Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 16.
doi: 10.1002/pds.4984. Online ahead of print.

Rise and Regional Disparities in Buprenorphine Utilization in the United States

Affiliations

Rise and Regional Disparities in Buprenorphine Utilization in the United States

Amir R Pashmineh Azar et al. Pharmacoepidemiol Drug Saf. .

Abstract

Purpose: Buprenorphine is an opioid partial agonist used to treat opioid use disorder. While several policy changes have attempted to increase buprenorphine availability, access remains well below optimal levels. This study characterized how buprenorphine utilization in the United States has changed over time and whether there are regional disparities in distribution of the medication.

Methods: The amount of buprenorphine distributed from 2007 to 2017 was obtained from the Drug Enforcement Administration's Automated Reports and Consolidated Ordering System. Data were expressed as the percent change and milligrams per person in each state. The formulations and cost for prescriptions covered by Medicaid (2008 to 2018) were also examined.

Results: Buprenorphine distributed to pharmacies increased about 7-fold (476.8 to 3179.9 kg) while the quantities distributed to hospitals grew 5-fold (18.6 to 97.6 kg) nationally from 2007 to 2017. Buprenorphine distribution per person was almost 20-fold higher in Vermont (40.4 mg/person) relative to South Dakota (2.1 mg/person). There was a strong association between the number of physicians authorized to prescribe buprenorphine and distribution per state (r[49] = +0.94, P < .0005). The buprenorphine/naloxone sublingual film (Suboxone) was the predominant formulation (92.6% of 0.31 million Medicaid prescriptions) in 2008 but accounted for less than three-fifth (57.3% of 6.56 million prescriptions) in 2018.

Conclusions: Although buprenorphine availability has substantially increased over the last decade, distribution was very nonhomogeneous across the United States.

Keywords: addiction; medication assisted treatment; opiate; opioid use disorder; pharmacoepidemiology.

Similar articles

See all similar articles

References

REFERENCES

    1. Mattick RP, Breen C, Kimber J, Davoli M. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev. 2014;(2):CD002207. https://doi.org/10.1002/14651858.CD002207.pub4.
    1. Sordo L, Barrio G, Bravo MJ, et al. Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ. 2017;357:j1550.
    1. Piper BJ, Shah DT, Simoyan OM, McCall KL, Nichols SD. Trends in medical use of opioids in the U.S., 2006-2016. Am J Prev Med. 2018;54(5):652-660. https://doi.org/10.1016/j.amepre.2018.01.034.
    1. Collins LK, Pande LJ, Chung DY, Nichols SD, McCall KL, Piper BJ. Trends in the medical supply of fentanyl and fentanyl analogues: United States, 2006 to 2017. Prev Med. 2019;123:95-100.
    1. Lofwall MR, Walsh SL. Review of buprenorphine diversion and misuse: current evidence base and experiences from around the world. J Addict Med. 2014;8:315-326.

LinkOut - more resources

Feedback