JAMA Study Finds Clinicians Not Maximizing Opportunities to Initiate Buprenorphine Treatment For Patients With Opioid Addiction

PainRelief.com: What are the main findings?

Response: Our study shows that buprenorphine initiation rates have been flat since the end of 2018 and that rates of 180-day retention in buprenorphine therapy have remained low throughout 2016-2022. Neither of these findings are particularly surprising, but they are disappointing. There were a lot of policy and clinical efforts to maintain and expand access to buprenorphine during the COVID-19 pandemic, such as allowing buprenorphine to be prescribed via telehealth without an in-person visit and eliminating training requirements for the waiver that previously was required to prescribe buprenorphine. The fact that buprenorphine initiation and retention did not rise after these efforts were implemented suggests that they were insufficient to meet the rising need for this medication. 

PainRelief.com: What should readers take away from your report?

Response: This study adds to a growing body of research suggesting that clinicians are not maximizing opportunities to initiate buprenorphine treatment among patients with opioid addiction. For example, I have done other research showing that only 1 in 12 patients were prescribed buprenorphine within 30 days of an emergency department visit for opioid overdose from August 2019 to April 2021, even though half of patients with emergency department visits with anaphylaxis were prescribed an epinephrine auto-injector during this period (https://pubmed.ncbi.nlm.nih.gov/34802772). My hope is that our new study will further underscore how much the health care system is underusing a critical tool to prevent opioid overdose deaths. 

PainRelief.com: What recommendations do you have for future research as a result of this study?

Response: The federal government recently eliminated the need for clinicians to obtain a waiver to prescribe buprenorphine. This is a welcome development, but it remains to be seen whether the elimination of the waiver requirement will move the needle on buprenorphine initiation and retention. Based on our data, it seems likely that this intervention will be insufficient to overcome the many other barriers to buprenorphine initiation and retention, such as stigma about the drug among clinicians, patients, and pharmacists.


Chua K-P, et al “Trends in buprenorphine initiation and retention in the United States, 2016-2022” JAMA 2023; DOI: 10.1001/jama.2023.1207.

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Last Updated on April 25, 2023 by PainRelief.com