic evaluation of Medicaid prescription data to determine this association. After examining 1,059 quarterly observations, they found data that showed a 10% increase in 100-patient-waivered physicians per 1,000,000 residents, associated with a 5.6% increase in the quarterly number of Medicaid-covered buprenorphine prescriptions and a 0.5% reduction in the quarterly number of opioid prescriptions. A 10% increase in 30-patient-waivered physicians per 1,000,000 residents was associated with a 4.5% increase in the quarterly number of Medicaid-covered buprenorphine prescriptions and a 0.6% reduction in the quarterly number of opioid prescriptions.

Interestingly, expanding the availability of buprenorphine-waivered physicians by 10% seemed to increase the Medicaid-covered buprenorphine prescribing rate by 10% and reduce the opioid prescribing rate by 1.2%.

“Expanding treatment capacity for buprenorphine holds the potential to improve access to opioid addiction treatment, which may further reduce prescription opioid use,” the authors concluded.

NIDA Releases Buprenorphine Resources

The National Institute on Drug Abuse (NIDA) recently announced2 the availability of clinician resources for those interested in initiating buprenorphine treatment in emergency department settings. The materials were developed in collaboration with emergency department specialists at Yale University.

Tools and resources now available include: treatment information, including step-by-step buprenorphine integration pathways and treatment algorithms to assess for opioid type and last use; five case study videos showcasing strategies to motivate patients towards emergency department-initiated buprenorphine, including seeking treatment for OUD, harm reduction, intervention and treatment; discharge instructions, which includes a guide for patients beginning buprenorphine at home; tools and assessments, including the Clinical Opioid Withdrawal Scale (COWS) and questions for emergency clinicians to ask to help with the identification of an OUD; provider resources, including a handout on words to use when discussing OUDs and ongoing opioid use studies from clinical trials; and heroes in practice videos, highlighting emergency physicians around the country who have partnered with state entities to develop life-saving and innovative strategies for OUD treatment in emergency departments.

Last updated on: November 1, 2018
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Managing Opioid Use Disorders and Chronic Pain
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