Researchers at the RAND Corporation looked at pharmacy records from the seven states with the most doctors approved to prescribe buprenorphine, which helps people manage cravings and avoid withdrawal. They found 3,234 doctors who had prescribed the drug, also known as Suboxone, to new patients from 2010 to 2013. The median number of patients by a doctor treated each month was 13. About half of the doctors treated 4 to 30 patients; 22 percent treated less than 4; 20 percent treated 31 to 75.
“We were really surprised,” says Dr. Bradley Stein, a psychiatrist and lead author of the study, which was published Tuesday in JAMA, the journal of the American Medical Association. “We found that only about 10 percent of doctors were what we would call heavy prescribers, with more than 75 patients a month.”
Only a fraction of the 4 million people thought to abuse prescription painkillers or heroin in the U.S. are getting medication-assisted treatment.
There’s been a big push to make it easier for doctors to prescribe buprenorphine, including new rules announced by the Obama administration in July that raised the number of patients a doctor can treat from 100 to 275. But this data suggests that those limits aren’t the only barrier to getting treatment to more people.
The researchers also were surprised to find that most patients weren’t prescribed buprenorphine for very long, even though it can be used long term. The mean length of prescribing was 53 days per patient.
“This really brought home for us the need for multiple approaches, so doctors are willing and able to prescribe buprenorphine,” Stein says.
Urban areas have typically been better equipped to provide treatment for opioid addiction, whether with methadone clinics or with buprenorphine, which people can take at home and doesn’t require people a daily clinic …