Approximately One in Five Adults With Opioid Use Disorder in Six Large US Healthcare Systems Receive Buprenorphine

The US is in the midst of an opioid use disorder (OUD) and overdose crisis. The current need for treatment far exceeds the capacity of specialty programs. Many individuals with OUD can be treated in a primary care setting with buprenorphine and naltrexone. This study described the prevalence of OUD and receipt of these medications in six large US healthcare systems over a three-year period (2013–2016).

• Of the 1.4 million primary care patients age ≥18 in the study sample—most with commercial or employer-based insurance—13,942 (1%) had a documented diagnosis of OUD.
• Patients with OUD were more likely to be younger, male, and to have state-subsidized insurance.
• Among people with documented OUD, 21% received buprenorphine and 1% received extended-release naltrexone.
• A number of factors were associated with being less likely to receive buprenorphine, including older age, black race, Hispanic ethnicity, and not being commercially insured.

Comments: The FDA approval of sublingual buprenorphine for the treatment of OUD 18 years ago provided an opportunity for US primary care physicians to deliver evidence-based treatment to their patients with OUD. This study shows that we still have a long way to go. As with many other effective treatments for substance use disorder, concerning disparities exist.

Darius A. Rastegar, MD

Reference: Lapham G, Boudreau DM, Johnson EA, et al. Prevalence and treatment of opioid use disorders among primary care patients in six health systems. Drug Alcohol Depend. 2020;207:107732.