Increasing Potential Access to Opioid Agonist Treatment in U.S. Treatment Shortage Areas

Opioid use disorders are a significant public health problem, affecting over 2 million individuals in the US. Although opioid agonist treatment, predominantly offered in licensed methadone clinics, is both effective and cost-effective, many individuals do not receive it. Buprenorphine, approved in 2002 for prescription by waivered physicians, could improve opioid agonist treatment access for individuals unable or unwilling to receive methadone.

We examine the extent to which the geographic distribution of waivered physicians has enhanced potential opioid agonist treatment access, particularly in non-metropolitan areas with fewer methadone clinics. We found that while the approximately 90% of counties classified as methadone clinic shortage areas remained constant, buprenorphine shortage areas fell from 99% of counties in 2002 to 51% in 2011, lowering the US population percentage residing in opioid treatment shortage counties to approximately 10%. The increase in buprenorphine-waivered physicians has dramatically increased potential access to opioid agonist treatment, especially in non-metropolitan counties.

Below:  Percent of Population Living in Counties with Opioid Treatment Program, Waivered Physician, and Opioid Agonist Treatment Shortages Source: Authors’ analysis

Full article at:   http://goo.gl/Zfftw6

By:  Andrew W. Dick, PhD,1 Rosalie Liccardo Pacula, PhD,1 Adam J. Gordon, MD, MPH,2,3 Mark Sorbero, MS,1 Rachel M. Burns, MPH,1 Douglas L. Leslie, PhD,4 and Bradley D. Stein, MD, PhD1,2

¹RAND Corporation

²University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213

³VA Pittsburgh Healthcare System, University Drive C, Pittsburgh, PA 15240

⁴Penn State College of Medicine, 90 Hope Drive, Hershey, PA 17033

Corresponding Author: Bradley Stein MD, PhD, RAND Corporation, 4570 Fifth Ave, Pittsburgh, PA 15219, Phone: 412-683-2300, extension 4476, Email: gro.dnar@niets

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