More doctors can prescribe leading addiction treatment. Why don’t more people get help?

4 Min Read

by Carla K Johnson

Credit: Unsplash/CC0 public domain

Since the U.S. government lifted a hurdle last year, it’s easier than ever for doctors to prescribe an important drug for opioid addiction. But despite the relaxed restrictions and the ongoing overdose crisis, a new study finds little change in the number of people taking the medication.

Researchers analyzed prescriptions from US pharmacies for the treatment drug buprenorphine. The number of prescribers rose last year after doctors no longer needed a special waiver to prescribe the drug, while the number of patients filling prescriptions barely changed.

It could take more than a year for the number of patients to increase, says study co-author Dr. Kao-Ping Chua of the University of Michigan Medical School.

“There are so many other barriers to prescribing that we need to address,” Chua said.

The findings were published Wednesday in the New England Journal of Medicine.

Buprenorphine, which helps fight cravings, comes in a pill or film that dissolves under the tongue. It costs about $100 per month. A common version of buprenorphine is Suboxone. Nurses, physician assistants and physicians can prescribe it.

“People think this is a very complicated drug and it requires some kind of complex knowledge to use, when that’s just not the case,” said Dr. Ryan Marino of Case Western Reserve University School of Medicine in Cleveland, who has treated hundreds of people. with buprenorphine. He had no role in the investigation.

Barriers include insurance hurdles, price, pharmacies not stocking the drug and doctors who believe addiction patients take up too much time, Chua and other experts said.

“There is a lot of stigma about this drug, and in general about patients with opioid addiction,” Chua said.

Additionally, some people may not want to try buprenorphine, Chua said. They may think they can’t really recover if they take the opioid-based medications, he said. And it can cause withdrawal symptoms, especially in people who have used fentanyl, the powerful opioid that now dominates the drug supply.

The researchers used a database that records 92% of filled prescriptions. Comparing 2022 and 2023, before and after the exemption was eliminated, they found 53,600 prescribers at the end of 2023, a 27% increase from a year earlier. The number of people writing prescriptions increased by about 2% to about 845,000.

The government should look for ways to encourage and even force hospitals and health care systems to provide more treatment, said Brendan Saloner, an addiction researcher at the Johns Hopkins Bloomberg School of Public Health who was not involved in the study.

More and more doctors are prescribing buprenorphine, but “it’s taking too long to catch up with most of the medical profession,” Saloner said.

More information:
Administration of buprenorphine after lifting the exemption requirement, New England Journal of Medicine (2024). DOI: 10.1056/NEJMc2312906. www.nejm.org/media/doi/full/10.1056/NEJMc2312906

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