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Opioids & SU

The Literature Collection contains over 11,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More

Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).

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1741
Buprenorphine Physician and Treatment Program Locator
Type: Web Resource
Authors: Substance Abuse and Mental Health Services Administration
Year: 2016
Abstract:

Find physicians authorized to treat opioid dependency with buprenorphine by state.

Topic(s):
Grey Literature See topic collection
,
Opioids & Substance Use See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

1743
Buprenorphine physician–pharmacist collaboration in the management of patients with opioid use disorder: results from a multisite study of the National Drug Abuse Treatment Clinical Trials Network
Type: Journal Article
Authors: Li‐Tzy Wu, William S. John, Udi E. Ghitza, Aimee Wahle, Abigail G. Matthews, Mitra Lewis, Brett Hart, Zach Hubbard, Lynn A. Bowlby, Lawrence H. Greenblatt, Paolo Mannelli
Year: 2021
Publication Place: Malden, Massachusetts
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
1744
Buprenorphine Prescribing Availability in a Sample of Ohio Specialty Treatment Organizations
Type: Journal Article
Authors: T. Molfenter, C. Sherbeck, M. Zehner, S. Starr
Year: 2015
Abstract: OBJECTIVE: Buprenorphine, a medication for treating opioid dependence, is underutilized in specialty addiction treatment organizations. Only physicians who have obtained a buprenorphine prescribing license or "waiver" may administer this medication. A limited number of physicians are pursuing this waiver, and a concern in the substance use disorder treatment field is that the shortage of prescribers could be contributing to the low use of buprenorphine at specialty addiction treatment centers. The objective of this study is to assess Ohio specialty treatment organizations' access to buprenorphine prescribers and the barriers they encounter when seeking new physician prescribing capacity. METHODS: Forty-one Ohio specialty addiction treatment organizations were invited to complete a survey of their buprenorphine practices and availability of buprenorphine prescribers during August-October 2014. Data was collected on pharmacotherapies used in the treatment of opioid dependence, arrangements treatment organizations have with prescribing physicians, buprenorphine prescribing capacity, and barriers encountered in recruiting new physician prescribers. RESULTS: Thirty-seven treatment organizations responded, for a response rate of 90.2%. Seventy-eight percent (n=29) of the sample provided buprenorphine therapy. Of those treatment organizations, 48.3% (n=14) reported insufficient prescribing capacity. Of those, 50% (n=7) indicated they had to turn patients away from buprenorphine therapy due to limited physician prescribing capacity. CONCLUSION: The study suggests that buprenorphine use is constrained by limited physician prescribing capacity, to the degree that 24.1% of the organizations surveyed using buprenorphine therapy had to turn patients away. Potential remedies include encouraging more specialty treatment organizations to have physicians on staff, removing the Drug Addiction Treatment Act (DATA 2000) cap that limits physician buprenorphine caseloads at 100 patients (after year 1), and developing strategies to recruit physicians into addiction treatment practice. Additional research is needed to increase the knowledge of physician prescribing capacity as a barrier to buprenorphine use, how to overcome these barriers, and to understand the extent physician capacity shortages are affecting buprenorphine use.
Topic(s):
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
1746
Buprenorphine prescribing practice trends and attitudes among New York providers
Type: Journal Article
Authors: A. Kermack, M. Flannery, B. Tofighi, J. McNeely, J. D. Lee
Year: 2017
Publication Place: United States
Topic(s):
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
1747
Buprenorphine Prescribing: To Expand or Not to Expand
Type: Journal Article
Authors: X. Li, D. Shorter, T. R. Kosten
Year: 2016
Publication Place: United States
Abstract: As a result of the prescription opioid epidemic in the United States, there has been an increasing need for effective treatment interventions, both pharmacological and nonpharmacological. Buprenorphine has emerged as a critical component of the treatment of opioid use disorder, yet its adoption has not been without some concerns. This article first reviews the pharmacology, clinical use, and US legislative action related to buprenorphine, followed by a discussion of the misuse and diversion of buprenorphine in the United States as well as internationally. We then explore the impact of buprenorphine abuse as well as discussing strategies for its reduction, including changes in policy, prescription and pharmacy monitoring, and continuing medical education for guiding and improving clinical practice.
Topic(s):
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
1748
Buprenorphine Provision by Early Career Family Physicians
Type: Journal Article
Authors: Sebastian T. Tong, Camille J. Hochheimer, Lars E. Peterson, Alex H. Krist
Year: 2018
Publication Place: United States
Topic(s):
Education & Workforce See topic collection
,
Opioids & Substance Use See topic collection
1749
Buprenorphine Quick Start Guide
Type: Web Resource
Authors: Substance Abuse and Mental Health Services Administration
Year: 2021
Publication Place: Rockville, MD
Topic(s):
Opioids & Substance Use See topic collection
,
Grey Literature See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

