https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(17)30029-6/pdf

Andrew S. Huhn, Kelly E. Dunn

Background & objective: Buprenorphine is an underutilized pharmacotherapy that can play a key role in combating
the opioid epidemic. Individuals with opioid use disorder (OUD) often struggle to find physicians that prescribe
buprenorphine. Many physicians do not have the waiver to prescribe buprenorphine, and a large
proportion of physicians that are waivered do not prescribe to capacity. This study aimed to quantitatively understand
why physicians do not utilize buprenorphine for the treatment of OUD more frequently.

Methods: Physicians (n = 558) with and without the waiver to prescribe buprenorphine were surveyed about
perceived drawbacks associated with prescribing buprenorphine. Furthermore, resources were identified that
would encourage those without the waiver to obtain it, and those with the waiver to accept more new patients.
The survey was distributed online to physicians in the spring/summer of 2016 via the American Society for Addiction
Medicine and American Medical Association listservs.

Results and conclusions: A logistic regression analysis was used to identify reasons that respondents indicated no
willingness to increase prescribing (χ2 (4)= 73.18, p b 0.001); main reasons were;

  1. lack of belief in agonist treatment (OR 3.98, 95% CI, 1.43 to 11.1, p = 0.008)
  2. lack of time for additional patients (OR 5.54, 95% CI, 3.5 to 8.7, p b 0.001),
  3. belief that reimbursement rates are insufficient (OR 2.50, 95% CI, 1.3 to 4.8, p = 0.006).

Differences between non-waivered and waivered physicians concerning attitudes toward buprenorphine treatment as well as resources
that would increase willingness to prescribe are also discussed. Identifying barriers to buprenorphine utilization is crucial in expanding treatment options for individuals with OUD.

Comment;

Education & compensation are key here!  Even lack of time can be made up for with compensation; make it worth your while to see more of these patients and you’ll streamline the rest of your practice to accommodate them!

Dr. Raymond Oenbrink
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