Researchers Call on Government to Update Outdated Buprenorphine Database, Policies

A federal database of buprenorphine providers is largely outdated, according to a new study published in the Journal of Psychiatric Practice.

Researchers argue government action is needed to help patients find medication-assisted treatment — and to expand the number of behavioral health clinicians able to provide services.

The Substance Abuse and Mental Health Services Administration (SAMHSA) created the Buprenorphine Practitioner Locator to help those with opioid use disorder (OUD) find MAT treatment.

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Buprenorphine is an increasingly popular drug used in MAT, as it helps diminishes withdrawal symptoms for those recovering from OUD.

Ideally, the online practitioner locator would allow OUD patients to find buprenorphine clinicians based on city, state and ZIP code. However, researchers found that inaccuracies on the site are making it difficult for patients to find care. 

For example, the locator listed incorrect phone numbers for more than a quarter of all providers researchers attempted to contact, according to the study. Another quarter of providers contacted said they were no longer prescribing buprenorphine. 

To reach their findings, researchers attempted to contact 505 practitioners listed on the Buprenorphine Practitioner Locator, as if they were going to make an appointment. Those practitioners came from 10 different counties nationwide, all of which have high opioid overdose death rates.

Across the board, the study found that buprenorphine providers were hard or impossible to reach. When researchers were able to make contact, they frequently faced long wait times between the call and the availability of the initial appointment. 

Ultimately, researchers were only able to secure appointments about 28% of the time. 

“[The Substance Abuse and Mental Health Services Administration] needs to take steps to ensure the database is accurate,” one of the study’s co-authors, J. Wesley Boyd, a psychiatrist at Cambridge Health Alliance and Harvard Medical School, told the Boston Globe

Meanwhile, SAMHSA officials told the publication it’s the job of clinicians to provide accurate information to keep the locator updated. They argued that SAMHSA is a small agency and does not have the manpower to do so alone. 

Beyond SAMHSA, authors of the study argue the findings illustrate the need for policy change to make buprenorphine more widely available to OUD patients. 

“The government also needs to remove federal policies limiting who can prescribe buprenorphine so all doctors can treat opioid addiction, not just those who engage in specialized training for buprenorphine prescribing,” Boyd and co-author Lila Flavin wrote in an opinion piece for Stat News.

In recent years, the government has made some attempts to grow the number of waivered MAT clinicians. 

For example, a 2017 law change allowed nurse practitioners (NPs) and physician assistants (PAs) to become buprenorphine prescribers. Following the change, rural access to the medication increased drastically, with the number of clinicians able to prescribe buprenorphine jumping 111% between 2016 to 2019 in rural areas.

But advocates say there’s still a long way to go before the need is fully met.

For example, some states continue to have restrictive scope-of-practice regulations that make it hard for non-physicians to become buprenorphine prescribers, despite federal laws that would allow them to do so.

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