Primary Care Doctors Could Hold the Key to Improved Access To Medications for Opioid Use Disorder

FOR IMMEDIATE RELEASE: Wednesday, January 15, 2020

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Leslie Champlin
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Primary Care Doctors Could Hold the Key to Improved Access To Medications for Opioid Use Disorder

WASHINGTON, DC — Primary care physicians comprise a large majority of doctors who prescribe buprenorphine for Medicare patients with opioid use disorder. At the same time, only a small percentage of all primary care doctors write prescriptions for the medicine. The result: limited patient access to medications for opioid use disorder, which could be addressed if more primary care physicians prescribed buprenorphine.

Those are the findings of a study by Robert Graham Center researcher Rohit Abraham, MD, MPH, MAT, and his colleagues. The study, “Characteristics of Office-Based Buprenorphine Prescribers for Medicare Patients,” was published in the January issue of the Journal of the American Board of Family Medicine.

Abraham analyzed primary care specialties to identify the characteristics of doctors who had completed mandated training in medications for opioid use disorder and who prescribed buprenorphine from 2013 to 2016. They found that, although primary care physicians total a greater number of prescribers when compared to psychiatrists, a smaller percentage of family physicians and internists wrote buprenorphine prescriptions. He then looked at demographic and other characteristics of doctors who do not prescribe buprenorphine.

Primary care specialists who were less likely to prescribe buprenorphine had more recently completed residency training, were female, practiced outside the Northeast region, had been international medical school graduates, had larger panels of Medicare beneficiaries and had larger numbers of nonwhite patients.

He also found that nearly one in four physicians who qualify to prescribe buprenorphine do not do so.

Removing mandatory training for treating opioid use disorder patients could help increase physician prescribing rates, according to the authors.

Abraham also suggests expanding the quality and quantity of addiction medicine curricula for all primary care specialties’ residency training and continuing medical education. Additionally, requiring residents to demonstrate expertise in prescribing medications for opioid use disorder before they graduate from residency training could increase the number and percentage of primary care physicians who prescribe buprenorphine for patients with opioid use disorder.

“Primary care physicians may be empowered to play a key role in addressing the gap in MOUD provision to combat the opioid crisis through policy changes in their medical education,” Abraham writes. “Graduate and continuing medical education programs of all primary care specialties must take strategic action to expand the quantity and quality of their addiction medicine curricula,” Abraham writes. “Policy efforts to include MOUD provision as a core competency that is required to graduate from residency training programs may also help curb the growing mortality rate in the national opioid crisis.”