Many Suboxone Prescribers Are Not Treating Enough Patients in Need, Study Says

Many Suboxone Prescribers Are Not Treating Enough Patients in Need, Study Says

By John Lavitt 09/26/16

The study also found that the average length of treatment among doctors who do utilize medication-assisted treatment was only 53 days. 

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Many Suboxone Prescribers Are Not Treating Enough Patients in Need, Study Says

A recent Rand Corporation study funded by the National Institute on Drug Abuse (NIDA) revealed that the biggest barrier to medication-assisted treatment (MAT) for opioid use disorder may be an unwillingness among doctors to treat more patients.

As reported by NPR, the study found that many buprenorphine and Suboxone prescribers are treating well below current legal patient limits. 

Suboxone (buprenorphine and naloxone) is the drug at the center of the federal government's push to address the national opioid epidemic. In the United States, buprenorphine and Suboxone can only be prescribed by doctors that have successfully completed an eight-hour course and obtained a waiver from the Drug Enforcement Administration. After completing these requirements, doctors can treat up to 30 patients at a time during the first year.

After a year of experience with the drug, the patient limit rises to 100, if requested by the physician. In July, the patient limit was increased to 275 by the federal government, due to the national extent of the opioid problem and the need for greater access. Despite this, however, prescribers have generally not followed suit. 

The researchers examined a database of pharmacy retail transactions from more than 80% of pharmacies nationwide. They analyzed 3,234 buprenorphine prescribers along with the 245,016 patients receiving a new prescription of buprenorphine.

The belief among policymakers was that by increasing the patient limit, doctors would treat more patients, and more people would have access to MAT. This outcome, however, has not been the case.

The study, published in the Journal of the American Medical Association, looked at pharmacy records from seven states that presently have the most doctors approved to prescribe buprenorphine and Suboxone. The results showed that prescribers on the whole are choosing to treat fewer patients than allowed. 

Overall, the median number of patients the approved prescribers chose to treat each month was 13. Only 20% treated between 31 to 75 patients. Close to 50% of the doctors treated four to 30 patients with an incredible 22% treating less than four patients at a time.

"We were really surprised," Dr. Bradley Stein, lead author of the study, told NPR. "We found that only about 10% of doctors were what we would call heavy prescribers, with more than 75 patients a month … This really brought home for us the need for multiple approaches, so doctors are willing and able to prescribe buprenorphine."

MAT patients are also being prescribed buprenorphine/Suboxone for a shorter duration than expected. The median treatment period of such patients was just about two months (53 days). The clinical recommendations of maintenance treatment is up to 12 months, the study noted.

Dr. Stein believes that new approaches must be taken in order to effectively address the national opioid epidemic. 

“People can recover," he told NPR. "They go on to live incredibly productive lives. And we want to have the high-quality treatment to get them there."

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles with his beautiful wife, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.

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