Original Article
Eligible Prescriber Experiences with Substance Use Disorder Treatment and Perceptions of Pharmacy Barriers to Buprenorphine
Abstract
Objectives: The primary aim of this study was to better understand North Carolina providers’ specific substance use disorder (SUD) and opioid use disorder treatment practices and buprenorphine prescribing. Furthermore, this study aimed to provide novel information regarding US South and rural providers’ opioid use disorder treatment behaviors and perceptions of patient experience at community pharmacies.Methods: An online survey consisting of closed-ended and open-ended questions was used. Surveys were delivered to healthcare providers’ e-mails and self-administered. Surveys were administered through an online survey platform.
Results: In total, 332 healthcare providers, who were eligible to be X-waivered to prescribe buprenorphine, completed the online survey. Survey participants reported not having their X-waiver to prescribe buprenorphine or actively prescribing buprenorphine. The majority of participants were uncertain of potential barriers to filling buprenorphine prescriptions. Providers treating a mix of rural and urban patients reported being less likely to screen for SUDs. Although there were no rurality differences in SUD screening, providers who treat mostly rural patients reported a lack of SUD treatment options in their area.
Conclusions: Early detection of SUDs can help prevent negative health outcomes for patients. Regardless of patient rurality, providers should screen for SUDs and familiarize themselves with the patient’s experience when filling a buprenorphine prescription, along with possible barriers. Furthermore, providers should incorporate questions about their patient’s ability to receive buprenorphine to help ensure that patients are receiving proper and necessary treatment.
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References
1. Centers for Disease Control and Prevention. Overdose deaths accelerating during COVID-19. https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html. Published December 17, 2020. Accessed June 9, 2022.
2. Martin SA, Chiodo LM, Bosse JD, et al. The next stage of buprenorphine care for opioid use disorder. Ann Intern Med 2018;169:628–635.
3. Carroll J, Green T, Noonan R. Evidence-based strategies for preventing opioid overdose: what’s working in the United States. https://www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf. Published 2018. Accessed December 2, 2019.
4. Flavin L, Malowney M, Patel NA, et al. Availability of buprenorphine treatment in the 10 states with the highest drug overdose death rates in the United States. J Psychiatr Pract 2020;26:17–22.
5. Substance Abuse and Mental Health Services Administration. Statutes, regulations, and guidelines. https://www.samhsa.gov/medication-assisted-treatment/statutes-regulations-guidelines. Accessed April 25, 2021.
6. Andrilla CHA, Patterson DG. Tracking the geographic distribution and growth of clinicians with a DEA waiver to prescribe buprenorphine to treat opioid use disorder. J Rural Health 2022;38:87–92.
7. Andrilla CHA, Moore TE, Patterson DG. Overcoming barriers to prescribing buprenorphine for the treatment of opioid use disorder: recommendations from rural physicians. J Rural Health 2019;35:113–121.
8. Andrilla CHA, Coulthard C, Larson EH. Barriers rural physicians face prescribing buprenorphine for opioid use disorder. Ann Fam Med 2017;15: 359–362.
9. Richard EL, Schalkoff CA, Piscalko HM, et al. “You are not clean until you’re not on anything”: perceptions of medication-assisted treatment in rural Appalachia. Int J Drug Policy 2020;85:102704.
10. Ostrach B, Foley K, Harless C. Evaluation Report: Increasing Workforce Capacity for Medication-Assisted Treatment (MAT). Asheville: UNC Health Sciences at MAHEC; 2019.
11. Cicero TJ, Ellis MS, Chilcoat HD. Understanding the use of diverted buprenorphine. Drug Alcohol Depend 2018;193:117–123.
12. Khan A, Khan Q, Kolb E. Supportive alternate site provision of buprenorphine: overcoming barriers and improving patient outcomes. J Subst Abuse Treat 2020;123:108256.
13. Hughes CM, McCann S. Perceived interprofessional barriers between community pharmacists and general practitioners: a qualitative assessment. Br J Gen Pract 2003;53:600–606.
14. Davidson LA, Pettis CT, Joiner AJ, et al. Religion and conscientious objection: a survey of pharmacists’ willingness to dispense medications. Soc Sci Med 2010;71:161–165.
15. Rafie S, Haycock M, Rafie S, et al. Direct pharmacy access to hormonal contraception: California physician and advanced practice clinician views. Contraception 2012;86:687–693.
16. Louie DL, Assefa MT, McGovern MP. Attitudes of primary care physicians toward prescribing buprenorphine: a narrative review. BMC Fam Pract 2019; 20:1–8.
17. Tsai AC, Kiang MV, Barnett ML, et al. Stigma as a fundamental hindrance to the United States opioid overdose crisis response. PLoS Med 2019;16: e1002969.
18. Fiscella K, Wakeman SE, Beletsky L. Buprenorphine deregulation and mainstreaming treatment for opioid use disorder: X the X waiver. JAMA Psychiatry 2019;76:229–230.
19. Ostrach B, Carpenter D, Cote LP. DEA disconnect leads to buprenorphine bottlenecks. J Addict Med 2021;15:272–275.
20. CampaignMonitor. Ultimate email marketing benchmarks for 2022: by industry and day. https://www.campaignmonitor.com/resources/guides/email-marketing-benchmarks/. Accessed June 9, 2022.
