Washington, D.C. – A researcher with the Johns Hopkins University School of Medicine told psychologists at the 125th Annual Convention of the American Psychological Association that physicians in private practice are under-using a drug that could help combat the nation’s epidemic of opioid addiction.
Andrew Huhn, Ph.D., a postdoctoral fellow with the school’s behavioral pharmacology research unit, said buprenorphine is similar to methadone but less addictive and is available to any primary care physicians with a waiver from the Substance Abuse and Mental Health Services Administration.
Under federal law, methadone can only be dispensed from authorized clinics.
Huhn said it is widely believed use of buprenorphine in primary care settings would increase the number of addicts receiving treatment, but physicians are not adopting it in pace with the magnitude of the opioid addiction.
Huhn’s research team surveyed 558 English-speaking medical doctors and determined only 74 did not have a waiver, which allows a physician to treat up to 30 patients this first year and up to 275 in each subsequent year.
He said, about one-third of those who did not have waivers said nothing would increase their willingness to get waivers and about half of those with waivers said nothing would persuade them to prescribe at the authorized level.
Those reluctant to apply for waivers said they did not want to be inundated with patient requests for the drug (29.7 percent) or had concerns about patients reselling their medication (25.7 percent).
Those with waivers said they were not prescribing to capacity because they did not have time for more patients (36 percent) or that reimbursement was inadequate (15.4 percent).
Overall, survey respondents said resources most likely to increase prescribing buprenorphine were having more information on local counseling resources, being paired with an experienced provider and receiving more continuing education courses on opioid abuse.
“I think the two biggest takeaways from our research are that there are not enough physicians prescribing buprenorphine to meet patient demand, and access to counseling services for patients and mentoring services for physicians would make physicians more likely to take on new patients with opioid use disorder,” Huhn said.