Quick access to medications for opioid use disorder (MOUD) is crucial to reducing the impact of the opioid crisis. However, certain communities are more likely to have access to these medications than others.
Pharmacies in socially and economically disadvantaged counties are 2.66 times more likely to restrict buprenorphine dispensing compared to the most privileged counties, according to a new study published in Drug and Alcohol Dependence Reports.
“Access to buprenorphine remains starkly divided along social axes, with white patients having roughly four times the odds of receiving buprenorphine, compared to Black patients,” the study’s authors wrote. “Among those with public insurance, minoritized racial and ethnic patients with [opioid use disorder] (OUD) are significantly less likely to receive MOUD.”
Researchers used data from a recent secret shopper study to determine the availability of buprenorphine at 858 pharmacies in 473 counties.
Of the 858 pharmacies included in the data set, 183 pharmacies reported that they could not fill a buprenorphine prescription. Pharmacies located in racially or ethnically segregated and economically deprived counties were significantly less likely to prescribe buprenorphine readily.
“These findings emphasize that physical access to pharmacies cannot be conflated with reliable and prompt access to buprenorphine for OUD treatment,” the study’s authors wrote.
The difficulty patients experience when filling prescriptions in these counties suggests that barriers to MOUD access persist even after clinicians prescribe the medications.
The reason why some pharmacies do not dispense buprenorphine is unclear, the study’s authors wrote. Stigma among pharmacists, pharmacy-level policies, and wholesaler “caps” on buprenorphine prescriptions may all contribute to these inequities.
Researchers recommend that more studies be conducted to determine why disadvantaged or racially or ethnically segregated communities restrict dispensing. It also recommended that educational interventions be instituted to reduce the stigma around MOUD among pharmacists and that pharmacies that limit or refuse to prescribe buprenorphine be monitored.
If these interventions fail to make a meaningful difference, researchers recommend that states institute legislation mandating that pharmacies carry and prescribe buprenorphine.
