Growth In Buprenorphine Waivers For Physicians Increased Potential Access To Opioid Agonist Treatment, 2002-11

被引:144
作者
Dick, Andrew W. [1 ]
Pacula, Rosalie L. [2 ]
Gordon, Adam J. [3 ,4 ]
Sorbero, Mark [5 ]
Burns, Rachel M. [5 ]
Leslie, Douglas [6 ]
Stein, Bradley D. [5 ,7 ]
机构
[1] RAND Corp, Boston, MA 02116 USA
[2] RAND, Santa Monica, CA USA
[3] Univ Pittsburgh, Sch Med, Med, Pittsburgh, PA 15260 USA
[4] Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA
[5] RAND, Pittsburgh, PA USA
[6] Penn State Coll Med, Publ Hlth Sci & Psychiat, Pittsburgh, PA USA
[7] Univ Pittsburgh, Sch Med, Psychiat, Pittsburgh, PA 15260 USA
基金
美国国家卫生研究院;
关键词
SUBSTANCE-ABUSE TREATMENT; OFFICE-BASED TREATMENT; COST-EFFECTIVENESS; ADDICTION TREATMENT; OPIATE ADDICTION; RISK BEHAVIORS; NONMEDICAL USE; UNITED-STATES; USE DISORDER; US ADULTS;
D O I
10.1377/hlthaff.2014.1205
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
100404 [儿少卫生与妇幼保健学];
摘要
Opioid use disorders are a significant public health problem, affecting two million people in the United States. Treatment with buprenorphine, methadone, or both is predominantly offered in methadone clinics, yet many people do not receive the treatment they need. In 2002 the Food and Drug Administration approved buprenorphine for prescription by physicians who completed a course and received a waiver from the Drug Enforcement Administration, exempting them from requirements in the Controlled Substances Act. To determine the waiver program's impact on the availability of opioid agonist treatment, we analyzed data for the period 2002-11 to identify counties with opioid treatment shortages. We found that the percentage of counties with a shortage of waivered physicians fell sharply, from 98.9 percent in 2002 to 46.8 percent in 2011. As a result, the percentage of the US population residing in what we classified as opioid treatment shortage counties declined from 48.6 percent in 2002 to 10.4 percent in 2011. These findings suggest that the increase in waivered physicians has dramatically increased potential access to opioid agonist treatment. Policy makers should focus their efforts on further increasing the number and geographical distribution of physicians, particularly in more rural counties, where prescription opioid misuse is rapidly growing.
引用
收藏
页码:1028 / 1034
页数:7
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