Geographic and Specialty Distribution of US Physicians Trained to Treat Opioid Use Disorder

The Article in Brief

Geographic and Specialty Distribution of Physicians Trained to Provide Office-Based Treatment of Opioid Use Disorder in the United States

Roger A. Rosenblatt , and colleagues

Background The United States is experiencing an epidemic of opioid-related deaths due to excessive prescribing of opioids, misuse of prescription drugs, and increased use of heroin. Buprenorphine-naloxone is an effective treatment for opioid use disorder. It can be prescribed by office-based physicians who complete training to obtain a waiver to treat opioid use. This study examines the extent to which the US population has local access to waivered clinicians who can provide effective treatment for opioid use disorder.

What This Study Found Only 3.6 percent of American primary care physicians have obtained the waiver required to dispense buprenorphine. Ninety percent of those physicians practice in urban counties, leaving the majority of US counties (53 percent) -- most of them rural -- with no physician who can dispense buprenorphine. Although primary care physicians are the predominant providers of health care in rural America, very low percentages of family physicians and general internists have obtained a waiver. Most US counties, therefore, have no physicians with waivers to prescribe buprenorphine-naloxone and, as a result, more than 30 million people live in counties without access to buprenorphine treatment.

Implications

• The low numbers of rural physicians trained to provide office-based treatment of opioid use disorder, the authors conclude, is a major barrier to office-based outpatient treatment for opioid use disorder.