As the United States undertakes intense efforts to increase the number of prescribers of buprenorphine for opioid use disorder, it is critical to understand who currently provides such treatment and how. A new study finds that in nonmetropolitan areas, buprenorphine is almost twice as likely to be provided by a primary care physician, compared to large metropolitan areas where specialists in addiction or psychiatry provide a majority of treatment. In a survey of a national random sample of buprenorphine physician prescribers (N=1,174), 11% (N=132) practiced in nonmetropolitan/rural areas, 33% (N=382) practiced in small metropolitan areas, and 56% (N=660) were located in large metropolitan areas. Buprenorphine prescribers in nonmetropolitan areas were much more likely to be primary care physicians, accept Medicaid, and less likely to work in an individual practice. Overall, buprenorphine prescribers across the rural/urban continuum were similar in many of their treatment practices, including frequency of visits and dosing. The authors recommend further research to understand variation in treatment practices and quality and how treatment relates to patient perceptions and outcomes.
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Comparing Buprenorphine-Prescribing Physicians across Nonmetropolitan and Metropolitan Areas in the United States
Lewei (Allison) Lin, MD, MS, et al
University of Michigan, Ann Arbor, Michigan
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