Study Finds Buprenorphine Inaccessible to Patients who Need Addiction Treatment

Despite the fact that around 130 Americans are dying from an opioid overdose every day, there are still a lot of barriers to treatment that keep patients from recovering. A new study found that addicted individuals who want to get better are still struggling when it comes to securing the necessary prescriptions.

When a person is addicted to a certain drug and they want to get better and become sober again, the last thing they need to face are barriers to treatment And yet researchers found that buprenorphine remains inaccessible to recovering individuals.

The “secret shopper” study involved researchers calling doctors’ offices and posing as addicted people seeking prescriptions for buprenorphine so they could stop using heroin. The researchers often struggled to even get an appointment with a doctor qualified to dispense the drug.

According to researchers, 46 percent of those who said they had Medicaid were denied an appointment. 38 percent of those who said they would pay in cash were turned away.

“When people are seeking treatment, you want to make it as easy as possible. But our study showed you have to be quite persistent. That can be tough and might lead to them giving up,” said Dr. Michael Barnett, senior author of the study. Barnett is an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health in Boston.

Barnett described buprenorphine as a “long-acting medication that stimulates the same receptors in the brain as opioids. It helps quash cravings without the euphoria or high of opioids. It lets people get back to their life.”

However, the challenge in prescribing the drug is in the fact that patients have to be in mild to moderate withdrawal before they can be given buprenorphine.

Barnett explained that buprenorphine has to be administered by someone who has had the right training because the medication can actually send a person into immediate and severe withdrawal. The process of drug detox has to be monitored by a medical professional.

Providers also have to obtain a federal waiver to be able to prescribe buprenorphine. Doctors are required to have eight hours of training, while nurse practitioners and physician assistants need 24 hours of training.

Fewer than 6 percent of doctors in the US have these waivers. Even those who do have the necessary training aren’t always actively prescribing the drug.

The study made use of a list provided by the US Substance Abuse and Mental Health Services Administration. It is a public list of doctors who agreed to be listed when they obtained their waivers to prescribe the drug.

Two female researchers called the doctors on the list, posing as heroin-addicted people seeking an appointment for a buprenorphine prescription. They posed as either a patient with Medicaid or someone who would pay with cash. Each doctor’s office was called twice, several weeks apart.

Originally, the study was to include nearly 1,100 providers in six states, all of which would be called by the researchers. However, 530 of the providers had to be removed from the list because either their contact information was invalid or they were no longer prescribing buprenorphine.

A few of the remaining doctors couldn’t be reached. The phone may have gone to voicemail instead of a live person. The researchers completed only over 430 calls as a Medicaid patient, and nearly 420 as a cash payer.

Only between half and two-thirds of doctors scheduling an appointment planned to give a buprenorphine prescription on the first visit. Click the link to see Tampa's top rehab placement programs.

“We do have a prescriber workforce that is open for business and ready to help, but it may be hard for patients to find these providers in those directories,” Barnett said.

The researchers did find one reason to be optimistic: when researchers did find a doctor willing to book an appointment, the wait time was often less than two weeks.

Barnett said that there are a number of reasons why the Medicaid group struggled to get an appointment. One is that Medicaid may put up barriers to prescribing buprenorphine, such as requiring prior authorization before prescribing the medication, etc. He also said that some doctors didn’t want to accept cash payments.

If someone in the family is struggling with opioid or alcohol addiction, it is important to seek help. A combination of medical detox and behavioral therapy can go a long way in the fight against drug abuse. But because every individual is affected by addiction differently, a comprehensive program tailored to their specific needs is necessary. Look for a nearby addiction treatment facility today and find out how drug treatment programs work.