Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder: Recommendations from Rural Physicians


  • Abstract

    Purpose:
    The United States is in the midst of a severe opioid use disorder
    epidemic. Buprenorphine is an effective office-based treatment that can be
    prescribed by physicians, nurse practitioners, and physician assistants with a
    Drug Enforcement Administration (DEA) waiver. However, many providers
    report barriers that keep them from either getting a DEA waiver or fully using
    it. The study team interviewed rural physicians successfully prescribing
    buprenorphine to identify strategies for overcoming commonly cited barriers
    for providing this service.
    Methods:
    Interview candidates were randomly selected from a list of rurally
    located physicians with a DEA waiver to prescribe buprenorphine who
    reported treating high numbers of patients on a 2016 survey. Forty-three rural
    physicians, who were prescribing buprenorphine to a high number of patients,
    were interviewed about how they overcame prescribing barriers previously
    identified in that survey.
    Findings:
    Interviewed physicians reported numerous ways to overcome common
    barriers to providing buprenorphine treatment in rural areas. Key recommendations
    included ways to (1) get started and maintain medication-assisted
    treatment, (2) minimize DEA intrusion and medication diversion, and (3) address
    the lack of mental health providers and stigma surrounding opioid use
    disorder (OUD). Overall, physicians found providing this service to be very
    rewarding.
    Conclusions:
    Despite known barriers, rural physicians around the country
    have been successful in adding buprenorphine treatment to their practices.
    Nonprescribing providers can learn from the strategies used by successful prescribers
    to add this service.


  • Authors:

    Andrilla CHA, Moore TE, Patterson DG

  • Journal/Publisher:

    J Rural Health

  • Edition:

    Jan 2019. 35(1):113-121

  • Link to Article

    Access the article here: J Rural Health

  • Citation:

    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. Jan 2019 35(1):113-121

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