In a move aimed at combating the ongoing opioid overdose crisis, the U.S. government lifted an obstacle last year that hindered doctors from prescribing buprenorphine, a key medication for opioid addiction. However, a new study has found that despite this relaxation in restrictions, the number of people taking the medication has seen little change.
The study, published in the New England Journal of Medicine, analyzed prescriptions filled by U.S. pharmacies for buprenorphine. Researchers observed an increase in the number of prescribers in the wake of the policy change, as doctors were no longer required to obtain a special waiver. However, the number of patients filling prescriptions remained largely stagnant.
According to Dr. Kao-Ping Chua of the University of Michigan Medical School, co-author of the study, it may take more than a year to witness a more significant increase in the number of patients. He highlighted the presence of numerous other barriers that need to be addressed, including insurance challenges, cost, limited availability of the drug at pharmacies, and the perception among some doctors that patients with addiction are time-consuming to treat.
Buprenorphine is a medication that helps reduce cravings for opioids and is available as a pill or a film that dissolves under the tongue. It typically costs around $100 per month, and a commonly prescribed version is Suboxone. Nurse practitioners, physician assistants, and doctors are all authorized to prescribe buprenorphine.
Dr. Ryan Marino of Case Western Reserve University School of Medicine in Cleveland, who has extensive experience in using buprenorphine to treat addiction, emphasized that the perception of the medication as complex and requiring specialized knowledge is unfounded. He stressed that this misconception should be dispelled.
Apart from the aforementioned barriers, Chua and other experts also cited the stigma associated with opioid addiction as a deterrent to treatment. Additionally, some individuals may be hesitant to use buprenorphine because they believe it undermines their recovery or that it can trigger withdrawal symptoms, particularly in those who have used fentanyl, the powerful opioid that is now prevalent in the drug supply.
The researchers utilized a database that captures 92% of filled prescriptions. By comparing data from 2022 and 2023, before and after the waiver elimination, they found that the number of prescribers increased by 27% to 53,600 at the end of 2023. Conversely, the number of people filling prescriptions rose by only 2% to approximately 845,000.
Experts suggest that the government should explore ways to encourage and even compel hospitals and health systems to provide more treatment options. Brendan Saloner, an addiction researcher at Johns Hopkins Bloomberg School of Public Health, emphasized the need for a more concerted effort to educate and engage the broader medical community. He expressed concern that the pace of progress in this area is insufficient to address the severity of the opioid crisis.