1750
Buprenorphine Quick Start Pocket Guide
Type: Web Resource
Authors: Substance Abuse and Mental Health Services Administration
Year: 2021
Publication Place: Rockville, MD
Topic(s):
Opioids & Substance Use See topic collection
,
Grey Literature See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

1751
Buprenorphine Receipt and Retention for Opioid Use Disorder following an Initiative to Increase Access in Primary Care
Type: Journal Article
Authors: E. J. Hawkins, C. A. Malte, H. J. Hagedorn, A. J. Gordon, E. C. Williams, R. S. Trim, B. E. Blanchard, A. Lott, A. N. Danner, A. J. Saxon
Year: 2024
Abstract:

OBJECTIVES: Buprenorphine, a medication for opioid use disorder (OUD), is underutilized in general medical settings. Further, it is inequitably received by racialized groups and persons with comorbidities. The Veterans Health Administration launched an initiative to increase buprenorphine receipt in primary care. The project's objective was to identify patient-related factors associated with buprenorphine receipt and retention in primary care clinics (n = 18) participating in the initiative. METHODS: Retrospective cohort quality improvement evaluation of patients 18 years or older with 2 or more primary care visits in a 1-year period and an OUD diagnosis in the year before the first primary care visit (index date). Buprenorphine receipt was the proportion of patients with OUD who received 1 or more buprenorphine prescriptions from primary care providers during the post-index year and retention the proportion who received buprenorphine for 180 days or longer. RESULTS: Of 2880 patients with OUD seen in primary care, 11.7% (95% confidence interval [CI], 10.6%-12.9%) received buprenorphine in primary care, 58.2% (95% CI, 52.8%-63.3%) of whom were retained on buprenorphine for 180 days or longer. Patients with alcohol use disorder (adjusted odds ratio [AOR], 0.39; 95% CI, 0.27-0.57), nonopioid drug use disorder (AOR, 0.64; 95% CI, 0.45-0.93), and serious mental illness (AOR, 0.60; 95% CI, 0.37-0.97) had lower buprenorphine receipt. Those with an anxiety disorder had higher buprenorphine receipt (AOR, 1.42; 95% CI, 1.04-1.95). Buprenorphine receipt (AOR, 0.55; 95% CI, 0.35-0.87) and 180-day retention (AOR, 0.40; 95% CI, 0.19-0.84) were less likely among non-Hispanic Black patients. CONCLUSIONS: Further integration of addiction services in primary care may be needed to enhance buprenorphine receipt for patients with comorbid substance use disorders, and interventions are needed to address disparities in receipt and retention among non-Hispanic Black patients.

Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
1752
Buprenorphine shared medical appointments for the treatment of opioid dependence in a homeless clinic
Type: Journal Article
Authors: Sara L. Doorley, Cheryl J. Ho, Elizabeth Echeverria, Charles Preston, Huy Ngo, Ahmad Kamal, Chinazo O. Cunningham
Year: 2017
Publication Place: United States
Abstract:

BACKGROUND: Opioid misuse and dependence are prevalent and rising problems in the United States. Treatment with buprenorphine is a successful treatment option for individuals with opioid dependence. This study describes and preliminarily evaluates a unique delivery system that provides buprenorphine treatment via a shared medical appointment. METHODS: A retrospective medical record review on all 77 opioid-dependent patients referred for a buprenorphine shared medical appointment in a homeless clinic from 2010 to 2012. RESULTS: Most patients were currently homeless (61%), unemployed (92%), had an Axis I psychiatric diagnosis (81%), and had recent polysubstance use (53%). Of the 77 patients, 95% attended at least 1 shared medical appointment. Treatment retention at 12 and 24 weeks was 86% and 70%, respectively. CONCLUSIONS: In a patient population with complex social and mental health histories, buprenorphine treatment via a shared medical appointment had high retention rates. Findings can help guide the development of unique delivery systems to serve real-world complex patients with opioid dependence.

Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
1753
Buprenorphine tapering schedule and illicit opioid use.
Type: Journal Article
Authors: Walter Ling, Maureen Hillhouse, Catherine Domier, Geetha Doraimani, Jeremy Hunter, Christie Thomas, Jessica Jenkins, Albert Hasson, Jeffrey Annon, Andrew Saxon, Jeffrey Selzer, Joshua Boverman, Richard Bilangi
Year: 2009
Topic(s):
Opioids & Substance Use See topic collection
1754
Buprenorphine therapy for opioid addiction in rural Washington: The experience of the early adopters
Type: Journal Article
Authors: T. L. Quest, J. O. Merrill, J. Roll, A. J. Saxon, R. A. Rosenblatt
Year: 2012
Publication Place: United States
Abstract: 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.
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
1755
Buprenorphine Therapy for Opioid Use Disorder
Type: Journal Article
Authors: Roger Zoorob, Alicia Kowalchuk, Maria Mejia de Grubb
Year: 2018
Publication Place: United States
Abstract: Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment. As a partial opioid agonist, buprenorphine has a ceiling effect that limits respiratory depression and adds to its safety in accidental or intentional overdose. Buprenorphine and combinations of buprenorphine and naloxone are generally well tolerated; adverse effects include anxiety, constipation, dizziness, drowsiness, headache, nausea, and sedation. Family physicians who meet specific requirements can obtain a Drug Addiction Treatment Act of 2000 waiver by notifying the Substance Abuse and Mental Health Services Administration of their intent to begin dispensing and/or prescribing buprenorphine. Medication-assisted treatment with buprenorphine is as effective as methadone in terms of treatment retention and decreased opioid use when prescribed at fixed dosages of at least 7 mg per day; dosages of 16 mg per day are clearly superior to placebo. Sporadic opioid use is not uncommon in the first few months of medication-assisted treatment and should be addressed by increased visit frequency and more intensive engagement with behavioral therapies. Follow-up visits should include documentation of any relapses, reemergence of cravings or withdrawal, random urine drug testing, pill or wrapper counts, and checks of state prescription drug database records.
Topic(s):
Education & Workforce See topic collection
,
Opioids & Substance Use See topic collection
1756
Buprenorphine to treat opioid use disorder: A practical guide
Type: Journal Article
Authors: T. Nissly, R. Levy
Year: 2018
Publication Place: United States
Topic(s):
Opioids & Substance Use See topic collection
1757
Buprenorphine training for physicians
Type: Web Resource
Authors: Providers Clinical Support System
Year: 2016
Topic(s):
Grey Literature See topic collection
,
Education & Workforce See topic collection
,
Opioids & Substance Use See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

1758
Buprenorphine treatment and 12-step meeting attendance: Conflicts, compatibilities, and patient outcomes.
Type: Journal Article
Authors: Laura B. Monico, Jan Gryczynski, Shannon Gwin Mitchell, Robert P. Schwartz, Kevin E. O'Grady, Jerome H. Jaffe
Year: 2015
Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
1759
Buprenorphine Treatment and Patient Use of Health Services after the Affordable Care Act in an Integrated Health Care System
Type: Journal Article
Authors: Cynthia I. Campbell, Sujaya Parthasarathy, Kelly C. Young-Wolff, Derek D. Satre
Year: 2017
Publication Place: United States
Abstract:

The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258). Logistic and negative binomial regressions were used to model persistent buprenorphine use, and to examine whether persistent use was related to health services utilization. Buprenorphine patients were largely similar pre- and post-ACA, although more post-ACA patients had a marijuana use disorder (p < .01). Post-ACA patients were more likely to have high-deductible benefit plans (p < .01). Use of psychiatry services was lower post-ACA (IRR: 0.56, p < .01), and high-deductible plans were also related to lower use of psychiatry services (IRR: 0.30, p < .01). The relationship between marijuana use disorder and prescription opioid use is complex, and deserves further study, particularly with increasingly widespread marijuana legalization. Access to psychiatry services may be more challenging for buprenorphine patients post-ACA, especially for patients with deductible plans.

Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Disparities See topic collection
,
Healthcare Policy See topic collection
,
Opioids & Substance Use See topic collection
1760
Buprenorphine Treatment By Primary Care Providers, Psychiatrists, Addiction Specialists, And Others
Type: Journal Article
Authors: M. Olfson, V. Zhang, M. Schoenbaum, M. King
Year: 2020
Publication Place: United States
Abstract:

Substantial increases in opioid-related morbidity and mortality have motivated the implementation of federal policies to expand the buprenorphine prescribing capacity of primary care providers and other clinicians. Using a national prescription database that covered 72-92 percent of the US population during 2010-18, we analyzed trends in buprenorphine treatment by prescriber specialty. Buprenorphine treatment rates by primary care providers increased from 12.9 people per 10,000 population in 2010 to 27.4 in 2018. The numbers for psychiatrists and addiction medicine specialists increased from 8.7 to 12.0 per 10,000 and those for other prescribers from 5.8 to 16.3 per 10,000. However, treatment of people ages 15-24 by primary care providers and by psychiatrists and addiction medicine specialists declined significantly. Across all patient age and provider groups, most patients were not retained on buprenorphine for the benchmark period of at least 180 days. Despite a recent national increase in buprenorphine treatment fueled primarily by nonspecialists, challenges persist with buprenorphine access-especially for younger people-and with retaining patients in long-term treatment.

Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Healthcare Policy See topic collection
,
Opioids & Substance Use See topic collection