Barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physicians
Despite federal legislation intended to increase the prescribing of buprenorphine as medication for opioid use disorder (MOUD), such as the Drug Addiction Treatment Act (DATA) of 2000, most providers have continued to prescribe to some patients or to not prescribe at all. We aimed to determine the c...
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AIMS Press
2025-01-01
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| Series: | AIMS Public Health |
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| Online Access: | https://www.aimspress.com/article/doi/10.3934/publichealth.2025005 |
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| author | James A. Swartz Dana Franceschini Nora M. Marino Adrienne H. Call Lisa Rosenberger Sarah Whitehouse |
| author_facet | James A. Swartz Dana Franceschini Nora M. Marino Adrienne H. Call Lisa Rosenberger Sarah Whitehouse |
| author_sort | James A. Swartz |
| collection | DOAJ |
| description | Despite federal legislation intended to increase the prescribing of buprenorphine as medication for opioid use disorder (MOUD), such as the Drug Addiction Treatment Act (DATA) of 2000, most providers have continued to prescribe to some patients or to not prescribe at all. We aimed to determine the continuing barriers and supports needed for expanding buprenorphine prescribing and compared barriers experienced by emergency department (ED) physicians with those in other practice settings, given the unique aspects of the ED practice setting. We obtained survey data from August through November 2021 from 412 X-waivered Illinois physicians licensed to prescribe buprenorphine as MOUD, 95 (23.1%) of whom worked primarily in a hospital-based ED. Survey questions included: 1) Professional background, practice characteristics, and prescribing practices; 2) barriers to prescribing buprenorphine; 3) barriers to expanding prescribing; and 4) training/additional supports needed to facilitate buprenorphine prescribing. We used bivariate crosstabulations and multivariable OLS and binary logistic regressions to compare the responses of physicians practicing in the ED versus other practice settings and to compare physicians who prescribed buprenorphine in the past year with those who had not. There were few statistically significant differences among the examined subgroups indicating general agreement regardless of practice setting and prescribing status. The most frequently perceived barrier was having an inadequate community-based behavioral health treatment system to which OUD patients could be referred. Insurance reimbursement, difficulties building practice- and community-based systems to support buprenorphine prescribing, and challenges knowing where and how to refer patients for follow-up and ongoing support services were also prominent concerns. Based on study findings, efforts to expand buprenorphine for OUD might focus on providing support to make and manage treatment referrals and expanding the availability of community-based behavioral healthcare services. Building networks of care could potentially have a greater impact on MOUD availability than increasing the number of practitioners trained to prescribe buprenorphine. |
| format | Article |
| id | doaj-art-3b93c5eb20ae4e1fb698468909db4b4b |
| institution | DOAJ |
| issn | 2327-8994 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | AIMS Press |
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| series | AIMS Public Health |
| spelling | doaj-art-3b93c5eb20ae4e1fb698468909db4b4b2025-08-20T03:08:57ZengAIMS PressAIMS Public Health2327-89942025-01-01121567610.3934/publichealth.2025005Barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physiciansJames A. Swartz0Dana Franceschini1Nora M. Marino2Adrienne H. Call3Lisa Rosenberger4Sarah Whitehouse5Jane Addams College of Social Work, University of Illinois Chicago, 1040 W. Harrison St., MC (309), Chicago IL 60607, USAJane Addams College of Social Work, University of Illinois Chicago, 1040 W. Harrison St., MC (309), Chicago IL 60607, USANational Opinion Research Center at the University of Chicago, 55 East Monroe St, 30th Floor, Chicago IL 60603, USANational Opinion Research Center at the University of Chicago, 55 East Monroe St, 30th Floor, Chicago IL 60603, USANational Opinion Research Center at the University of Chicago, 55 East Monroe St, 30th Floor, Chicago IL 60603, USANational Opinion Research Center at the University of Chicago, 55 East Monroe St, 30th Floor, Chicago IL 60603, USADespite federal legislation intended to increase the prescribing of buprenorphine as medication for opioid use disorder (MOUD), such as the Drug Addiction Treatment Act (DATA) of 2000, most providers have continued to prescribe to some patients or to not prescribe at all. We aimed to determine the continuing barriers and supports needed for expanding buprenorphine prescribing and compared barriers experienced by emergency department (ED) physicians with those in other practice settings, given the unique aspects of the ED practice setting. We obtained survey data from August through November 2021 from 412 X-waivered Illinois physicians licensed to prescribe buprenorphine as MOUD, 95 (23.1%) of whom worked primarily in a hospital-based ED. Survey questions included: 1) Professional background, practice characteristics, and prescribing practices; 2) barriers to prescribing buprenorphine; 3) barriers to expanding prescribing; and 4) training/additional supports needed to facilitate buprenorphine prescribing. We used bivariate crosstabulations and multivariable OLS and binary logistic regressions to compare the responses of physicians practicing in the ED versus other practice settings and to compare physicians who prescribed buprenorphine in the past year with those who had not. There were few statistically significant differences among the examined subgroups indicating general agreement regardless of practice setting and prescribing status. The most frequently perceived barrier was having an inadequate community-based behavioral health treatment system to which OUD patients could be referred. Insurance reimbursement, difficulties building practice- and community-based systems to support buprenorphine prescribing, and challenges knowing where and how to refer patients for follow-up and ongoing support services were also prominent concerns. Based on study findings, efforts to expand buprenorphine for OUD might focus on providing support to make and manage treatment referrals and expanding the availability of community-based behavioral healthcare services. Building networks of care could potentially have a greater impact on MOUD availability than increasing the number of practitioners trained to prescribe buprenorphine.https://www.aimspress.com/article/doi/10.3934/publichealth.2025005buprenorphinemedication for opioid use disordersmatemergency departmentopioid-related overdosesdrug addiction treatment actx-waiver |
| spellingShingle | James A. Swartz Dana Franceschini Nora M. Marino Adrienne H. Call Lisa Rosenberger Sarah Whitehouse Barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physicians AIMS Public Health buprenorphine medication for opioid use disorders mat emergency department opioid-related overdoses drug addiction treatment act x-waiver |
| title | Barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physicians |
| title_full | Barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physicians |
| title_fullStr | Barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physicians |
| title_full_unstemmed | Barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physicians |
| title_short | Barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physicians |
| title_sort | barriers and facilitators to prescribing buprenorphine for treating opioid use disorder among emergency department and other practice setting physicians |
| topic | buprenorphine medication for opioid use disorders mat emergency department opioid-related overdoses drug addiction treatment act x-waiver |
| url | https://www.aimspress.com/article/doi/10.3934/publichealth.2025005 |
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