TY - JOUR
KW - Buprenorphine, Naloxone Drug Combination
KW - Buprenorphine/therapeutic use
KW - Health Care Surveys
KW - Humans
KW - Naloxone/therapeutic use
KW - Opiate Substitution Treatment/methods
KW - Opioid-Related Disorders/drug therapy/rehabilitation
KW - Practice Patterns, Physicians'/statistics & numerical data
KW - Rural Health Services/statistics & numerical data
KW - Treatment Outcome
KW - Washington
AU - T. L. Quest
AU - J. O. Merrill
AU - J. Roll
AU - A. J. Saxon
AU - R. A. Rosenblatt
A1 - 
AB - BACKGROUND: The introduction of buprenorphine as office-based treatment for opioid dependence was designed to expand treatment capacity, but virtually there are no data about use of this medication in rural areas. METHODS: The survey of the first cohort of physicians in rural Washington State who obtained buprenorphine waivers (2002-2010) to determine the volume of treated patients, physician appraisal of the efficacy of this treatment, and perceived barriers to treatment was conducted. Twenty-four (73 percent) of the 33 rural buprenorphine-certified physicians practicing in the state were interviewed in 2010. RESULTS: Twenty physicians (83 percent) were actively prescribing buprenorphine/naloxone for treatment of addiction. Those currently prescribing averaged 23 active patients and had treated 125 patients since certification. All respondents reported that buprenorphine was efficacious in the treatment of addiction and 95 percent recommended that other rural colleagues adopt buprenorphine treatment. The following four major barriers were cited: 1) lack of adequate financial support from Medicaid, the largest source of third-party coverage for these patients; 2) unavailability of local mental health and behavioral addiction treatment services; 3) difficulty in finding consultants to assist in managing complex patients; and 4) shortages of other rural physicians providing this service. CONCLUSIONS: Buprenorphine is viewed as a highly effective treatment of opioid addiction by early adopters in rural Washington State, but relatively few rural physicians currently provide this service. Inadequate insurance coverage, a shortage of effective links with consultants and colleagues, and the lack of mental health services are persistent barriers to the use of this modality in rural Washington State.
BT - Journal of opioid management
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 1
CY - United States
IS - 1
JF - Journal of opioid management
N2 - BACKGROUND: The introduction of buprenorphine as office-based treatment for opioid dependence was designed to expand treatment capacity, but virtually there are no data about use of this medication in rural areas. METHODS: The survey of the first cohort of physicians in rural Washington State who obtained buprenorphine waivers (2002-2010) to determine the volume of treated patients, physician appraisal of the efficacy of this treatment, and perceived barriers to treatment was conducted. Twenty-four (73 percent) of the 33 rural buprenorphine-certified physicians practicing in the state were interviewed in 2010. RESULTS: Twenty physicians (83 percent) were actively prescribing buprenorphine/naloxone for treatment of addiction. Those currently prescribing averaged 23 active patients and had treated 125 patients since certification. All respondents reported that buprenorphine was efficacious in the treatment of addiction and 95 percent recommended that other rural colleagues adopt buprenorphine treatment. The following four major barriers were cited: 1) lack of adequate financial support from Medicaid, the largest source of third-party coverage for these patients; 2) unavailability of local mental health and behavioral addiction treatment services; 3) difficulty in finding consultants to assist in managing complex patients; and 4) shortages of other rural physicians providing this service. CONCLUSIONS: Buprenorphine is viewed as a highly effective treatment of opioid addiction by early adopters in rural Washington State, but relatively few rural physicians currently provide this service. Inadequate insurance coverage, a shortage of effective links with consultants and colleagues, and the lack of mental health services are persistent barriers to the use of this modality in rural Washington State.
PP - United States
PY - 2012
SN - 1551-7489; 1551-7489
SP - 29
EP - 38
EP - 
T1 - Buprenorphine therapy for opioid addiction in rural Washington: The experience of the early adopters
T2 - Journal of opioid management
TI - Buprenorphine therapy for opioid addiction in rural Washington: The experience of the early adopters
U1 - Opioids & Substance Use; Healthcare Disparities
U2 - 22479882
VL - 8
VO - 1551-7489; 1551-7489
Y1 - 2012
ER -