Many Buprenorphine Prescribers Not Offering New Appointments

 For callers reporting heroin use, many buprenorphine prescribers do not offer new appointments or rapid access to buprenorphine, according to a study published in the Annals of Internal Medicine.

Tamara Beetham, from the Harvard T.H. Chan School of Public Health in Boston, and colleagues examined real-world access to buprenorphine treatment for uninsured or Medicaid-covered patients reporting current heroin use. Callers contacted 546 publicly listed buprenorphine prescribers twice from July to November 2018 while posing as uninsured or Medicaid-covered patients seeking treatment.

The researchers found that clinicians offered new appointments to 54 and 62 percent of Medicaid contacts and uninsured self-pay contacts, respectively, while 27 and 41 percent, respectively, were offered an appointment with the possibility of a buprenorphine prescription at the first visit. Median wait times until the first visit were six and five days, respectively, for Medicaid contacts and uninsured self-pay contacts. Regardless of clinician type or payer status, these wait times were similar. Wait time from first contact to possible buprenorphine induction was a median of eight and seven days for Medicaid-insured and uninsured self-pay contacts, respectively.

"Many publicly-listed buprenorphine prescribers in states with a high opioid use disorder-related mortality rate were not accepting new patients," the authors write. "Nevertheless, among those who were accepting new patients, wait times were not long, suggesting an underused capacity for buprenorphine treatment in areas with great need."

One author disclosed financial ties to a law company and is retained as an expert witness for litigation against opioid manufacturers and distributors.

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