Gaps in buprenorphine access: Examining provider availability and treatment continuity

Area of Science:

• Addiction Medicine
• Public Health
• Pharmacotherapy

Background:

• Buprenorphine is a critical treatment for opioid use disorder (OUD).
• Disruptions in buprenorphine prescribing by primary providers can lead to significant gaps in patient care.
• Loss of consistent access to a buprenorphine provider increases the risk of treatment discontinuation.

Purpose of the Study:

• To investigate the impact of primary buprenrenorphine provider cessation on treatment continuity.
• To identify factors associated with re-establishing buprenorphine pharmacotherapy after a provider disruption.

Main Methods:

• Retrospective cohort study using Texas Prescription Monitoring Program data (2018-2021).
• Analysis included patients with a single prescriber who ceased prescribing for at least 90 days.
• Primary outcome was re-establishing care with a new provider within 90 days; logistic regression identified associated factors.

Main Results:

• 24% of patients did not re-establish buprenorphine care after their primary provider stopped prescribing.
• Rural residence was associated with lower odds of treatment resumption (aOR=0.60).
• Higher buprenorphine doses (>8 mg/day) and longer prior treatment duration (>60 days) increased treatment continuity.

Conclusions:

• A significant proportion of patients (24%) experience treatment interruptions following primary prescriber cessation.
• Rural patients are disproportionately affected by these care gaps.
• Policy interventions, including telehealth, are needed to ensure consistent OUD treatment and mitigate disruptions.