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Waiver program approving office-based buprenorphine treatment may increase access to opioid addiction treatment

Recent analysis in Health Affairs showed that as the number and geographic distribution of physicians with waivers allowing them to provide office-based medication-assisted buprenorphine treatment for opioid addiction increased, access to treatment increased.

“In the past, many people living in rural counties have had no practical way to get treatment. They have seen the greatest benefit from the introduction of buprenorphine and the growth in the number of physicians approved to prescribe the drug,” study researcher Bradley D. Stein, PhD, of the University of Pittsburgh School of Medicine and the RAND corporation, said in a press release. “Those rural residents with addiction to heroin or prescription painkillers now have an opportunity to receive treatment with effective medications, which is an essential piece of successfully addressing the nation's recent epidemic of opioid overdoses.”

Bradley D. Stein

In 2002, the FDA approved buprenorphine for prescription by physicians who completed a course and received a waiver from the Drug Enforcement Administration.

To assess the waiver program’s impact on the availability of treatment for opioid addiction, Andrew W. Dick, PhD, of the RAND Corporation, and colleagues analyzed data from 2002 through 2011 that identified counties with opioid treatment shortages.

From 2002 to 2011, the percentage of counties with a shortage of waivered physicians significantly decreased from 98.9% to 46.8%.

Accordingly, counties considered to have opioid treatment shortages decreased from 48.6% in 2002 to 10.4% in 2011.

Andrew W. Dick

“These findings suggest that the increase in waivered physicians has dramatically increased potential access to opioid agonist treatment,” Dick and colleagues wrote. “Policy makers should focus their efforts on further increasing the number and geographical distribution of physicians, particularly in more rural counties, where prescription opioid misuse is rapidly growing.” – by Amanda Oldt

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