Online Program

337809
Buprenorphine Prescriber Availability in a Sample of Ohio Specialty Treatment Organizations


Tuesday, November 3, 2015 : 10:50 a.m. - 11:10 a.m.

Todd Molfenter, Ph.D., NIATx Center, University of Wisconsin-Madison, Madison, WI
Buprenorphine, a medication for treating opioid dependence, is underutilized in specialty addiction treatment organizations. Only physicians who have obtained a buprenorphine prescribing license or “waiver” may administer this medication. A limited number of physicians are pursuing this waiver, and a concern in the substance use disorder treatment field is that the shortage of prescribers could be contributing to the low use of buprenorphine at specialty addiction treatment centers. The objective of this study was to assess Ohio specialty treatment organizations’ access to buprenorphine prescribers and the barriers they encounter when seeking new physician prescribing capacity.  Forty-one Ohio specialty treatment organizations were invited to complete a survey of their buprenorphine practices and availability of buprenorphine prescribers during August-October 2014. Data was collected on buprenorphine prescribing capacity and barriers encountered in recruiting new physician prescribers. Thirty-seven treatment organizations responded, for a response rate of 90.2%.  Seventy-eight percent (n=29) of the sample provided buprenorphine therapy. Of those treatment organizations, 48.3% (n=14) reported insufficient prescribing capacity. Of those, 50% (n=7) indicated they had to turn patients away from buprenorphine therapy due to limited physician prescribing capacity.  In conclusion, the study suggests that buprenorphine use is constrained by limited physician prescribing capacity, to the degree that 24.1% of the organizations surveyed using buprenorphine therapy had to turn patients away. Potential remedies include encouraging more specialty treatment organizations to have physicians on staff, removing the Drug Addiction Treatment Act (DATA 2000) cap that limits physician buprenorphine caseloads at 100 patients (after year 1), and developing strategies to recruit physicians into addiction treatment practice. Additional research is needed to increase the knowledge of physician prescribing capacity as a barrier to buprenorphine use, how to overcome these barriers, and to understand the extent physician capacity shortages are affecting buprenorphine use.

Learning Areas:

Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify the current challenges with buprenorphine prescribing capacity and prescriber recruitment. Describe recruitment strategies for buprenorphine prescribers.

Keyword(s): Treatment, Prescription Drug Abuse and Misuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Todd Molfenter, Ph.D., is the Deputy Director for the NIATx Center at the University of Wisconsin-Madison. He has been the principal and co-investigator for several federal and state of Wisconsin funded grants. He specializes in organizational and systems change with interests in technology and medication assisted therapy adoption. Dr. Molfenter is serving as the Principal Investigator for the NIDA Dissemination and Implementation grant titled, "To Test a Payer/Treatment Agency Intervention to Increase Use of Buprenorphine."
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.