Role of an Accurate Treatment Locator and Cash-Only Practices in Access to Buprenorphine for Opioid Use Disorders
Authors: Pooja A. Lagisetty, Amy Bohnert
Journal: Annals of Internal Medicine (2019)

Editorials2 July 2019Role of an Accurate Treatment Locator and Cash-Only Practices in Access to Buprenorphine for Opioid Use DisordersPooja A. Lagisetty, MD, MSc and Amy Bohnert, PhDPooja A. Lagisetty, MD, MScUniversity of Michigan School of Medicine, Veterans Affairs (VA) Ann Arbor Healthcare System, and Institute of Health Policy and Innovation, Ann Arbor, Michigan (P.A.L.)Search for more papers by this author and Amy Bohnert, PhDVeterans Affairs Ann Arbor Healthcare System, Institute for Health Policy and Innovation, and University of Michigan School of Medicine, Ann Arbor, Michigan (A.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-1429 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Despite several studies demonstrating efficacy for opioid use disorder (OUD) medications, their use remains low (1). A previous study estimated that only 30% of patients receive OUD medication after an opioid overdose (2). A major reason for low treatment uptake is thought to be insufficient access to buprenorphine prescribers. In 2000, Congress passed the Drug Addiction Treatment Act to expand access to buprenorphine by permitting qualified clinicians to receive a waiver to prescribe the medication in nonspecialty settings, such as primary care. Despite this policy, the cumulative capacity for treatment in many U.S. regions is insufficient for the estimated number ...References1. Volkow ND, Jones EB, Einstein EB, et al. Prevention and treatment of opioid misuse and addiction: a review. JAMA Psychiatry. 2019;76:208-16. [PMID: 30516809] doi:10.1001/jamapsychiatry.2018.3126 CrossrefMedlineGoogle Scholar2. Larochelle MR, Bernson D, Land T, et al. Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study. Ann Intern Med. 2018;169:137-45. [PMID: 29913516]. doi:10.7326/M17-3107 LinkGoogle Scholar3. Comprehensive Addiction and Recovery Act of 2016. S. 524, 114th Cong. (2016). Google Scholar4. Haffajee RL, Bohnert ASB, Lagisetty PA. Policy pathways to address provider workforce barriers to buprenorphine treatment. Am J Prev Med. 2018;54:S230-42. [PMID: 29779547] doi:10.1016/j.amepre.2017.12.022 CrossrefMedlineGoogle Scholar5. Beetham T, Saloner B, Wakeman SE, et al. Access to office-based buprenorphine treatment in areas with high rates of opioid-related mortality. An audit study. Ann Intern Med. 2019;171:1-9. doi:10.7326/M18-3457 LinkGoogle Scholar6. Rhodes K. Taking the mystery out of “mystery shopper” studies. N Engl J Med. 2011;365:484-6. [PMID: 21793739] doi:10.1056/NEJMp1107779 CrossrefMedlineGoogle Scholar7. Candon M, Zuckerman S, Wissoker D, et al. Declining medicaid fees and primary care appointment availability for new medicaid patients. JAMA Intern Med. 2018;178:145-6. [PMID: 29131904] doi:10.1001/jamainternmed.2017.6302 CrossrefMedlineGoogle Scholar8. Harper J. There's an illegal market for an opioid addiction medication. Is that such a bad thing? Cincinnati Public Radio podcast. Accessed at www.wvxu.org/post/theres-illegal-market-opioid-addiction-medication-such-bad-thing#stream/0 on 8 May 2019. Google Scholar9. LaBelle CT, Han SC, Bergeron A, et al. Office-based opioid treatment with buprenorphine (OBOT-b): statewide implementation of the massachusetts collaborative care model in community health centers. J Subst Abuse Treat. 2016;60:6-13. [PMID: 26233698] doi:10.1016/j.jsat.2015.06.010 CrossrefMedlineGoogle Scholar10. Lagisetty PA, Bohnert A, Clay M, Maust DT. Buprenorphine treatment divide by race/ethnicity. JAMA Psychiatry. 2019 [Epub ahead of print]. doi:10.1001/jamapsychiatry.2019.0876- CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Michigan School of Medicine, Veterans Affairs (VA) Ann Arbor Healthcare System, and Institute of Health Policy and Innovation, Ann Arbor, Michigan (P.A.L.)Veterans Affairs Ann Arbor Healthcare System, Institute for Health Policy and Innovation, and University of Michigan School of Medicine, Ann Arbor, Michigan (A.B.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1429.Corresponding Author: Pooja A. Lagisetty, MD, MSc, University of Michigan, North Campus Research Center, 2800 Plymouth Road, Building 16-243E, Ann Arbor, MI 48109; e-mail, [email protected]umich.edu.Current Author Addresses: Dr. Lagisetty: University of Michigan, North Campus Research Center, 2800 Plymouth Road, Building 16-243E, Ann Arbor, MI 48109.Dr. Bohnert: University of Michigan, North Campus Research Center, 2800 Plymouth Road, Building 16-227W, Ann Arbor, MI 48109.This article was published at Annals.org on 4 June 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAccess to Office-Based Buprenorphine Treatment in Areas With High Rates of Opioid-Related Mortality Tamara Beetham , Brendan Saloner , Sarah E. Wakeman , Marema Gaye , and Michael L. Barnett Metrics Cited byBarriers and Facilitators to the Use of Medications for Opioid Use Disorder: a Rapid Review 2 July 2019Volume 171, Issue 1Page: 58-59KeywordsForecastingMotivationNursesOpioid addictionOpioid use disorderOpioidsOutpatientsPatientsPsychiatry and mental healthSubstance abuse ePublished: 4 June 2019 Issue Published: 2 July 2019 PDF downloadLoading ...