Many Pharmacies in US Counties With High Opioid Overdose Rates Do Not Provide Buprenorphine

Buprenorphine is an effective treatment for opioid use disorder (OUD), but most individuals with OUD are not engaged in treatment. One of the potential barriers to treatment is access to buprenorphine at local pharmacies. Researchers investigated access by contacting 2 randomly selected pharmacies (one independent and one chain pharmacy) in each of 473 US counties with an opioid overdose rate over the national average, and inquired about the availability of buprenorphine.

  • Of the 971 pharmacies contacted, 675 (73%) reported that they did dispense buprenorphine, 183 (20%) reported that they did not, and the remaining 63 (7%) would not disclose this over the phone.
  • Independent pharmacies were significantly more likely to report being unable to dispense buprenorphine (25% versus 15% of chain pharmacies). Pharmacies in the South were more likely to deny buprenorphine dispensing than those in other regions (26% versus 11–18%).
  • In analyses adjusted for potential confounders, pharmacy variables associated with not dispensing buprenorphine included being in the South compared with the Northeast (adjusted prevalence ratio [aPR], 2.1), and being independent (aPR, 1.6).

Comments: This study shows that lack of access to buprenorphine in pharmacies is another barrier to OUD treatment. The reasons for pharmacies not providing buprenorphine were not assessed in this study, but possibilities include heightened vigilance of opioid prescribing in general, and stigma towards individuals with OUD.

Darius A. Rastegar, MD

Reference: Kazerouni NJ, Irwin AN, Levander XA, et al. Pharmacy-related buprenorphine access barriers: an audit of pharmacies in counties with high opioid overdose burden. Drug Alcohol Depend. 2021;224:108729.

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