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Addiction drug buprenorphine underused by primary care doctors in US, says survey

Primary care doctors in the United States are not prescribing the addiction drug buprenorphine to the extent they should to patients for addiction treatment, according to a recent survey. Buprenorphine is the first approved drug for use by doctors in treating opioid use disorder.

Researcher Andrew Huhn, a postdoctoral fellow at the Johns Hopkins University School of Medicine’s behavioral pharmacology research unit, said that doctors rarely apply for the federal waiver that would grant them permission to prescribe buprenorphine. In addition, those who have received a waiver do not prescribe the drug to as many patients they should have done.

Physicians received a waiver from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) back in 2002, which allowed them to prescribe it to their patients. Even those who are not addiction medicine specialists are eligible to prescribe it when the need arises.

The opioid epidemic is throttling the U.S., killing thousands of people due to overdose, lack of emergency care and proper treatment programs. As doctors are not prescribing enough buprenorphine to patients of opioid use disorder, it is not doing any good in curtailing the opioid epidemic in the country.

Huhn felt that such an apathy would only exacerbate matters. “This year is probably going to be the worst on record for overdose deaths,” said Huhn. “It’s possible we’re going to have more drug overdose deaths this year than people that died in the Vietnam War.” The U.S. military casualties in the Vietnam War was 58,220, whereas, in 2015, more than 52,400 people succumbed to overdoses. In 2016, it went up to 59,000, according to a report published in The New York Times.

How buprenorphine helps in getting rid of addiction

Buprenorphine acts upon the same brain receptors as opioids, but its effects are weaker and it manages to level off even with increasing doses, said the SAMHSA. It is due to this “ceiling effect” that the chance of misuse and addiction to buprenorphine is much lower.

Huhn said, “We know when we put people on buprenorphine, the risk of overdose goes way down and the risk of relapse goes way down. It is a medication that is effective at stabilizing people’s lives.” When Huhn and his colleagues surveyed some 558 U.S. physicians in 2016 to know how many of them had actually applied for a waiver, it revealed that very few doctors were prescribing buprenorphine to treat patients with opioid use disorder. It was despite the fact that more than 80 percent of the doctors had a buprenorphine waiver.

Last year, when the researchers were conducting the survey, the SAMHSA allowed physicians to prescribe buprenorphine to only 100 patients, which has now gone up to 275.

The researchers found that doctors who had the waiver turned away one to three patients every month who came to them for buprenorphine treatment. They were not utilizing their waiver to the full capacity.

The findings revealed that doctors were unable to do so because of paucity of time to take on additional patients (36 patients). Another reason for not prescribing opioid treatment medicine was inadequate reimbursement for addiction treatment services (15 percent). “They kind of represent more negative attitudes toward this line of treatment in the first place,” Huhn said.

Dealing with addiction

Addiction is not the end of the road. Even long-term addiction can be treated with appropriate medical intervention. If you have a loved one struggling with an addiction, don’t delay, get in touch with our 24-hour drug helpline members at 855-441-4405 for a quick resolution. Any delay can exacerbate the situation.

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