According to a study conducted between 2010 and 2013, even physicians who have secured the DATA 2000 waiver are not treating the full number of patients allowed under the waiver.1 The study found that doctors cited lack of access to substance abuse counseling for patients as one reason for not treating more patients.
The SAMHSA 2014 Buprenorphine Summit Report of Proceedings reports that along with lack of counseling for patients, doctors don’t prescribe buprenorphine due to:
- Lack of institutional support
- The regulations and scrutiny attached to buprenorphine prescribing
- Concerns about auditing visits from the Drug Enforcement Agency (DEA)
- Low third-party reimbursement rates
A study by Hutchison 2 of buprenorphine prescribing physicians in the state of Washington also cited lack of mental health and psychosocial support for patients as the most frequently cited barrier to prescribing the medication.
Another study by Molfenter 3 found that the main barriers to buprenorphine prescribing in Ohio were physicians’ reluctance to work with people with substance use disorders and their lack of time to treat them.
Health care providers’ beliefs about people who use substances, and the stigma attached to substance use disorders, may also influence decisions to prescribe buprenorphine or other addiction treatment medications.
1 Stein, B.D, Sorbero, M. Dick, A., Liccardo Pacula, R., Burn, R., Gordon, A. (2016). Physician capacity to treat opioid use disorder with buprenorphine-assisted treatment. JAMA, 316, 11
2 Hutchinson, E., Catlin, M., Andrilla, C. H. A., Baldwin, L. M., & Rosenblatt, R. A. (2014). Barriers to primary care physicians prescribing buprenorphine. The Annals of Family Medicine, 12(2), 128-133.
3 Molfenter, T., Sherbeck, C., Zehner, M., Quanbeck, A., McCarty, D., Kim, J. S., & Starr, S. (2015). Implementing buprenorphine in addiction treatment: payer and provider perspectives in Ohio. Substance Abuse Treat Prevention Policy, 10, 13. doi: 10.1186/s13011-015-0009-2